Direct anticoagulant, standard or unfractionated heparin[8]

Treatment of deep vein thrombosis, pulmonary embolism, unstable angina, acute peripheral arterial occlusion[1]

Prophylaxis / prevention in orthopedic surgeries, general & gynaecological surgery[1]

Prophylaxis and treatment of venous thrombosis[6]

Prophylaxis and treatment of pulmonary embolism[6]

Prophylaxis and treatment of peripheral arterial embolism[6]

Diagnosis and treatment of acute and chronic consumption coagulopathies (DIC)[6]

Prevention of postoperative deep venous thrombosis(DVT)[6]

For adult the dose is subcutaneous 10,000 to 20,000 unit as initial dose followed by 8000 to 20,000 unit every 8 to 12 h. Intermittent IV 10,000 unit as initial dose followed by 5,000 to 10,000 unit every 4 to 6 h. IV infusion 20,000 to 40,000 unit/day. [30]

For children the dose is intermittent IV 50 unit/kg as initial dose followed by 100 unit/kg every 4 h. IV infusion 50 unit/kg as initial dose followed by 20,000 unit/m 2 /24 h. [30]

Common side effect associated with use of heparin includes: [1]
Hemorrhage
Thrombocytopenia
Hyperkalemia
Alopecia(hair loss)
Hypersensitivity
Osteoporosis

i. Heparin – Non-Steroid Anti Inflammatory Drugs (NSAIDs)
Not compatible and will increase risk of bleeding when using heparin with NSAIDs agent[6]

ii. Heparin- Aspirin
Heparin anticoagulant effect is enhanced with use of Aspirin. Lead to increased risk of  bleeding[1]

iii. Heparin – Diclofenac
Increased risk of Hemorrhage when using heparin together with intravenous diclofenac[1]

iv. Heparin – Glyceryl trinitrate
Heparin anticoagulant effect is reduced with infusion of glyceryl trinitrate[1]

v. Heparin – Angiotensin-II receptor antagonist
Usage of Heparin with angiotensin-II receptor antagonist lead to increased risk of hyperkalemia

Higher risk of bleeding for skinny patient ( women below 45kg, men below 57kg)[7]

Increased risk of bleeding in patients having kidney impairment[7]

Delayed elimination of Enoxaparin in elderly patient. High risk of bleeding[7]

Extreme caution in patient that has history of heparin-induced thrombocytopenia[8]

Should be avoided in patient having uncontrolled arterial hypotension[8]