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Heparin Sodium Injection

[17 July 2014]

Products Affected - Description

Heparin Sodium for Injection
Heparin sodium injection, Fresenius Kabi4
1,000 unit/mL, 1 mL multiple-dose vial (NDC 63323-0540-01)
5,000 unit/mL, 1 mL multiple-dose vial (NDC 63323-0262-01)
5,000 unit/mL, 10 mL multiple-dose vial (NDC 63323-0047-10)
10,000 unit/mL, 4 mL multiple-dose vial (NDC 63323-0459-09)
20,000 unit/mL, 1 mL multiple-dose vial (NDC 63323-0915-01)
 
Heparin sodium injection, Hospira
5,000 unit/mL, 1 mL glass vial (NDC 00409-2723-01)
 
Heparin Sodium Flush Solution
Heparin sodium flush solution for injection, Covidien
10 unit/mL, 10 mL prefilled syringe (NDC 17474-0123-01)

 
Heparin sodium flush for injection, Fresenius Kabi
10 unit/mL, 1 mL multiple-dose vial (NDC 63323-0544-01)
10 units/mL, 10 mL multiple-dose vial (NDC 63323-0544-11)
10 units/mL, 10 mL preservative-free vial (NDC 63323-0017-10)
10 unit/mL, 1 mL preservative-free vial (NDC 63323-0557-01)
100 unit/mL, 1 mL multiple-dose vial (NDC 63323-0545-01) 
 
Heparin sodium flush solution for injection, Hospira
10 unit/mL, 1 mL Luer-lock syringe (NDC 00409-1280-31)  
10 unit/mL, 10 mL multiple-dose vial (NDC 00409-1151-70)
10 unit/ mL, 2 mL, Luer lock syringe (NDC 00409-1280-32)
10 unit/mL, 3 mL Luer lock syringe (NDC 00409-1280-33)
10 unit/mL, 5 mL Luer-lock syringe (NDC 00409-1280-35)
100 unit/mL, 2 mL multiple-dose vial (NDC 00409-1152-78)
100 unit/mL, 1 mL Carpuject syringe (NDC 00409-1281-31)  
100 unit/mL. 2 mL Carpuject syringes (NDC 00409-1281-32)
100 unit/mL, 4 mL multiple-dose vial (NDC 00409-1152-70)
100 unit/mL, 3 mL Carpuject syringe (NDC 00409-1281-33)
100 unit/mL. 5 mL Carpuject syringes (NDC 00409-1281-35)

Heparin sodium large volume infusion solutions
Heparin sodium large volume infusion solutions, B. Braun
1,000 unit/500 mL in 0.9% Sodium Chloride injection (NDC 00264-9872-10)
25,000 unit/250 mL in Dextrose 5% injection (NDC 00264-9587-20)
25,000 unit/500 mL in Dextrose 5% injection (NDC 00264-9577-10)
20,000 unit/500 mL in Dextrose 5% injection (NDC 00264-9567-10)
 
Heparin sodium large volume infusion solutions, Hospira
12,500 unit/250 mL in Dextrose 5% injection (NDC 00409-7794-62)
20,000 unit/250 mL in Dextrose 5% injection (NDC 00409-7760-03)
25,000 unit/ 250 mL in Dextrose 5% injection (NDC 00409-7793-62)
25,000 unit/ 500 mL in Dextrose 5% injection (NDC 00409-7761-03)

Reason for the Shortage

  • FDA has issued import bans against 22 Chinese manufacturers of heparin due to inadequate good manufacturing practices (GMPs).1
  • West-Ward obtained five presentations of the heparin sodium injection from Baxter in September, 2011. Baxter only retained two large volume heparin presentations. All other Baxter presentations have been discontinued.2,3
  • Fresenius Kabi (formerly APP) reports that heparin products are on back order due to increased demand for the product.4
  • Hospira states the shortage of heparin vials is due to manufacturing delays.5
  • Covidien and B. Braun could not provide a reason for the shortage.9,11

