LIQUAEMIN LOCK FLUSH
Clinical safety rating: caution
Comprehensive clinical and safety monograph for LIQUAEMIN LOCK FLUSH (LIQUAEMIN LOCK FLUSH).
Heparin potentiates the activity of antithrombin III, thereby inactivating thrombin (factor IIa) and activated factor X (Xa), and preventing fibrin clot formation. It also inhibits factors IXa, XIa, and XIIa.
| Metabolism | Primarily metabolized in the liver via desulfation and depolymerization; also cleared by the reticuloendothelial system. |
| Excretion | Renal (predominantly via reticuloendothelial system and liver metabolism; unchanged drug excreted in urine). |
| Half-life | 1-2 hours (dose-dependent; prolonged with higher doses, renal impairment, or in elderly). |
| Protein binding | Very high (>95%; primarily to antithrombin III, but also to albumin and other proteins). |
| Volume of Distribution | 0.05-0.1 L/kg (confined to plasma; does not cross placenta or blood-brain barrier). |
| Bioavailability | Intravenous: 100% (only route used). |
| Onset of Action | Intravenous: immediate. |
| Duration of Action | 2-6 hours (dose-dependent; prolonged with renal impairment or higher doses). |
| Molecular Weight | 15000 (average molecular weight of unfractionated heparin) |
10-100 units/mL solution; flush intermittent intravenous catheters after each use with 1-5 mL; for central venous catheters, use 2-3 mL of 10 units/mL solution; for peripheral catheters, use 1-2 mL of 10 units/mL solution.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment required for heparin lock flush; however, monitor for bleeding in severe renal impairment (CrCl <30 mL/min) due to potential accumulation. |
| Liver impairment | No specific dose adjustment required; use with caution in severe hepatic impairment (Child-Pugh C) due to increased risk of bleeding. |
| Pediatric use | Weight-based: 0.5-2 mL of 10 units/mL solution per flush for intermittent intravenous catheters; maximum 10 units/kg per flush; repeat after each catheter use. |
| Geriatric use | No specific dose adjustment; use lower end of dosing range (1-2 mL of 10 units/mL) due to increased risk of bleeding and renal function decline. |
| 1st trimester | Heparin does not cross the placenta; no evidence of teratogenicity in humans. Use is generally considered safe if clinically indicated. |
| 2nd trimester | No known fetal harm; heparin is recommended for anticoagulation during pregnancy due to lack of placental transfer. |
| 3rd trimester | Risk of maternal hemorrhage (especially at delivery) but no fetal risk. Monitor coagulation parameters closely. |
Clinical note
Comprehensive clinical and safety monograph for LIQUAEMIN LOCK FLUSH (LIQUAEMIN LOCK FLUSH).
| Placental transfer | Does not cross placenta due to high molecular weight and negative charge; no measurable fetal concentrations. |
| Breastfeeding | Heparin is not excreted into breast milk due to high molecular weight and lack of oral bioavailability, considered compatible with breastfeeding. |
■ FDA Black Box Warning
Heparin-induced thrombocytopenia (HIT) with thrombosis; spinal/epidural hematoma risk with neuraxial anesthesia or spinal puncture.
| Serious Effects |
History of heparin-induced thrombocytopenia (HIT)Active major bleedingHypersensitivity to heparin
| Precautions | Monitor platelet counts for HIT; risk of hemorrhage; use preservative-free formulation in neonates; caution in renal impairment; monitor aPTT or anti-Xa levels. |
| Food/Dietary | No known food interactions. |
| Clinical Pearls |
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| Lactation Rating |
| L1 (Safe) |
| Teratogenic Risk | Heparin does not cross the placenta. No evidence of teratogenicity in first trimester. Risk of maternal hemorrhage and fetal complications (e.g., placental abruption) in second and third trimesters due to anticoagulant effects, but drug itself not directly teratogenic. Fetal risk is related to maternal bleeding. |
| Fetal Monitoring | Monitor maternal activated partial thromboplastin time (aPTT) every 6 hours until stable, then daily. Observe for signs of hemorrhage (e.g., bruising, epistaxis, hematuria). Fetal monitoring: assess fetal growth and amniotic fluid index with ultrasound; monitor for placental abruption symptoms (abdominal pain, vaginal bleeding). |
| Fertility Effects | No known effects on fertility or reproductive function. Heparin does not interfere with ovulation, spermatogenesis, or implantation. |
| Heparin lock flush solution is used to maintain patency of intravenous catheters; do not use as a systemic anticoagulant. Flush volume should match catheter dead space. Monitor for signs of bleeding, especially in patients with coagulation disorders. Do not use if solution is discolored or contains particulates. Incompatible with many drugs; avoid mixing in same line. |
| Patient Advice | This medication is used to keep your IV line clear and working properly. · Do not swallow or inject this solution into a muscle. · Report any signs of bleeding, such as bruising, blood in urine or stool, or prolonged bleeding from cuts. · Tell your healthcare provider if you have a history of heparin-induced thrombocytopenia (HIT) or bleeding problems. · Keep the catheter site clean and dry; do not touch the injection cap. |