Heparin recall prompts changes

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Heparin recall prompts changes
Some in hospitals given different type of the blood thinner

Saturday,  March 1, 2008 3:06 AM
By Misti Crane
THE COLUMBUS DISPATCH

A safety recall by the largest manufacturer of a widely used blood thinner has some hospitals switching out some patients' medication for an alternative, and it has hospital pharmacists closely watching what the coming days and weeks might bring.

Heparin is used to prevent blood clots that travel in the body and clog other vessels. It also is used in the treatment of blood clots in the lungs and clotting-related heart conditions.

Baxter International, the largest manufacturer of the drug, issued a recall this week, citing concerns that the drug might be linked to 21 deaths.

The recall came after the Food and Drug Administration said potential problems had been found at a Chinese plant that supplied an active ingredient to Baxter.

The FDA said there isn't a definitive link between the drug and the deaths, and the other major supplier will be able to meet the needs of hospitals, dialysis centers and others.

As of yesterday, Ohio State University Medical Center and Mount Carmel hospitals had made adjustments in medication, giving a different kind of heparin -- one with a lower molecular weight -- to some patients.

The highest-risk patients -- those for whom the alternative is not a good option -- continue to get traditional heparin made by the other supplier, said Jerry Siegel, Ohio State's senior director of pharmacy.

Typically, about one in four patients at Ohio State is on heparin, he said.

The other company, APP Pharmaceuticals, has reassured Mount Carmel that it has ramped up heparin production and should be able to deliver more Tuesday, hospital spokeswoman Janice Piscitelli said.

OhioHealth, which owns Riverside Methodist, Dublin Methodist and Doctors' hospitals, got rid of its supplies from Baxter but had plenty of other heparin to function as usual, spokesman Mark Hopkins said.

Nationwide Children's Hospital was in the same position, spokeswoman Pam Barber said.

Siegel said the OSU Medical Center has a lot of low- molecular-weight heparin, but it can't be used in all patients. People with end-stage kidney disease and heart attack patients, for instance, should be given traditional heparin, he said.

One of the challenges with the alternative heparin is that it is harder to properly dose in patients with kidney problems, he said.

"Everybody will have a better idea Monday of what they can get," Siegel said.

There's been no discussion of further adjustments, including postponing elective surgeries, he said.

"We're not out today by any means. It's a very large recall that will impact probably everyone if the alternate suppliers are not able to supply" enough.

Siegel would not estimate how many days' worth of heparin are in stock at Ohio State.

He said the situation is under control, and it's important that patients not panic.

mcrane@dispatch.com

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