Available Products

Heparin sodium for injection
Heparin sodium injection, Fresenius Kabi4
1,000 unit/mL, 2 mL multiple-dose vial (NDC 63323-0276-02)
1,000 unit/mL, 10 mL multiple-dose vial (NDC 63323-0540-11)
1,000 unit/mL, 30 mL multiple-dose vial (NDC 63323-0540-31)
10,000 unit/mL, 0.5 mL single-dose vial (NDC 63323-0543-02)
10,000 unit/mL, 1 mL multiple-dose vial (NDC 63323-0542-01)
10,000 unit/mL, 5 mL multiple-dose vial (NDC 63323-0542-07)
 
Heparin sodium injection, Hospira5
1,000 unit/mL, 1 mL single-dose glass vial (NDC 00409-2720-01)
1,000 unit/mL, 10 mL multiple-dose glass vial (NDC 00409-2720-02)

1,000 unit/mL, 30 mL multiple-dose glass vial (NDC 00409-2720-03)
5,000 unit/mL, 1 mL Carpuject (NDC 00409-1402-12)
5,000 unit/mL, 10 mL multiple-dose vial (NDC 00409-2723-02)
10,000 unit/mL, 1 mL glass vial (NDC 00409-2721-01)
10,000 unit/mL, 0.5 mL Carpuject, package of 50 (NDC 00409-1316-32)

Heparin sodium injection, Sagent6
1,000 unit/mL, 2 mL vial (NDC 25021-0401-02)
1,000 unit/mL, 10 mL vial (NDC 25021-0400-10)
1,000 unit/mL, 30 mL vial (NDC 25021-0400-30)
5,000 unit/mL, 1 mL vial (NDC 25021-0402-01)
5,000 unit/mL, 10 mL vial (NDC 25021-0402-10)
10,000 unit/mL, 1 mL vial (NDC 25021-0403-01)
10,000 unit/mL, 4 mL vial (NDC 25021-0403-04)
20,000 unit/mL, 1 mL vial (NDC 25021-0404-01)
 
Heparin sodium injection, Pfizer7
1,000 unit/mL, 2 mL vial, package of 25 (NDC 00069-0043-01)
1,000 unit/mL, 10 mL vial, package of 25 (NDC 00069-0058-01)
5,000 unit/mL, 10 mL vial, package of 25 (NDC 00069-0059-01)
5,000 unit/mL, 1 mL vial, package of 25 (NDC 00069-0059-03)
10,000 unit/mL, 1 mL vial, package of 25 (NDC 00069-0062-01)
 
Heparin sodium injection, West-Ward
1,000 unit/mL, 2 mL vial (NDC 00641-0391-12)
5,000 unit/mL, 2 mL vial (NDC 00641-0400-12)
5,000 unit/mL, 10 mL vial (NDC 00641-2460-55)
10,000 unit/mL, 2 mL vial (NDC 00641-0410-12)
 
Heparin sodium flush solution
Heparin sodium flush for injection, Fresenius Kabi4
100 units/mL, 1 mL preservative-free vial (NDC 63323-0549-01)
100 units/mL, 5 mL multiple-dose vial (NDC 63323-0545-05)
 
