Heparina sódica
Heparin Sodium
Unfractionated Heparin (UFH)
También conocido como: Hep-Lock · Hep-Loc U/P · Hepflush-10 · Unfractionated Heparin · UHF · heparinum natricum · sodium heparin · soluble heparin
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Evidencia de dosis v13 auditada
Evidencia estructurada para el cálculoThromboprophylaxis (extra-label)
Requiere verificación veterinaria
- q6h
NA
Contexto clínico obligatorio (2)
- Heparin is an anionic, heterogeneous sulfated glycosaminoglycan molecule with an average molecular weight of 12,000 daltons that is found naturally in mast cells. It is available commercially as the sodium salt and is obtained from either porcine intestinal mucosa or bovine lung tissue (sodium salt only). Heparin sodium occurs as a white, amorphous, hygroscopic powder having a faint odor. It is soluble in water and practically insoluble in alcohol; the commercial injections have a pH of 5 to 7.5. Heparin potency is expressed in terms of USP heparin units, and values are obtained by comparing against a standard reference from the USP. The USP requires that potencies be not less than 180 units/mg on a dried basis for heparin derived from lung tissue, and 140 units/mg when derived from all other tissue sources.
- Heparin solutions should be stored at room temperature (15°C-30°C [59°F-86°F]) and not frozen. Avoid excessive exposure to heat.
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
La heparina sódica es un anticoagulante parenteral utilizado principalmente en medicina veterinaria para el manejo de enfermedades tromboembólicas y, de forma más controvertida, para la coagulación intravascular diseminada (CID).
Las aplicaciones clínicas clave incluyen:
- Profilaxis tromboembólica: Existe evidencia sólida que respalda su uso para reducir el tromboembolismo macrovascular en pacientes de alto riesgo.
- Manejo de la CID: Históricamente utilizada para la CID, aunque el consenso actual desaconseja su uso en pacientes con CID que presentan procesos inflamatorios concurrentes.
- Medicina equina: Se utiliza para la profilaxis de la laminitis, la CID y como lavado intraperitoneal para prevenir adherencias intestinales postquirúrgicas.
Perla clínica: La heparina no fraccionada (HNF) tiene un perfil farmacocinético altamente variable en comparación con las heparinas de bajo peso molecular (HBPM) como la dalteparina o la enoxaparina. La HNF requiere un monitoreo intensivo del aPTT o de la actividad anti-Xa para garantizar la eficacia terapéutica y evitar hemorragias catastróficas.
Mecanismo de acción
Heparin acts as an indirect anticoagulant by binding to and potentiating the activity of Antithrombin III (ATIII).
- Low Concentrations: The Heparin-ATIII complex rapidly inactivates Factor Xa, preventing the conversion of prothrombin to thrombin.
- High Concentrations: The complex inactivates Thrombin (Factor IIa), blocking the conversion of fibrinogen to fibrin, and also inactivates factors IX, XI, and XII.
- Fibrin Stabilization: By inhibiting the activation of Factor XIII, heparin prevents the formation of stable fibrin clots.
Note: Heparin does not lyse existing clots (it is not a thrombolytic); rather, it prevents the expansion of existing thrombi and the formation of new ones. It also increases the release of lipoprotein lipase, boosting the clearance of circulating lipids.
Seguridad y advertencias
Contraindicaciones
- Known hypersensitivity to heparin
- Severe thrombocytopenia
- Uncontrollable bleeding (not caused by DIC)
- Intramuscular (IM) administration (causes hematomas)
- Actively bleeding DIC patients with severe factor depletion
Efectos adversos
- Hemorrhage (most common)
- Thrombocytopenia
- Hypersensitivity reactions (derived from bovine/porcine tissue)
- Anemia in horses (due to erythrocyte agglutination)
- Injection site pain and hematoma (especially if given IM)
- Vasospastic reactions
- Osteoporosis (with long-term use)
- Rebound hyperlipidemia
- Hyperkalemia
- Alopecia
Precauciones
Use with extreme caution in patients with dysfunctional interactions between inflammatory and hemostatic systems (e.g., DIC with concurrent inflammation). Do not administer IM due to the risk of severe hematoma formation. Deep SC dosing may cause pain and irritation. Dogs with renal insufficiency may have lower plasma levels and faster elimination rates, requiring dosage adjustments. Safe use in pregnancy is not firmly established (FDA Category C).
