Heparin attaches to antithrombin, a natural protein in the blood that switches off clotting factors. This changes the shape of antithrombin and makes it work much faster. The boosted antithrombin blocks key clotting factors, mainly factor Xa and thrombin, which the blood needs to build a clot. It also blocks a factor that turns a loose clot into a firm one.
Given into a vein, it starts working right away, and the body clears half of it in 0.5 to 2 hours, depending on the dose. It keeps new clots from forming and existing ones from growing, but it does not dissolve a clot that is already there. Because it blocks clotting, bleeding is its main danger and can happen almost anywhere in the body. It can also cause an immune reaction called HIT that lowers the platelet count and can, in turn, cause new clots in veins and arteries.