Each ampoule contains heparin calcium 5000 or 12000 I.U.
Heparin calcium (Cal-Heparine®)inhibits the reactions that lead to the clotting of blood and the formation of fibrin clots both in vitro and in vivo.
Small amounts of heparin calcium can inhibit thrombosis by inactivating the activated factor-X and inhibiting the conversion of prothrombin into thrombin. In the already developed thrombosis, larger amounts of heparin calcium can inhibit further coagulation by inactivating thrombin and preventing the conversion of fibrinogen into fibrin. It also inhibits the activation of fibrin stabilizing factor.
- Postoperative venous thrombosis and pulmonary embolism ( low dose regimen)
- Clotting in arterial and heart surgery
- Thromboembolic accidents, e.g., occlusive arterial disease of the lower extremities, myocardial infarction and some arrhythmias.
- Pulmonary embolism
- Cerebral thrombosis
- Myocardial infarction
- Atrial fibrillation with embolization
- Peripheral arterial embolism or thrombosis
Cal-Heparine® is also employed as an anticoagulant in blood transfusion, dialysis procedure and blood sampling.
- Bacterial endocarditis
- C.N.S. trauma
- During Vitamin K antagonist therapy
- Any active bleeding
- Postoperative period following brain or spinal cord surgery.
Haemorrhagic states or tendencies due to:
- Clotting factors deficiencies, e.g., thrombocytopenia, hypofibrinogenemia, hemophilia and permeability disorders
- Vascular permeability disorders, e.g., purpura.
- Severe hypertension
- Hypersensitivity to heparin
- Consumption coagulopathy
- Antiplatelet or dextran therapy
- During menstruation
- Heparin resistance
- Gastric ulcers
- Pediatric use
- Increased risk in the hepatin elderly over 60 years of age.
Pregnancy: Although calcium does not cross the placental barrier and has no teratogenic effect, it should not be given to a pregnant woman unless mandatory.
- Heparin should not be given intramuscularly.
- Ensure thorough mixing of Cal-Heparine® with infusion solution before administration.
- When heparin is given with dicumarol or coumarins, a period of at least 5 hours after the last I.V.dose or 24 hours after the last S.C.dose should elapse before shifting to oral anticoagulants to avoid haemorrhagic risks.
Platelet inhibitors: Acetylsalicylic acid, dextran, phenylbutazone, ibuprofen, indomethacin, dipyridamole, hydroxychloroquine and other drugs interfering with platelet aggregation reactions should be used with caution in patients receiving heparin calcium so as not to induce bleeding.
Other Interactions: Digitalis, tetracyclines, nicotine and antihistamines may partially counteract the anticoagulant action of heparin.
Laboratory test interactions: Significant elevations of aminotransferases (SGOT and SGPT) levels may occur in patients and healthy subjects who have received heparin.
Haemorrhage, hepersensitivity or local irritation may occur with heparin therapy.
The anticoagulant activity of heparin can be neutralized by slow I.V. infusion of protamine sulfate 1% solution.
Each 1 mg of protamine sulfate neutralizes approximately 100 I.U heparin (max. 50mg protamine sulfate).
Dosage and Administration
Injection of one ampoule (5000 I.U) S.C. two hours before operation; then every 8 hours following surgery, for 7 to 10 days or complete ambulation.
The dosage of Cal-Heparine® should be adjusted to each case according to the results of activated partial thromboplastin time (APTT) and coagulation tests.
The dose is considered adequate when APTT is 1.5 to 2 times the normal or when coagulation time is approximately 2.5 to 3 times the control value.
When Cal-Heparine® is given by deep subcutaneous or intermittent I.V. injection, a coagulation test should be performed before each injection during the early stages of treatment and dialy thereafter.
When Cal-Heparine® is administered by continuous I.V. infusion, a coagulation test should be carried out approximately every 4 to 6 hours in the early stages of therapy.
- Box of 1 or 3 ampoules, containing 5000 I.U
- Box of 3 ampoules, containing 12000 I.U
Keep all medicaments out of reach of children
Product of: AMOUN PHARMACEUTICAL CO. El-Obour City, Cairo, Egypt. ATC Code: B01AB01