Heparin ointment (Ointment) Instructions for Use

ATC Code

C05BA53 (Heparin in combination with other drugs)

Active Substances

Heparin sodium (Rec.INN registered by WHO)

Benzocaine (Rec.INN registered by WHO)

Benzylnicotinat (DAB German Pharmacopoeia)

Clinical-Pharmacological Group

A drug with antithrombotic action for topical use

Pharmacotherapeutic Group

Angioprotectors; preparations for the treatment of varicose veins; heparins or heparinoids for topical application

Pharmacological Action

A combined medicinal product for external use.

Heparin is a direct-acting anticoagulant belonging to the group of medium molecular weight heparins. When applied externally, it exerts a local anticoagulant, anti-exudative, and moderate anti-inflammatory effect. It blocks the formation of thrombin. Heparin reduces the inflammatory process and exerts an anticoagulant effect, indirectly improves microcirculation, which promotes the process of resorption of hematomas and thrombi and reduces tissue swelling.

Benzocaine is a local anesthetic for superficial anesthesia. By reducing the permeability of the cell membrane to sodium ions, it blocks the conduction of nerve impulses. It prevents the occurrence of pain impulses in the endings of sensory nerves and their conduction along nerve fibers.

Benzyl nicotinate dilates superficial vessels, promoting the absorption of heparin.

Pharmacokinetics

Heparin. It is absorbed insignificantly. Plasma protein binding is up to 95%, V_d is 0.06 L/kg. It does not cross the placental barrier and into breast milk. It is intensively captured by endothelial cells and cells of the mononuclear-macrophage system, concentrated in the liver and spleen. It is metabolized in the liver by N-desulfamidase and platelet heparinase, which is involved in the metabolism of heparin at later stages. Desulfated molecules are converted into low molecular weight fragments under the influence of renal endoglycosidase. T_1/2 is 1-6 hours (on average – 1.5 hours); it increases with obesity, hepatic and/or renal insufficiency; it decreases with pulmonary embolism, infections, malignant tumors.

It is excreted by the kidneys mainly as inactive metabolites, and only when used in high doses is excretion (up to 50%) in unchanged form possible. It is not excreted by hemodialysis.

Benzocaine is practically not absorbed when applied externally. It is hydrolyzed by plasma and hepatic cholinesterase to metabolites of para-aminobenzoic acid and is excreted in the urine.

Indications

Superficial thrombophlebitis (prevention and treatment); post-injection and post-infusion phlebitis; external hemorrhoids; inflammation of postpartum hemorrhoids; trophic ulcers of the leg; elephantiasis; superficial periphlebitis; lymphangitis; superficial mastitis; localized infiltrates and edema; injuries and bruises (including those of muscle tissue, tendons, joints), subcutaneous hematoma.

ICD codes

Dosage Regimen

Ointment

For external use. Apply a thin layer of the ointment to the affected area (at the rate of 0.5-1 g (2-4 cm of ointment) on an area with a diameter of 3-5 cm) and gently rub the ointment into the skin. The ointment is used 2-3 times a day daily until the inflammatory phenomena disappear, on average from 3 to 7 days. The possibility of a longer course of treatment is determined by the doctor.

For thrombosis of external hemorrhoids, the ointment is applied to a cotton or linen pad, which is applied directly to the thrombosed nodes and fixed. The ointment should be used daily until symptoms disappear, on average from 3 to 14 days; for the same purpose, a tampon soaked in heparin ointment can be used, which is inserted into the anus.

Adverse Reactions

Local reactions skin hyperemia, allergic reactions.

Contraindications

Hypersensitivity; ulcerative-necrotic processes; impaired integrity of the skin, children under 2 years of age.

With caution

Thrombocytopenia, increased bleeding tendency.

Use in Pregnancy and Lactation

Use during pregnancy and breastfeeding is possible only if the potential benefit to the mother outweighs the risk to the fetus and child.

Pediatric Use

Contraindicated in children under 2 years of age.

Special Precautions

Do not apply to open wounds, to mucous membranes, in the presence of purulent processes.

Avoid contact with eyes due to possible irritation. If the ointment accidentally gets into the eyes, rinse immediately with running water.

Drug Interactions

Do not use externally simultaneously with NSAIDs, tetracyclines, antihistamines.

Storage Conditions

Store at 2°C (36°F) to 15°C (59°F). Keep in original packaging, protected from light. Keep out of reach of children.

Dispensing Status

Over-the-Counter

Important Safety Information

This information is for educational purposes only and does not replace professional medical advice. Always consult your doctor before use. Dosage and side effects may vary. Use only as prescribed.