Table 2.

Clinical uses of UFH

Drugs	Indications	Dosing, timing, duration	Monitoring	Precautions
Unfractionated heparin	Treatment of VTE	80 U/kg bolus then 18 U/kg/h infusion adjusted to maintain aPTT 2–2.5 times control or per local heparin nomogram	aPTT: at least 6 h after initiation, then at least once daily Anti-Xa Levels (alternative if available, consider if patients with heparin resistance) CBC HIT antibody testing (not warranted in the absence of thrombocytopenia, thrombosis, heparin-induced skin lesions, or other signs pointing to a potential diagnosis of HIT Signs and symptoms of bleeding	Allergic or hypersensitivity-type reactions Congenital or acquired bleeding disorders Indwelling epidural catheter Gastrointestinal ulceration and ongoing tube drainage of the small intestine or stomach Hepatic disease with impaired hemostasis Hereditary AT III deficiency and concurrent use of AT Menstruation Neonates and infants weighing <10 kg Premature infants weighing less than 1 kg Risk of delayed onset of HIT and HITT
	Treatment of ACS	IV bolus: 60 U/kg (max 4,000 U) 12 U/kg/h (max 1,000 U) ± fibrinolysis, adjusted to maintain aPTT 1.5–2 times control or per local heparin nomogram
	Bridge therapy for AF, cardioversion	IV infusion: 60–80 U/kg bolus Target aPTT, 60 s, range 50–70 s
	Prophylaxis of VTE in the medically ill or surgical population	5,000 U SC every 8–12 h
	Prophylaxis of VTE in pregnancy (with prior VTE)	7,500–15,000 U SC every 12 h

VTE venous thromboembolism, aPTT activated partial thromboplastin time, CBC complete blood count, HIT heparin-induced thrombocytopenia, HITT heparin-induced thrombocytopenia and thrombosis, ACS acute coronary syndrome, IV intravenous, SC subcutaneous