Heparin sodium flush solution for injection, BD8
10 unit/mL, 2 mL fill in 3 mL syringe, 120 count (NDC 08290-3065-27)
10 unit/mL, 3 mL fill in 3 mL syringe, 120 count (NDC 08290-3065-12)
10 unit/mL, 3 mL fill in 10 mL syringe, 120 count (NDC 08290-3065-21)
10 unit/mL, 3 mL fill in 3 mL syringe, 480 count (NDC 08290-3064-13)
10 unit/mL, 5 mL fill in 5 mL syringe, 480 count (NDC 08290-3064-14)
10 unit/mL, 5 mL fill in 5 mL syringe, 120 count (NDC 08290-3065-11)
10 unit/mL, 5 mL fill in 10 mL syringe, 120 count (NDC 08290-3065-10)
10 unit/mL, 5 mL fill in 10 mL syringe with cannula, 120 count (NDC 08290-3065-25)
10 unit/mL, 6 mL fill in 10 mL syringe, 120 count (NDC 08290-3065-09)
100 unit/mL, 2 mL fill in 3 mL syringe, 120 count (NDC 08290-3065-28)
100 unit/mL, 3 mL fill in 3 mL syringe, 120 count (NDC 08290-3065-17)
100 unit/mL, 3 mL fill in 5 mL syringe, 120 count (NDC 08290-3065-16)
100 unit/mL, 3 mL fill in 10 mL syringe, 120 count (NDC 08290-3065-14)
100 unit/mL, 3 mL fill in 3 mL syringe, 480 count (NDC 08290-3064-23)
100 unit/mL, 5 mL fill in 5 mL syringe, 480 count (NDC 08290-3064-24)
100 unit/mL, 5 mL fill in 5 mL syringe, 120 count (NDC 08290-3065-15)
100 unit/mL, 5 mL fill in 10 mL syringe, 120 count (NDC 08290-3065-13)
100 unit/mL, 4 mL fill in 10 mL syringe with cannula, 120 count (NDC 08290-3065-31)
 
Heparin sodium flush solution for injection, Covidien9
10 unit/mL, 3 mL prefilled syringe (NDC 17474-0123-03)
10 unit/mL, 5 mL prefilled syringe (NDC 17474-0123-05)
100 unit/mL, 10 mL prefilled syringe (NDC 17474-0125-01)
100 unit/mL, 3 mL prefilled syringe (NDC 17474-0125-03)
100 unit/mL, 5 mL prefilled syringe (NDC 17474-0125-05)
 
Heparin sodium flush for injection, Medefil10
10 unit/mL, 1 mL fill in 6 mL syringe (NDC 64253-0222-21)
10 unit/mL, 3 mL fill in 6 mL syringe (NDC 64253-0222-23)
10 unit/mL, 3 mL fill in 12 mL syringe (NDC 64253-0222-33)
10 unit/mL, 5 mL fill in 12 mL syringe (NDC 64253-0222-35)
100 unit/mL, 1 mL fill in 6 mL syringe (NDC 64253-0333-21)
100 unit/mL, 3 mL fill in 6 mL syringe (NDC 64253-0333-23)
100 unit/mL, 3 mL fill in 12 mL syringe (NDC 64253-0333-33)
100 unit/mL, 5 mL fill in 12 mL syringe (NDC 64253-0333-35)
 
Heparin sodium large volume infusion solutions
Heparin sodium large volume infusion solutions, Baxter2
1,000 unit/500 mL in 0.9% Sodium Chloride injection (NDC 00338-0431-03)
2,000 unit/1000 mL in Dextrose 5% injection (NDC 00338-0433-04)

Heparin sodium large volume infusion solutions, Hospira5
1,000 unit/500 mL in 0.9% Sodium Chloride injection (NDC 00409-7620-03)
2,000 unit/1000 mL in 0.9% Sodium Chloride injection (NDC 00409-7620-59)
12,500 unit/250 mL in 0.45% Sodium Chloride injection (NDC 00409-7651-62)
25,000 unit/250 mL in 0.45% Sodium Chloride injection (NDC 00409-7650-62)
25,000 unit/500 mL in 0.45% Sodium Chloride injection (NDC 00409-7651-03)

Estimated Resupply Dates

Heparin sodium for injection
  • Fresenius Kabi has heparin sodium 1,000 unit/mL 1 mL vials and heparin sodium 5,000 unit/mL 10 vials on back order and the company estimates release dates in late-August 2014. Heparin 5,000 unit/mL 1 mL vials are on back order and the company estimates a release date in mid-July 2014. Heparin sodium 10,000 unit/mL 4 mL vials and heparin 20,000 unit/mL 1 mL vials are on allocation because products are short-dated.4
  • Hospira has heparin 5000 unit/mL 1 mL glass vials on back order and the company estimates a release date in July 2014.5

