heparin infusion schedule

Last reviewed 01/2018

Check with local guidelines.

Example guidance:

Loading dose 5000 iu iv over 5 minutes

Initial infusion 25,000 iu heparin made up in saline to rate 50 ml gives a final concentration of 500 iu/ml, to be started at 2.8 ml/hr (1400 iu/hr)

Check APTT after 6 hours. Adjust according to APTT ratio (APTT: control) as follows:

APTT ratio infusion rate range
>7 stop for 30 minutes to 1 hour and reduce by 500 iu/hr
5.1-7.0 reduce by 500 iu/hr
4.1-5.0 reduce by 300 iu/hr
3.1-4.0 reduce by 100 iu/hr
2.6-3.0 reduce by 50 iu/hr
1.5-2.5 no change - target range
1.2-2.4 increase by 200iu/hr
<2 increase by 400 iu/hr

After a change of schedule then APTT should be checked again after 10 hours. However if the APTT ratio is > 5.0 then the APTT ratio should be rechecked in 4 hours.