Adverse Effects of Heparin

  • S. AlbanEmail author
Part of the Handbook of Experimental Pharmacology book series (HEP, volume 207)


All the adverse effects of heparins are related to their wide variety of biological activities, with bleeding being the most important safety issue, resulting directly from the potency of heparin as an anticoagulant. However, it is hard to define the bleeding risk, since it depends on numerous parameters including the indication, dosage, method, and duration of heparin application, the clinical study design and definition of bleeding as well as patient characteristics and determinants of bleeding such as type of surgery and co-medication. Nonbleeding complications of heparins are caused by binding of heparin molecules to proteins other than antithrombin and to cells, which is generally more pronounced with unfractionated heparin than with low-molecular-weight heparins. Accordingly, heparin-induced thrombocytopenia, the most severe nonbleeding adverse reaction, occurs about 10 times less with low-molecular-weight heparins than with unfractionated heparin. Frequent and therefore important adverse reactions of heparins are skin lesions resulting from delayed-type hypersensitivity reactions. All the other undesirable effects are discussed as well, but they are mostly clinically irrelevant.


Heparin Bleeding Heparin-induced thrombocytopenia (HIT) Osteoporosis 



Acute coronary syndrome


Activated partial thromboplastin time




anti-Factor Xa


Bone mineral density


Body weight


Drug-induced thrombocytopenic purpura


Delayed-type hypersensitivity reactions


Direct thrombin inhibitor


Deep vein thrombosis


Enzyme immunoassay


European Medicines Agency




Glycoprotein IIb/IIIa inhibitors


Global Utilization of Streptokinase and Tissue plasminogen activator for Occluded coronary arteries


Heparin-induced platelet activation assay


Heparin-induced thrombocytopenia


International Society on Thrombosis and Hemostasis


Low-molecular-weight heparin


Medicines and Healthcare Products Regulatory Agency


Nonsteroidal anti-inflammatory drug


Odds ratio


Percutaneous coronary intervention


Pulmonary embolism


Platelet factor 4


Receptor activator for nuclear factor-κB


Receptor activator for nuclear factor-κB ligand


Randomized controlled trial


Registry of Patients with Venous Thromboembolism


Serotonin release assay




Thrombolysis In Myocardial Infarction


Unfractionated heparin


Vitamin K antagonist


Venous thromboembolism


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© Springer-Verlag Berlin Heidelberg 2012

Authors and Affiliations

  1. 1.Pharmazeutisches Institut, Abteilung Pharmazeutische BiologieChristian-Albrechts-Universität zu KielKielGermany

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