Heparin sodium flush solution

  • Covidien has heparin sodium flush 10 unit/mL 10 mL prefilled syringes available in limited supply.9
  • Fresenius Kabi has heparin sodium flush 10 unit/mL 1 mL multi-dose vials and 10 mL preservative free vials on back order and the company cannot estimate a release date. Heparin sodium flush 10 unit/mL 1 mL preservative-free vials are on back order with an estimated release date of early-August 2014. Heparin sodium flush 10 unit/mL 10 mL vials and 100 unit/mL 1 mL multi-dose vials are on back order with an estimated release date of mid-August 2014.4
  • Hospira has all heparin sodium flush products on back order and the company cannot estimate a release date.5

Heparin sodium large volume infusion solutions

  • B. Braun has all heparin sodium large volume infusion products on allocation.11
  • Hospira has heparin sodium 12,500 unit/250 mL in 5% dextrose and 25,000 unit/250 mL in 5% dextrose on back order and the company cannot estimate a release date. Heparin sodium 20,000 unit/250 mL in 5% dextrose and heparin sodium 25,000 unit/500 mL in 5% dextrose are on back order and the company estimates a release date of 2015.5

Implications for Patient Care

Heparin sodium injection is labeled for anticoagulant therapy including prevention and treatment of venous thrombosis; for prevention of postoperative deep venous thrombosis (DVT) and pulmonary embolism (PE) in patients undergoing major abdominal or thoracic surgery or patients with other risk factors for thromboembolism; for prevention and treatment of PE; for prevention of embolization during chronic atrial fibrillation; for diagnosis and treatment of acute consumption coagulopathies (e.g., disseminated intravascular coagulation); for prevention of clotting in cardiovascular surgery; for prevention and treatment of peripheral arterial embolism; and as an anticoagulant in blood transfusions, extracorporeal circulation procedures, dialysis procedures, and in laboratory blood samples.12

Safety

Limit use of heparin sodium 10,000 unit/mL and 20,000 unit/mL to minimize risk of medication errors (i.e., inadvertent use of wrong concentration).

Alternative Agents & Management

Table 1 compares heparin sodium with other available anticoagulant products, and Table 2 addresses alternatives in specific situations. Low molecular weight heparins may be acceptable alternatives to heparin sodium in many situations.12-14  Prior to beginning anticoagulation therapy, clinicians should obtain a baseline complete blood cell count (CBC) with platelets, activated partial thromboplastin time (aPTT), and renal function studies. Each institution must work closely with prescribers to develop strategies for dealing with this shortage.

