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). |
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 | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for LIQUAEMIN LOCK FLUSH (LIQUAEMIN LOCK FLUSH).
| Breastfeeding | Heparin is not excreted into breast milk due to its high molecular weight, making it safe for breastfeeding. No M/P ratio is available; use is considered compatible. |
| 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. |
■ FDA Black Box Warning
Heparin-induced thrombocytopenia (HIT) with thrombosis; spinal/epidural hematoma risk with neuraxial anesthesia or spinal puncture.
| Serious Effects |
Active major bleeding; history of heparin-induced thrombocytopenia; severe thrombocytopenia; hypersensitivity to heparin; not for intramuscular use.
| 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. |
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| 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. |