Comparative Pharmacology
Head-to-head clinical analysis: COUMADIN versus HEPARIN SODIUM 20 000 UNITS AND DEXTROSE 5 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: COUMADIN versus HEPARIN SODIUM 20 000 UNITS AND DEXTROSE 5 IN PLASTIC CONTAINER.
COUMADIN vs HEPARIN SODIUM 20,000 UNITS AND DEXTROSE 5% IN PLASTIC CONTAINER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Inhibits vitamin K epoxide reductase complex 1 (VKORC1), thereby decreasing the synthesis of vitamin K-dependent clotting factors II, VII, IX, and X, as well as anticoagulant proteins C and S.
Heparin binds to antithrombin III, accelerating its inhibition of thrombin (factor IIa) and activated factor X (Xa), thereby preventing fibrin formation. Dextrose 5% provides caloric support.
Initial dose 2-5 mg orally once daily, adjusted based on INR response; typical maintenance dose 2-10 mg/day.
IV: Initial bolus 80 units/kg, then continuous infusion at 18 units/kg/hr; adjust based on aPTT. Typical concentration: 20,000 units heparin in 500 mL D5W (40 units/mL).
None Documented
None Documented
Terminal elimination half-life: 20–60 hours (mean ~40 hours); clinically, anticoagulant effect persists for 2–5 days after stopping due to hepatic synthesis of functional clotting factors.
30–150 minutes (mean 90 min) for continuous IV infusion; shorter with higher doses due to saturable clearance. Prolonged in hepatic or renal impairment.
Renal (approximately 92% as inactive metabolites), fecal/biliary (minor, approximately 8%). Less than 2% excreted unchanged.
Renal: negligible at therapeutic doses; hepatic metabolism to uroheparin and low molecular weight species; biliary/fecal: minimal. Clearance is dose-dependent and saturable.
Category C
Category A/B
Anticoagulant
Anticoagulant