Related Shortages

References

  1. U.S. Food and Drug Administration. Import Alert 55-03: Detention Without Physical Examination of Different Forms of Heparin and Heparin-Related Products for CGMP Issues. Available online. Accessed February 29, 2012.
  2. Baxter Healthcare, (personal communications). February 7, 11, 22, 25, and 29, March 12 and 24, April 11 and 30, May 14, June 2, July 10, August 12, October 1, November 17, 2008, January 8 and 15, March 2, May 19, July 16, September 18, October 20, December 1, 2009; January 5, 8, and 11, February 10, March 4 and 17, April 23, June 1, July 21, September 1, November 29, 2010; January 6, February 17, March 1, April 6, May 11, June 1, and November 3, 2011; February 29, May 2 and 29, September 7, 2012; January 11, March 1, April 8, May 10, August 15, September 23, October 1, November 1 and 27, and December 3 and 17, 2013; January 21, February 20, May 7 and 19, and June 19, 2014.
  3. West-Ward, Customer Service (personal communications). September 28, November 2, 2011, January 27, February 29, May 4 and 23, August 31, October 4 and 26, November 16, 2012; January 11, February 28, March 8 and 23, April 8, May 10, June 7, July 18, August 13, September 23, October 4 and 28, November 27, December 13, 2013; January 17 and 31, February 20 and 21, March 14, 21, and 31, April 16, May 7 and 28, and June 11, 2014.
  4. Fresenius Kabi, Customer Service (personal communications). February 7, 22, 25, and 29, March 12 and 24, April 11 and 30, May 12, June 2, July 10, August 12, October 1, November 17, 2008, January 5, March 2, May 20, July 16, September 18, October 20, December 1, 2009; January 5, February 10, March 17, April 23, May 28, June 1, July 21, September 1, 10, and 29, October 18, November 15, December 2, 2010; January 5 and 26, February 10 and 17, March 3, April 6, May 11 and 31, August 17, September 16 and 27, October 4 and 12, November 3, 7, and 22, 2011; January 27, February 29, March 9, 21, and 22, May 2, 18, and 30, June 25, July 11, August 13, September 7, October 2 and 16, November 5 and 19, 2012; January 11, February 6, and 28, March 12 and 19, April 8, May 10, June 10 and 28, July 18, August 13 and 19, September 12 and 24, October 8, November 1, 5, and 27, December 3, 16, and 19, 2013; January 3,16, 18, and 21, February 3, 24, and 28, March 14, 18, and 28, April 16 and 24, May 7, 19, and 30, June 17, and July 1 and 17, 2014.
  5. Hospira, (personal communications and website). February 7, 22, 25, and 29, March 10 and 24, April 11 and 30, May 14, June 2, July 10, August 13, October 2, November 17, 2008; January 8, March 2 and 23, May 20, July 16, August 12, September 15, October 20, December 1, 2009; January 5 and 28, February 12, March 2, 18, and 22, April 28, June 1 and 2, July 22, September 10 and 29, November 17, December 2, 2010; January 4, 10 and 27, February 7 and 9, March 3 and 10, April 8, May 13 and 31, June 28, July 20, August 16 and 19, September 13, October 12, November 2 and 22, December 14, 2011; January 27, February 29, March 12 and 21, May 2, 14, and 31, June 25, July 11, August 13, September 7, October 1 and 15, November 5 and 19, 2012; January 11, February 28, March 8 and 25, April 10 and 23, May 10, June 10, 19, and 26, July 18, 25, and 30, August 13, September 13 and 23, October 7, November 1, 4, and 27, December 2, 4, and 17, 2013; January 3 and 21, February 3 and 20, March 3, 18 and 24, April 16, May 7, June 2 and 16, and July 2, 2014.
  6. Sagent, Customer Service (personal communications). July 21, September 1 and 29, November 17, 2010; January 4 and 26, February 9, March 1, April 6, May 11, June 2 and 28, August 15, November 3, 2011; January 27, February 29, March 28 and 30, April 26, May 18 and 29, June 25, July 9, August 13, September 5, October 1 and 15, November 5 and 19, 2012; January 11, February 6 and 28, March 12 and 25, April 9, May 10, June 13, July 18 and 30, August 13 and 19, September 12 and 24, October 2, November 1, 7, and 27, December 19, 2013; January 23, February 3, 20 and 27, March 17, 19, and 26, April 16, May 7, 19, and 30, and June 13, 2014.
