Heparin Sodium in 5% Dextrose Injection
Clinical Indications
Systemic anticoagulation in: venous thromboembolism (DVT/PE) treatment and prophylaxis; acute coronary syndrome (ACS) management; atrial fibrillation with embolic risk; extracorporeal circulation; disseminated intravascular coagulation (DIC). Heparin in D5W is the standard pre-mixed IV heparin formulation.
Dosing & Administration Rate
Weight-based dosing protocol (e.g., Raschke protocol): Loading dose 80 units/kg IV bolus, then initial infusion 18 units/kg/hr. Adjust by aPTT every 6 hrs until therapeutic (aPTT 60–100 sec or 1.5–2.5× baseline). Each institution should have an approved heparin nomogram.
Warnings & Precautions
Heparin-Induced Thrombocytopenia (HIT): monitor platelets every 2–3 days during the first 14 days. A platelet fall of >50% from baseline should prompt HIT workup and immediate heparin cessation. Bleeding is the primary adverse effect. Overdose antidote: protamine sulphate 1 mg per 100 units heparin. Contraindicated in active uncontrolled bleeding and severe thrombocytopenia.
Contraindications
Severe thrombocytopenia. History of HIT (Heparin-Induced Thrombocytopenia). Uncontrolled active bleeding. Suspected intracranial hemorrhage.
Pharmacology & Safety Profile
Mechanism of Action
Potentiates the action of antithrombin III, inactivating thrombin and preventing the conversion of fibrinogen to fibrin.
Adverse Reactions
Hemorrhage, HIT (immune-mediated), osteoporosis (with long-term use), alopecia, elevation of aminotransferases.
Compatibility Notes
Incompatible with many medications — dedicated IV line or lumen strongly recommended. Incompatible with: gentamicin, amikacin, ciprofloxacin (in same line), alteplase.
Electrolyte & Composition Profile
| Component | Amount / Concentration |
|---|---|
| Heparin Sodium (porcine) | 25,000 units / 500 mL (50 units/mL) or 12,500 units / 250 mL |
| Dextrose (Anhydrous) | 50 mg/mL (5%) |
| Water for Injection | q.s. |
| Caloric Density | 170 kcal/L (from dextrose) |
Clinical Parameters
Clinical Disclaimer: Data compiled from FDA DailyMed, Baxter/Fresenius prescribing information, and USP monographs. Always verify against the physical product label, your institution's IV protocols, and current pharmacist guidance before administration.
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