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February 4, 1974

Medical News

JAMA. 1974;227(5):481-490. doi:10.1001/jama.1974.03230180001001

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'Unit doses' of heparin may vary in anticoagulant potency  Heparin is heparin, right? Wrong. Or so says a pathologist at Duke University Medical Center, and he is not alone in saying it.James W. Wilson, MD, PhD, associate professor of pathology at Duke, maintains there are clear differences in potency between the two major kinds of heparin used in the United States: that derived from pork gut mucosa and the heparin refined from beef lungs. The two are substituted freely as though they were equivalent, he says, and patients sometimes are the losers.Many of the problems stem from the fact that heparin is supplied as a "unit dose" drug, Dr. Wilson told Medical News. The trouble is that the "unit dose" is defined in terms of the amount of another biological product—protamine sulfate, itself subject to variability—that is required to neutralize a given amount of heparin. He suggests