  7. Pfizer, (personal communications), September 16 and November 2, 2011; May 2 and 30, September 7, October 1, November 19, 2012; January 11, February 28, April 8, May 10, June 7, July 18, August 13, September 20, October 4, November 1 and 27, December 13 and 30, 2013; January 16 and 21, February 3, 20 and 28, March 14, 21, and 27, April 16 and 21, May 7, 19, and 30, and June 13, 2014. 
  8. BD Medical (personal communications). June 7, October 5, 2012; January 11, April 9, June 14, September 23, and December 2, 2013.
  9. Covidien, Customer Service (personal communication). March 31, June 3, August 13, October 2, 2008; October 21, December 1, 2009; January 5, February 12, March 17, April 23, June 1, July 21, September 1 and 10, November 17, 2010, January 4 and 27, February 9, March 1, April 6, May 11, June 2, August 15, and November 2, 2011, January 27, February 29, May 18 and 29, June 25, August 16, October 1 and 10, 2012; January 11, February 28, April 8, May 10, June 14, August 13, September 25, October 28, November 27, and December 17, 2013; January 21, February 3 and 20, March 3 and 24, May 7, and June 20 and 30, 2014.
  10. Medefil, Customer Service (personal communications). September 7, 2012; January 11, February 28, April 8, May 10, June 14, August 13, September 23, and December 18, 2013; January 21, and June 16, 2014.
  11. B. Braun, Customer Service (personal communications). February 7, March 24, April 11 and 30, May 14, June 2, July 10, August 12, October 2, November 17, 2008, January 8, 2009; January 5, February 12, March 17, April 23, June 1 and 23, July 21, September 1 and 20, November 17, 2010, January 6, 10 and 26, February 8, March 1, April 6, May 11 and 31, August 17, November 3, December 14, 2011; February 29, May 2 and 29, September 7, October 17, and November 12, 2012; February 28, April 8 and 23, May 10, June 14, July 2 and 16, August 13, September 25, and December 19, 2013; January 21 and 30, May 7, and June 20, 2014. 
  12. Heparin sodium. In: 2006 Mosby’s Drug Consult. St. Louis, MO: Mosby Inc; 2006:1439-1443.
  13. Anticoagulants. In: Hebel SK, ed. Drug Facts and Comparisons. St. Louis, MO: Facts and Comparisons; 2007: 162-181.
  14. Anticoagulants. In: McEvoy GK, ed. AHFS 2008 Drug Information. Bethesda, MD: American Society of Health-Systems Pharmacists; 2008:1458-1514.
  15. Food and Drug Administration. FDA Issues Warnings on Tricitrasol Dialysis Catheter Anticoagulant. April 14, 2000. Available online. Accessed on June 9, 2011.
  16. Grudzinski L, Quinan P, Kwok S, Pierratos A. Sodium citrate 4% locking solution for central venous dialysis catheters – an effective, more cost-efficient alternative to heparin. Nephrol Dial Transplant. 2007;22:471-476.
  17. American Society of Health-System Pharmacists. ASHP guidelines on managing drug product shortages. Am J Health-Syst Pharm. 2001;58:1445-1450.
  18. Traynor K. Meningitis deaths linked to drug shortages. Available online. Accessed on June 9, 2011.. Bethesda, MD: American Society of Health-System Pharmacists. July 17, 2001.
  19. Rusho WJ. Clinical issues and concerns in the use of extemporaneously compounded medications. J Pharm Care Pain Sympt Contr. 1996;4:5-20.
  20. Deaths from Intravenous Colchicine Resulting from a Compounding Pharmacy Error – Oregon and Washington, 2007. MMWR. Oct 12 2007;56(40):1050-1052.
  21. ASHP therapeutic position statement on the institutional use of 0.9% sodium chloride injection to maintain patency of peripheral indwelling intermittent infusion devices. Am J Hosp Pharm. 1994;51:572-574.
  22. Terry J, et al, eds. Intravenous Therapy: Clinical Principles & Practice. Philadelphia, PA: Intravenous Nurses Society;1995:488-491.
  23. Peterson FY, Kirchhoff KT. Analysis of the research about heparinized versus nonheparinized intravascular lines. Heart Lung. 1991;20:631-642.
  24. Gyr P, Smith K, Pontious S, Burroughs T, Mahl C, Swerczek L. Double blind comparison of heparin and saline flush solutions in maintenance of peripheral infusion devices. Pediatr Nurs. 1995;21:383-389, 366.
  25. Fujita T, Namiki T, Suzuki T, Yamamoto E. Normal saline flushing for maintenance of peripheral intravenous sites. J Clin Nurs. 2006;15(1):103-104.