Interacciones farmacológicas
May increase the risk for hemorrhage
May increase the risk for hemorrhage
May increase the risk for hemorrhage
May increase the risk for hemorrhage
May partially counteract heparin's anticoagulant effects
May partially counteract heparin's anticoagulant effects
May partially counteract heparin's anticoagulant effects
May partially counteract heparin's anticoagulant effects
May partially counteract heparin's anticoagulant effects
Monitorización
- Activated partial thromboplastin time (aPTT) - most often recommended
- Whole blood clotting time (WBCT)
- Partial thromboplastin time (PTT)
- Activated clotting time (ACT)
- Thromboelastography (TEG)
- Platelet counts
- Packed cell volume (PCV) / Hematocrit
- Occult blood in stool and urine
- Clinical signs of bleeding or efficacy
Farmacocinética
Absorción
Not absorbed orally; must be given parenterally. Anticoagulant activity begins immediately after direct IV bolus, but may take up to 1 hour after deep SC injection. Bioavailability after SC injection in healthy dogs is about 50%.
Distribución
Extensively protein bound, primarily to fibrinogen, low-density lipoproteins, and globulins. Does not appreciably cross the placenta or enter milk.
Metabolismo
Metabolic fate is not completely understood. Partially metabolized by the liver and inactivated by the reticuloendothelial system.
Eliminación
Eliminated via hepatic metabolism and the reticuloendothelial system. Dogs with renal insufficiency may have faster elimination rates.
Sobredosis
Overdosage of heparin is directly associated with severe bleeding.
Clinical signs preceding frank hemorrhage include:
- Hematuria
- Tarry stools (melena)
- Petechiae and ecchymoses (bruising)
Reversal: Protamine sulfate can be administered to reverse heparin's anticoagulant effects. It binds to heparin to form a stable, inactive complex.
Productos disponibles
Formulaciones
- Injection solutions (1,000 to 40,000 Units/mL)
- Unit-Dose injections
- Heparin Sodium Lock Flush (10 to 100 Units/mL)
- Heparin Sodium in 0.9% or 0.45% Sodium Chloride
Etiquetado para humanos
- Heparin Sodium Injection: 1000, 2000, 2500, 5000, 10,000, 20,000, & 40,000 Units/mL
- Heparin Unit-Dose Sodium Injection: 1000 to 20,000 Units/dose
- Heparin Sodium and 0.9% or 0.45% Sodium Chloride Injection
- Heparin Sodium Lock Flush (IV use) Injection: 1, 10, and 100 Units/mL
Estado regulador
Sin datos reguladores para: 🇺🇸 US · 🇪🇺 EU · 🇬🇧 UK · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Store solutions at room temperature (15-30°C). Do not freeze. Avoid excessive exposure to heat.
Información para el cliente
La heparina es un anticoagulante potente utilizado para tratar o prevenir coágulos sanguíneos potencialmente mortales.
- Atención hospitalaria: Debido al monitoreo intensivo requerido (análisis de sangre frecuentes para verificar los tiempos de coagulación) y a la naturaleza grave de las enfermedades que trata, la heparina se utiliza casi exclusivamente en un entorno hospitalario por profesionales veterinarios.
- Riesgo de sangrado: El riesgo más significativo es el sangrado. Si su mascota es dada de alta con un medicamento similar a la heparina, observe de cerca cualquier signo de hematomas, sangrado de encías, sangre en la orina o heces, o letargo extremo, y comuníquese con su veterinario de inmediato.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.