Heparin injections

[Luggs]

Hi everyone hope you all keeping well, I’m having bad tummy problems at the moment with Apaxiban tried Rivaroxiban same problems they both badly irritate my digestive system, my pulmonary embolism was supposedly provoked due to a very long journey so I’m on oral coagulation at least till August, so I was talking to my pharmacist today and he’s suggested I ask my doctor if I could change to Heparin injections to do myself, anyone used this alternative?

[Kleasmile]

Heparin you can use only if the Inr is low, below 2.0.Alsonit used as a bridge therapy if you have to do any surgery.I know pregnant woman used that one. Bc blood thinner are bad for unborn babies.Long term use of heparin is not good.

[mestala]

Not heard that name for years.I had a serious PE and clots on my lungs in 2012 whilst living abroad,and I was so ill that after surgery whilst recovering in ICU, I had 20,yes 20 injections over 5 days,all in the stomach ...not pleasant but it got me through,

I wouldn't have thought that heparin would take the place of normal blood thinning meds for regular use....but I'm not a doctor..When I eventually left hospital after 14 days I was on Sintrom,which is similar to warfarin,and still on it back here in uk.

I refused changing over to the new type,''no testing'' drugs......I like to see what my levels are....good luck.

[Luggs in reply to mestala]

Thanks for that mestala , I’m glad your ok now, did the clots come on due to surgery? Mine was provoked due to sitting down on a long journey, I have multiple small clots, didn’t have to many symptoms apart from feeling generally unwell and shortness of breath at times but I know now I was extremely lucky it could of been worse, it’s just that I can’t tolerate Apaxiban it’s really messing with my digestive tract, bad fatigue and headaches, I’ve been told that they will reduce my dose in June and hopefully be of the meds by August, have you thought of coming of the blood thinners or are happy to carry on?

[TLBK in reply to Luggs]

I had to have the injections before and after gallbladder surgery. I detest needles so this for me was a horrid experience. My next door neighbour had to do them for me each day. By the end my stomach was multicoloured with bruising and very painful so we tried other places like the thigh and upper arm. After 9 days my inr still wasn't in range but I'd had enough and told my neighbour I didn't need the injections no more and instead I took a slightly higher dose of warfarin than what the clinic had said to take. (I'm on life long warfarin cos I have a metal heart valve

[SpeedyH]

Hi there. Rivaroxaban and Apixaban are very similar and prevent blood clotting in the same way. There is another anticoagulant called Dabigatran that works in a different way and your doctor may suggest that you try that next. Dabigatran is a very acid med and it is important that you drink lots of water with it to ensure it gets into the stomach before the capsule starts dissolving and take it with food. I couldn’t tolerate Rivaroxaban/Apixaban but get on fine with Dabigatran but everyone seems to react to the anticoagulants in different ways so you just have to find one that suits you. There ARE a very small number of people who have Heparin injections as their anticoagulant but this is really a last resort. I used them for six weeks during which time my stomach was black and blue (don’t forget you bruise easily on anti coagulants) and very tender. There is also the hassle of arranging used needle collection with your council and all the hygiene issues around injecting.

Even though your PEs appear to be caused by a long journey before you come off anticoagulants you should still be offered an abdomen ultrasound to ensure there is nothing else causing the clots and blood tests specifically to rule out blood clotting disorders. Hope this helps. 🙂

[Luggs in reply to SpeedyH]

That’s great advice speedy and thank you it’s much appreciated, I’m going to give the heparin a go for about a month this is the advice from anticoagulant nurse until things settle down, and she suggested giving Dabigatran a go after so your spot on about that one, I’ll let you know how I get on

[SpeedyH in reply to Luggs]

That sounds like a good plan. Heparin suited me best but I couldn’t manage the injections long term. It is all about finding the best compromise, I hope you feel much better very soon.

[Luggs in reply to SpeedyH]

Thank you speedy 👍🏻

[cheritorrox in reply to Luggs]

How about good old fashioned warfarin (or in my case sintrom which acts the same way)? I agree with @mestala that it's actually nice to have INR checks regularly!

[Jngomo]

after run to the hospital due to a PE I was given few heparing injections (inject myself) as warfarin take couple of days kick off in your system and herparin acts imminently.

i am with Apixaban now but i have not issues.

[cheritorrox in reply to Jngomo]

I had to come off sintrom (like warfarin) prior to a special blood test (to see if there was a genetic reason for DVT - there was) and had to inject heparin - was running out of places in stomach without bruises!

[Hidden in reply to cheritorrox]

I had a heparin injection in a and e after the d dimer test came back abnormal to stop the clot getting any bigger just before I went for my ct scan and it was like having a bee sting!

[cheritorrox in reply to Hidden]

Reckon we're all saying no way does anyone go for this as a regular option!!

[Hidden in reply to cheritorrox]

No not if you have any choices you don't!

They offer it to pregnant women and cancer patients as that's their only choice but with so many other options available open to you then no its not usually a first choice!