  26. Myrianthefs P, Sifaki M, Samara I, Baltopoulos G. The epidemiology of peripheral vein complications: evaluation of the efficiency of differing methods for the maintenance of catheter patency and thrombophlebitis prevention. J Eval Clin Pract. 2005;11(1):85-89.
  27. Smith S, Dawson S, Hennessey R, Andrew M. Maintenance and patency of indwelling central venous catheters: Is heparin necessary? Am J Pediatr Hematol Oncol. 1991;13:141-143.
  28. Stephens LC, Haire WD, Tarantolo S, et al. Normal saline versus heparin flush for maintaining central venous catheter patency during apheresis collection of peripheral blood stem cells (PBSC). Transfus Sci. 1997;18:187-193.
  29. Hirsh J, Warkentin TE, Shaughnessy SG, et al. Heparin and low molecular-weight heparin. Mechanisms of action, pharmacokinetics, dosing, monitoring, efficacy, and safety. Chest. 2001; 119:64S-94S.
  30. Hirsh J, Raschke R. Heparin and low molecular-weight heparin. The Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004; 126 (3):188S-203S.
  31. Hutchison TA, Shahan DR, eds. Drugdex System. Greenwood Village, CO: Micromedex. Accessed on February 22, 2008.
  32. Schenk P, Rosenkranz AR, Wolfl G, et al. Recombinant tissue plasminogen activator is a useful alternative to heparin in priming Quinton Permacath. Am J Kidney Dis. 2000;35(1):130-136.
  33. Gittins NS, Hunter-Blair YL, Matthews JN, Coulthard MG. Comparison of alteplase and heparin in maintaining the patency of paediatric central venous haemodialysis lines: a randomised controlled trial. Arch Dis Child. 2007;92(6):499-501.
  34. Romao JE, Fadil MA, Sabbaga E, Marcondes M. Haemodialysis without anticoagulant: haemostasis parameters, fibrinogen kinetic, and dialysis efficiency. Nephrol Dial Transplant. 1997;12:106-110.
  35. Chuang P, Parikh C, Reilly RF. A case review: anticoagulation in hemodialysis patients with heparin-induced thrombocytopenia. Am J. Nephrol. 2001;21:226-231.
  36. Levy J, Morgan J, Brown E, eds. Oxford Handbook of Dialysis. Oxford, UK: Oxford University Press;2001:148-153.
  37. GlaxoSmithKline. Medical Information (written communication). January 17, 2003.
  38. Matsuo T, Yamada T, Yamanashi T, Ryo R. Anticoagulant therapy with MD805 of a hemodialysis patient with heparin-induced thrombocytopenia. Thromb Res. 1990;58:663-666.
  39. Matsuo T, Kario K, Chikahira Y, et al. Treatment of heparin-induced thrombocytopenia by use of argatroban, a synthetic thrombin inhibitor. Br J Haematol. 1992;82:627-629.
  40. Koide M, Yamamoto S, Matsuo M, et al. Anticoagulation for heparin-induced thrombocytopenia with spontaneous platelet aggregation in a patient requiring haemodialysis. Nephrol Dial Transplant. 1995;10:2137-2140.

Updated

Updated July 17, 2014 by Leslie Jensen, PharmD, Drug Information Specialist; April 23, 2013 by Jane Chandramouli, PharmD, Drug Information Specialist. Created September 26, 2001 by Erin R. Fox, PharmD, Director, Drug Information, and M. Christina Beckwith, PharmD, Drug Information Specialist. Copyright 2014, Drug Information Service, University of Utah, Salt Lake City, UT.

Disclaimer

This information is provided through the support of Novation to ASHP solely as a service to its members, which shall not use this information for their further commercial use. The content was prepared by the Drug Information Center of University of Utah. Novation, ASHP, and the University of Utah make no representations or warranties, express or implied, including, but not limited to, any implied warranty of merchantability and/or fitness for a particular purpose, which respect to such information, and specifically disclaim all such warranties. Users of this information are advised that decisions regarding the use of drugs and drug therapies are complex medical decisions and that in using this information, each user must exercise his or her own independent professional judgment. Neither Novation, ASHP nor the University of Utah assumes any liability for persons administering or receiving drugs or other medical care in reliance upon this information, or otherwise in connection with this bulletin. Neither Novation, ASHP nor University of Utah endorses or recommends the use of any drug.

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