Drug
Heparin (Porcine) in D5W
Pronounced
"HEP-uh-rin"
Drug Interactions
See also How to Use section.
Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.
Some products that may interact with this drug include: mifepristone, oritavancin, telavancin, other drugs that can cause bleeding/bruising (including "blood thinners" such as apixaban/dabigatran).
This medication is sometimes used together with other drugs that have "blood thinning" or anti-platelet effects such as aspirin, clopidogrel, or warfarin. If your doctor prescribes a combination of these drugs, your doctor will monitor you closely to minimize your risk of bleeding. Keep all medical and lab appointments.
Check all prescription and nonprescription medicine labels carefully since many medications contain pain relievers/fever reducers (NSAIDs such as ibuprofen, naproxen, or aspirin) that can increase the risk of bleeding when used with heparin. However, if your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details.
Cigarette smoking decreases blood levels of this medication. Tell your doctor if you smoke or if you have recently stopped smoking.
This medication may interfere with certain lab tests (such as certain liver function tests, prothrombin time), possibly causing false test results. Make sure lab personnel and all your doctors know you use this drug.
Negative Interactions
9- Potential Negative Interaction
Heparin
Dong Quai
Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding. These herbs include dong quai, fenugreek, horse chestnut, red clover, sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.
Dong QuaiHeparin- Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician's Guide. New York: Pharmaceutical Products Press, 1999, 313-5.
- Potential Negative Interaction
Heparin
Fenugreek
Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding. These herbs include dong quai, fenugreek, horse chestnut, red clover, sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.
FenugreekHeparin- Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician's Guide. New York: Pharmaceutical Products Press, 1999, 313-5.
- Potential Negative Interaction
Heparin
Ginger
Ginger has been shown to reduce platelet stickiness in test tubes. Although there are no reports of interactions with anticoagulant drugs, people should consult a healthcare professional if they are taking an anticoagulant and wish to use ginger.
GingerHeparin- Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: The Pharmaceutical Press, 1996, 135-7.
- Potential Negative Interaction
Heparin
Ginkgo
Ginkgo extracts may reduce the ability of platelets to stick together, possibly increasing the tendency toward bleeding. Standardized extracts of ginkgo have been associated with two cases of spontaneous bleeding, although the ginkgo extracts were not definitively shown to be the cause of the problem. People taking heparin should consult with a physician knowledgeable about botanical medicines if they are considering taking ginkgo.
GinkgoHeparin- Kleijnen J, Knipschild P. Ginkgo biloba. Lancet 1992;340:1136-9 [review].
- Rosenblatt M, Mindel J. Spontaneous hyphema associated with ingestion of Ginkgo biloba extract. N Engl J Med 1997;336:1108 [letter].
- Matthews MK Jr. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998;50:1933-4 [letter].
- Potential Negative Interaction
Heparin
Horse Chestnut
Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding. These herbs include dong quai, fenugreek, horse chestnut, red clover, sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.
Horse ChestnutHeparin- Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician's Guide. New York: Pharmaceutical Products Press, 1999, 313-5.
- Potential Negative Interaction
Heparin
Red Clover
Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding. These herbs include dong quai, fenugreek, horse chestnut, red clover, sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.
Red CloverHeparin- Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician's Guide. New York: Pharmaceutical Products Press, 1999, 313-5.
- Potential Negative Interaction
Heparin
Reishi
As it may increase bleeding time, reishi (Ganoderma lucidum) is not recommended for those taking anticoagulant (blood-thinning) medications.
ReishiHeparin- Brinker F. Herb Contraindications and Drug Interactions. Sandy, OR: Eclectic Medical Publications, 1998,166-9.
- Potential Negative Interaction
Heparin
Sweet Clover
Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding. These herbs include dong quai, fenugreek, horse chestnut, red clover, sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.
Sweet CloverHeparin- Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician's Guide. New York: Pharmaceutical Products Press, 1999, 313-5.
- Potential Negative Interaction
Heparin
Sweet Woodruff
Although there are no specific studies demonstrating interactions with anticoagulants, the following herbs contain coumarin-like substances that may interact with heparin and could conceivably cause bleeding. These herbs include dong quai, fenugreek, horse chestnut, red clover, sweet clover, and sweet woodruff. People should consult a healthcare professional if they’re taking an anticoagulant and wish to use one of these herbs.
Sweet WoodruffHeparin- Miller LG, Murray WJ, eds. Herbal Medicinals: A Clinician's Guide. New York: Pharmaceutical Products Press, 1999, 313-5.
Supportive Interactions
1- Replenish Depleted Nutrients
Heparin
Vitamin D
Heparin may interfere with activation of vitamin D in the body.Osteoporosis (thinning of the bone) has been reported in patients who received high amounts of heparin for several months. Osteopenia (decreased bone density) has been reported in women who received heparin therapy during pregnancy.
Vitamin DHeparin- Aarskog D, Aksens L, Markestad TK, et al. Heparin induced inhibition of 1,25-dihydroxyvitamin D formation. Am J Obstet Gynecol 1984;148:1141-2.
- Majerus PW, Broze GJ Jr, Miletich JP, Tollefsen DM. Anticoagulant, thrombolytic, and antiplatelet drugs. In Goodman and Gilman's The Pharmacological Basis of Therapeutics, 9th ed. New York: McGraw-Hill 1996, 1346.
- Wise PH, Hall AS. Heparin induced osteopenia in pregnancy. BMJ 1980;281:110-1.
- Haram K, Hervig T, Thordarson H, Aksnes L. Osteopenia caused by heparin treatment in pregnancy. Acta Obstet Gynecol Scand 1993;72:674-5.
Explanation Required
2- Needs Explanation
Heparin
Digitalis
Digitalis (Digitalis purpurea) refers to a group of plants commonly called foxglove, which contains chemicals related to the drug digoxin. Digitalis may interfere with the anticoagulant action of heparin, reducing its action. Digitalis should only be used under the direct supervision of a doctor trained in its use.
DigitalisHeparin- Threlkeld DS, ed. Blood Modifiers, Anticoagulants, Heparin. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1997, 87a-7f.
- Needs Explanation
Heparin
Potassium
Heparin therapy may cause hyperkalemia (abnormally high potassium levels). Potassium supplements, potassium-containing salt substitutes (No Salt®, Morton Salt Substitute®, and others), and even high-potassium foods (primarily fruit) should be avoided by persons on heparin therapy, unless directed otherwise by their doctor.
PotassiumHeparin- Threlkeld DS, ed. Blood Modifiers, Anticoagulants, Heparin. In Facts and Comparisons Drug Information. St. Louis, MO: Facts and Comparisons, Jun 1997, 87a-7f.
- Perazella MA. Drug-induced hyperkalemia: Old culprits and new offenders. Am J Med 2000;109:307-14 [review].