Thrombocytopenia
Thrombocytopenia has been reported to occur in patients receiving Heparin with a reported incidence of 0 to 30%. Platelet counts should be obtained at baseline and periodically during Heparin administration. Mild thrombocytopenia (count greater than 100,000/mm3) may remain stable or reverse even if Heparin is continued. However, thrombocytopenia of any degree should be monitored closely. If the count falls below 100,000/mm3 or if recurrent thrombosis develops, the Heparin product should be discontinued, and if necessary, an alternative anticoagulant administered.
Delayed Onset of HIT and HITT
Heparin-induced Thrombocytopenia and Heparin-induced Thrombocytopenia and Thrombosis can occur up to several weeks after the discontinuation of Heparin therapy. Patients presenting with thrombocytopenia or thrombosis after discontinuation of Heparin should be evaluated for HIT and HITT.
Use in Neonates
Carefully examine all Heparin Sodium Injection vials and cartridges to confirm choice of the correct strength prior to administration of the drug. Pediatric patients, including neonates, have died as a result of medication errors in which Heparin Sodium Injection vials have been confused with “catheter lock flush” vials.
Heparin Resistance
Increased resistance to Heparin is frequently encountered in fever, thrombosis, thrombophlebitis, infections with thrombosing tendencies, myocardial infarction, cancer, and in postsurgical patients.
Increased Risk to Older Patients, Especially Women
A higher incidence of bleeding has been reported in patients, particularly women over 60 years of age.
Monitor platelet counts. Discontinue treatment if thrombocytopenia occurs. Hypersensitivity, elderly, pregnancy.
