Cal-Heparine

Composition: Each ampoule contains Heparin Calcium 5000, 12000 or 20000I.U.

Properties: Pharmacological Actions:
Heparin Calcium (Cal-Heparine®) inhibits 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 to fibrin.  It also inhibits the activation of fibrin stabilizing factor.

Indications: Preventive:
-    Post-operative venous thrombosis and pulmonary embolism (low dose regimen).
-    Clotting in arterial and heart surgery.
-    Thromboembolic accidents e.g. occlusive arterial diseases of lower extremities, myocardial infarction and some arrhythmias
Curative:
-    Thrombophlebitis.   
-    Pulmonary embolism.
-    Cerebral thrombosis
-    Myocardial infarction.
-    Atrial fibrillation with embolization.
-    Peripheral arterial embolism or thrombosis.
-    Cal-Heparine® is also used as an anti-coagulant in blood transfusion, dialysis procedure and blood sampling.

Contra-Indictions: -    Haemorrhagic states or tendencies due to:
•    Clotting factors deficiencies e.g. thrombocytopenia, hypofibrinogenemia, hemophilia and permeability disorders.
•    Vascular permeability disorders e.g. Purpura.
-    Postoperative period following brain or spinal cord surgery.
-    Any active bleeding.          
-    C.N.S. trauma.
-    Bacterial endocarditis.      
-    Abortion.
-    During Vitamin K antagonist therapy.

Adverse Effects:-    Haemorrhage, hypersensitivity or local irritation may occur with heparin therapy.

Antidote:
-    The anti-coagulant activity of heparin can be neutralized by slow I.V. infusion of protamine sulfate 1% solution.
-   Each 1mg of Protamine Sulfate neutralizes approximately 100USP heparin units (maximum 50mg Protamine Sulfate).

Dosage & Administration: Prophylactic Dose:
-    Injection of one ampoule (5000I.U.) S.C. two hours before operation; then every 8 hours following surgery for 7 to 10 days or complete ambulation.
Therapeutic Dose:
-    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. infusion, coagulation test should be performed before each injection during the early stages of treatment and daily thereafter.
-    When Cal-Heparine® is administered by continuous I.V. infusion, coagulation test should be carried out approximately every 4 to 6 hours in the early stages of therapy.

How supplied: Box of 1 or 3 Ampoules; each containing 5000I.U.
Box of 1 or 3 Ampoules; each containing 12000I.U.
Box of 1 or 3 Ampoules; each containing 20000I.U.

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