[Luggs]

Unfortunately I couldn’t tolerate rivaroxiban or Apaxiban they really irritated my stomach badly, so that’s why I opted for Heparin, I’m doing ok so far, doesn’t hurt and not bruising to badly either, only side affect is a slight headache no nausea, hopefully if alls well I should be off blood thinners by August, I know there’s one I think called Anoxiban which isn’t to bad so if have to stay on them for a while I could try that one it’ll be a lower dose so maybe not so bad on the tummy

[SpeedyH in reply to Luggs]

Hi Luggs. Anoxiban is another brand name for Rivaroxiban. Same drug.

The available options are:

Warfarin

Rivaroxiban/

Apixaban

Dabigatran/

Edoxaban

Heparin

anything else is just another brand of one of these. The four different types of anticoagulant work on different parts of the clotting cycle. 🙂

[Luggs in reply to SpeedyH]

Thanks for that speedy much appreciated, one can get some what confused, I’m doing ok on the injections so far not much bruising, I get a little hot at times but everything seems ok, did you get any side effects, I did notice on some of the forums and you also mentioned Dabigatran is quite acidic so maybe because of my sensitive tummy maybe not good for me but will have to see what happens, and yes Edoxaban is another contender but as you mentioned they all generally act the same and have to find the one that suits, and thanks again 👍🏻

[SpeedyH in reply to Luggs]

It is hard to determine which side effects are to do with the clots and which are the meds in the early days. I think my main side effect from the Heparin was the headaches, but like you, after feeling extremely nauseous with diarrhoea and stomach cramps on Rivaroxiban and Apixaban, this seemed like a small worry! I also had stomach issues with Warfarin which is what I tried next.

For me, the side effects of the Dabigatran are to do with the acidity. I am not prone to stomach troubles (which is why the previous meds were so debilitating for me) and the side effects for me only amount to acid reflux if for example I lay down too soon after taking the tablet, or I don’t follow it with food. I am on anti coagulants long term as I didn’t fit any ‘provoked’ box unfortunately, but if I only had a few months to go, I would be tempted to continue with the Heparin. See how you get on. 🙂

[Luggs in reply to SpeedyH]

Like yourself I’ve never suffered from stomach problems until now I’m not getting any diarrhoea but cramps tummy making gurgling noises and lots of wind which the missus ain’t to pleased about😬I’ve had a test for h pylori and came back negative my doctor seems to think it’s gastritis caused by stress and anxiety or maybe an ulcer lurking so I’ll make appointment at hospital when things start moving again, I have appointment in June with the coagulation nurse but I’m not sure if they’ll put me on a reduced dose then? or carry on till August, but as you mentioned I’d like them to check for any underlying conditions ie blood etc, do they give you another scan to check on the PE clots?

[Suebo2 Moderator]

Perhaps swap to warfarin ??

[Luggs in reply to Suebo2]

Yes that’s another option just don’t fancy the inconvenience of the regular blood tests at the moment, doing ok so far on the heparin but just in case I have to stay on thinnners long term I hope to find one that suits and warfarin is another choice, is that what you take?

[tracey13]

I've used heparin injection three times had three separate DVTs.

I'm not sure if herpin is only short term use.

I'm on rivoxaban and I've had no problems I've been on it 6 years . I couldn't get away with warfarin my inr levels wouldn't stable.

Hope you can get sorted out with a medication that works for you .

[Luggs in reply to tracey13]

Thanks Tracey, I’m back on apaxiban Cos unfortunately the injections didn’t agree, ended up in A&E I just can’t win at the moment, the problem I was having the tablets were irritating my stomach and have caused gastritis so doctor prescribed me Lansoprazole which has settled it all down but I wouldn’t like to take them long term

[tracey13 in reply to Luggs]

I take an omoperzole stomach protection tablet it was prescribed to take along side rivoxaban maybe I would of had an irritated stomach without the stomach protection tablet.

Hope you get sorted soon.

[Brookiebiceps]

Tracy and Luggs, how are you both doing now? Luggs are you off meds? If not what are you using? Any advice?

[Luggs in reply to Brookiebiceps]

Hi thanks for asking, I’m fine now I had a choice to come of the meds a few weeks ago as I’d been on them for 6 months which is the recommended period but I chose to stay on a lower dose of 2.5 twice a day Apaxiban , all the problems I was having with stomach etc was down to Anxiety, which I’ve never suffered with before so it was all new to me, obviously the lockdown didn’t help either it was a double whammy, hope you feel better soon and take care

[Brookiebiceps]

That's wonderful.. thank you.. I suffered from terrible anxiety when I got diagnosed. It still pops up.. I hope you stay well, keep us posted...

[Manda1212panda]

I was on Heparin during pregnancy (had it in week or 2 doses before to boost INR levels) but I had it from mid November until the following September as they couldn't settle my bloods following my little boys birth.

It was horrendous! I soon ran out of places to inject and was so sore. It didn't help that I needed a higher dose so sometimes had to have 2 injections at one time.

I feel if it is necessary then go for heparin but if you can try an alternative oral anticoagulant, this would be better in the long run.

Your life becomes over run with when you will need to inject yourself and when you need a sharps box. It's a pain in the bottom! But helped me to get my son here so forever grateful for heparin.

Hope you get the right care you need soon

[Brookiebiceps]

Manda are you still on thinners?