肝素 (未分級)
Heparin (unfractionated)
Heparin sodium
別名: Hepsal · UFH · Unfractionated heparin · Heparin sodium · Heparinum
由 VetSheet 獸醫團隊審訂更新於 2026年4月5日本內容以實證獸醫文獻為本
各物種劑量
此藥的劑量資料尚未收錄於 VetSheet 藥典，以下其他章節資料完整。開立處方前請參閱最新仿單。
概覽
肝素是一種未分級的注射型抗凝血劑，在獸醫學中用於預防和治療血栓栓塞性疾病，並維持靜脈導管的通暢。它依賴內源性抗凝血酶 III (AT III) 的存在來發揮作用。
臨床警告： 肝素具有顯著的出血風險。它不能溶解現有的血栓，但能防止其擴大。
臨床提示： 由於肝素需要 AT III 才能發揮作用，因此在患有嚴重蛋白質流失性腎病或腸病（AT III 耗竭）的病患中可能無效。
作用機轉
Heparin exerts its effects primarily by enhancing the binding of antithrombin III (AT III) to factors IIa, IXa, Xa, XIa and XlIa.
- AT III/clotting factor complex formation → subsequent removal by the liver.
- Inactivates thrombin → blocks the conversion of fibrinogen to fibrin.
- Inhibition of Factor XII activation → prevents the formation of stable fibrin clots.
Note: Heparin is only effective if adequate AT III is present. It does not significantly change the concentrations of clotting factors, nor does it lyse pre-existing clots.
安全性與警告
禁忌症
- Active bleeding or severe bleeding disorders
- Severe thrombocytopenia
- Recent neurosurgery or ocular surgery
- Known hypersensitivity to heparin
不良反應
- Hemorrhage (most common)
- Heparin-induced thrombocytopenia (HIT)
- Injection site reactions (hematoma, pain)
- Hypersensitivity reactions
注意事項
Important: Do NOT administer intramuscularly (IM) due to the high risk of severe hematoma formation. Monitor activated partial thromboplastin time (aPTT) closely during therapeutic use. Extreme caution is advised in patients with severe hepatic or renal disease.
藥物交互作用
Increased risk of bleeding due to platelet inhibition
Increased risk of gastrointestinal ulceration and bleeding
Synergistic anticoagulant effect; increased bleeding risk
Increased risk of bleeding
監測
- aPTT (Activated Partial Thromboplastin Time) - typically target 1.5 to 2.5 times baseline
- Platelet count
- Packed Cell Volume (PCV) and Total Protein (TP)
- Clinical signs of bleeding (mucous membranes, feces, urine)
藥物動力學
半衰期
吸收
Not absorbed orally. Well absorbed following subcutaneous (SC) or intravenous (IV) administration.
分佈
Extensively bound to plasma proteins. Does not cross the placenta or enter maternal milk.
代謝
Metabolized by the liver and the reticuloendothelial system.
排除
Excreted primarily in the urine. Clearance is dose-dependent.
過量
The primary sign of overdosage is hemorrhage (e.g., epistaxis, hematuria, melena, petechiae).
- Mild to moderate overdose: Discontinue heparin therapy; due to its short half-life, coagulation parameters often normalize quickly.
- Severe, life-threatening hemorrhage: Administer protamine sulfate as a specific reversal agent (antidote). Administer slowly IV to avoid hypotension and anaphylactoid reactions.
可用產品
劑型
- Injectable solution: 1,000 IU/ml
- Injectable solution: 5,000 IU/ml
- Injectable solution: 10,000 IU/ml
- Injectable solution: 25,000 IU/ml
- Saline flush solution: 10 IU/ml
- Saline flush solution: 100 IU/ml
獸醫用
- Heparin flush solutions (10 IU/ml, 100 IU/ml)
人用標示
- Heparin sodium injection (1,000 to 25,000 IU/ml)
- Hepsal
各地核准狀態
Human-approved products are commonly used off-label in veterinary medicine.
Available as POM (Prescription Only Medicine).
POM-V or POM-VPS depending on the specific formulation.
暫無法規資料: 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
儲存與穩定性
Store at room temperature (15-30°C). Do not freeze. Inspect for particulate matter or discoloration prior to administration.
飼主須知
肝素用於預防危險的血栓。
- 注意出血： 最常見的副作用是出血。如果您發現寵物牙齦蒼白、不明原因的瘀傷、流鼻血、尿液帶血或排出黑色柏油狀糞便，請立即聯繫您的獸醫。
- 預防受傷： 在使用此藥物期間，請保持寵物平靜，避免粗暴的遊戲或可能導致受傷或瘀傷的活動。
- 請勿混合用藥： 未經獸醫同意，切勿給您的寵物服用阿斯匹靈、非類固醇消炎藥 (NSAIDs) 或任何其他非處方藥，因為這可能導致致命的出血。
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