Heparin users

alylove11

My OB had me switch to Heparin this week, and I have no clue how to do this. The pharmacy was no help and the nurse on the phone helped a bit, but I could use a visual demonstration of how to do this. Do you ladies have an tips? My dosage is 5,000 units/1mL. The vial is the exact dosage, so I don't have to worry about drawing up too much medicine. I tried drawing up 1 vial, but still had a tiny air bubble in it. No matter how many times I tried flicking it, it wouldn't pop. I expelled it, but then I was left with only about 80% of the vial. What am I doing wrong?

Sarah1241

Alylove,

I have not taken Heparin, but I have taken Lovenox (a low molecular-weight Heparin) and, although the medicine is pre-pulled into the syringe, there is always a small air bubble. My doctor and pharmacist said that this is normal, non-harmful and it should be injected along with the medicine. I have never had problems doing this (other than bruising from the injection). I would ask the pharmacist at your pharmacy to make sure it is the same with Heparin, just to be sure, but I would imagine that as long as it is a small bubble, it won't hurt you or the baby. 

Here is a link to how to inject Lovenox, as I am guessing it is done the same way:

https://www.lovenox.com/consumer/prescribed-lovenox/self-inject/inject-lovenox.aspx

Good luck!

alylove11

Thank you!

kneenah1231

I dont take heparin but I am certified to give injections. Just like above post said. If its a little bubble no big deal. That needle is so small its hard sometimes to remove every little bubble..

alylove11

Ahh, good to know!! There was a small bubble that would not go away. I thought it may be okay since there is a decent size bubble in the lovenox pre-filled, and I was told to inject that bubble last. Thanks for the reassurance!

Mac2588

Silly question but are you drawing when the vial is upside down? Maybe there are some you tube videos?

allieb543

I switched from Lovenox and  have been on Heparin for about two weeks now.  After much trial and error, here are my tips!  When I put the needle in the upside down vial, I have it pulled out slightly.  Once the needle is in the bottle, I depress the little bit of air into the vial. Then when I pull the plunger out to get my full dose, it fills completely.  It's slow, but if you just wait, it will fill the whole thing and there shouldn't be any bubbles.  If you do get bubbles it shouldn't be a problem,but the method I described seems to work really well.  

Also, when I started I was pinching the skin and ended up with bruising.  Now I just swab the area and stick the needle in with no pinching and I don't get any bruises.  I'm not sure if it's the "no pinching" or I'm getting more used to it.  Either way, I actually like the heparin better than the Lovenox shots now.  Good luck!  There is definitely a learning curve.  I'd be glad to answer any other questions or help if I can! 

alylove11

I do the vial upside down. A lab tech or nurse said there should be a small bubble by the plunger to "lock" the heparin in. That made me feel better, and the Lovenox has the same thing. Thanks ladies for all the help!

syoung0413

You tube it!!

syoung0413

I belong to a wonderful group on Facebook called Lovenox Ladies.  They have been a fantastic source of knowledge and help to me while taking lovenox. 

In case your interested  https://www.facebook.com/groups/LovenoxLadies/

Nikkipal82

I swear this problem completely drove me crazy the entire first year I was a nurse.  The only problem the bubble will cause is if you can't get all of the medicine into the syringe or the dose is off.  If you are getting it all out of the vial it is fine.  I find it helpful to knock the vial while it is upside down to make sure all of the medicine is at the bottom.  Also, you have to pull that tiny needle way down to the very bottom of the vial to get every last bit out.  Sometimes I have to knock the syringe to get the air bubbles out at the end as well.  I was reading this board because I am 6 weeks pg with a history of a blood clot, so I should be starting Lovenox in two weeks.  I was told I'd go to heparin when I get closer to deliver.  The whole thing sounds pretty painful and awful (I was on Lovenox for 2 months with blood clot before coumadin levels finally came up), but I'm sure it will be all worth it in the end.