Unihepa (Heparin Sodium)

1. Key Benefits

Unihepa is a naturally occurring mucopolysaccharide which inhibits the clotting of blood in vitro and in vivo, enhancing the rate at which antithrombin III neutralizes thrombin and activated factor X (Xa). The medication provides rapid-onset anticoagulation with predictable pharmacodynamics, enabling effective prevention and treatment of thrombotic events. With low-dose therapy, anticoagulation results from neutralization of Factor Xa which prevents the conversion of prothrombin to thrombin, offering precise control over coagulation processes.

2. Indications

Unihepa (Heparin Sodium) is indicated for:

• Prophylaxis and treatment of venous thrombosis and pulmonary embolism
• Myocardial infarction (MI) and arterial embolism management
• Prevention of clotting in arterial and heart surgery
• Prevention of cerebral thrombosis
• Anticoagulant therapy in blood transfusion and extracorporeal circulation
• Dialysis procedures including continuous renal replacement therapy
• Laboratory purposes requiring anticoagulation
• Prevention of deep vein thrombosis (DVT) in surgical patients

3. How it Works

Heparin is a naturally occurring mucopolysaccharide that inhibits reactions leading to blood clotting and fibrin clot formation both in vitro and in vivo. Small amounts of heparin in combination with antithrombin III can inhibit thrombosis by inactivating Factor Xa and thrombin. Once active thrombosis has developed, larger amounts of heparin can inhibit further coagulation by inactivating thrombin and preventing the conversion of fibrinogen to fibrin. Heparin also prevents formation of a stable fibrin clot by inhibiting the activation of the fibrin stabilizing factor.

4. Quality and Safety

Manufacturing Excellence: Each mL contains Heparin Sodium (Bovine Mucosa) 5000 IU with Benzyl Alcohol 1.0% w/v as preservative, ensuring consistent potency and stability.

Safety Profile: Hemorrhage is the chief complication that may result from heparin therapy. Patients should undergo monitoring for bleeding that may present in urine or stool, as well as bruising, petechial rash, and nosebleeds. Thrombocytopenia typically occurs in up to 30% of patients who receive heparin, with heparin-induced thrombocytopenia (HIT) and heparin-induced thrombocytopenia and thrombosis (HITT) being serious potential complications.

Storage Requirements: Store below 30°C, protect from light and freezing. A vial can be stored for up to 28 days at 30°C following first withdrawal, provided the solution is withdrawn with strict aseptic technique.

5. Important Considerations

Dosing Guidelines:

• Intravenous: 5,000-10,000 IU every 4 hours or 500 IU/kg daily as continuous infusion
• Subcutaneous: Initially 250 IU/kg every 12 hours
• Surgical Prophylaxis: 5,000 IU 2 hours pre-op, then every 8-12 hours post-op for 10-14 days

Contraindications:

• History of heparin-induced thrombocytopenia (HIT) or heparin-induced thrombocytopenia and thrombosis (HITT)
• Hypersensitivity to low molecular weight heparin (LMWH)
• Uncontrolled active bleeding state
• Conditions where blood coagulation tests cannot be performed at appropriate intervals

Critical Monitoring:

• Activated partial thromboplastin time (aPTT) monitoring for dose optimization
• Regular platelet counts during therapy to detect thrombocytopenia
• Periodic hematocrit and occult blood in stool testing
• Plasma potassium levels prior to and regularly during therapy
• Coagulation time approximately every 4 hours in early treatment stages

Drug Incompatibilities: Incompatibility reported with numerous medications including: amikacin sulphate, amiodarone, ampicillin sodium, benzylpenicillin sodium, ciprofloxacin lactate, gentamicin sulphate, haloperidol lactate, and many others. Do not mix or administer through the same intravenous line with other medications unless compatibility has been established.

Special Precautions:

• Use with caution in diabetes mellitus, preexisting metabolic acidosis, and raised plasma potassium
• Monitor carefully with peridural or spinal catheter anesthesia
• Risk of hemorrhage increased with concomitant NSAIDs, platelet inhibitors, and anticoagulants
• May be inactivated when used with artificial kidney due to calcium, magnesium, and acetate ions from dialysate
• Chronic renal and hepatic impairment require careful monitoring

Adverse Reactions:

• Hemorrhage (most common)
• Transient alopecia
• Diarrhea
• Osteoporosis with spontaneous bone fracture (long-term use)
• Hypersensitivity reactions
• Local irritation at injection sites

Professional Note: Unihepa represents reliable heparin sodium anticoagulation requiring intensive monitoring and expert management. Healthcare providers must ensure proper patient selection, comprehensive monitoring protocols, and awareness of drug interactions and contraindications to maximize therapeutic benefits while minimizing serious bleeding and thrombocytopenic complications.

References

1. Unihepa: Full Prescribing Information – MIMS Malaysia
2. Heparin – StatPearls – NCBI Bookshelf, August 2025
3. Heparin: Uses, Interactions, Mechanism of Action – DrugBank Online
4. Heparin Sodium Injection – FDA Prescribing Information
5. Heparin Dosing, Indications, Interactions – Medscape Reference
6. Heparin Package Insert / Prescribing Information – Drugs.com
7. Clinical Pharmacology and Safety Monitoring Guidelines