NDA 17-037/S-158
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preventing the conversion of fibrinogen to fibrin. Heparin also prevents the formation of a stable fibrin
clot by inhibiting the activation of the fibrin stabilizing factor.
Bleeding time is usually unaffected by heparin. Clotting time is prolonged by full therapeutic doses of
heparin; in most cases, it is not measurably affected by low doses of heparin. Loglinear plots of
heparin plasma concentrations with time, for a wide range of dose levels, are linear, which suggests the
absence of zero order processes. Liver and the reticulo-endothelial system are the sites of
biotransformation. The biphasic elimination curve, a rapidly declining alpha phase (t
½
= 10 min), and
after the age of 40 a slower beta phase, indicates uptake in organs. The absence of a relationship
between anticoagulant half-life and concentration half-life may reflect factors such as protein binding
of heparin.
Patients over 60 years of age, following similar doses of heparin, may have higher plasma levels of
heparin and longer activated partial thromboplastin times (APTTs) compared with patients under 60
years of age.
Heparin does not have fibrinolytic activity; therefore, it will not lyse existing clots.
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