Doses of the drug should not exceed recommended. Dosing should be without adjustments to body weight.
Preparation of the drug solution for intravenous, intraarterial and intracoronary injection.
In a bottle with Eberkinase slowly 5 ml of water for injections is slowly added along the wall. To dissolve the preparation, the bottle is gently rotated, not shaking to avoid the formation of foam. The resulting concentrated solution is aseptically transferred to a vial for infusion of a suitable volume, according to the needs of the patient. The most suitable solvents are 0.9% sodium chloride solution or 5% dextrose solution.
Do not add to the drug other components and medicines. The finished solutions should be used within 12 hours.
Acute myocardial infarction.
Treatment should be started as soon as possible, but no later than 12 hours after the occurrence of a heart attack. The drug is administered in one of two ways: intravenously - once in a dose of 1,500,000 IU for 60 minutes; or intracoronary (via a catheter) - bolus in a dose of 20,000 IU, and then intravenously as an infusion of 2,000-4,000 IU per minute for 30-90 minutes.
Deep vein thrombosis.
Intravenously through a catheter in the subclavian region or lower leg. If thrombosis affects several areas, the drug is injected into the most affected one. The initial dose of 250 000 ME of EKERKINASIS diluted in 100 ml of a 5% solution of dextrose or 0.9% sodium chloride solution is injected for 30 minutes, then transferred to a maintenance infusion of 100,000 IU per hour, lasting 24-72 hours depending on the time lysis of the clot.
Thrombosis of permanent vascular access in patents with ESRD. who are on program hemodialysis.
Eberkinase is injected directly into the arterial part of the vascular access at a dose of 1 000 000 ME; the maximum duration of infusion is 1 hour.
Thromboembolism of the pulmonary artery and thrombosis with prosthetic heart valves.
Via the peripheral vein of the upper limbs, 250 000 ME of EBERKINASIS are injected in 100 ml of a 5% dextrose solution or 0.9% sodium chloride solution for 30 minutes. Then continue infusion of 100,000 IU per hour before the onset of thrombus lysis, but no more than 72 hours.
Acute and subacute thrombosis and thromboembolism of peripheral arteries. Retrombosis after operations on the vessels.
Via the peripheral vein of the upper limbs, an initial dose of 250,000 IU of EKERKINASIS is administered,diluted in 100 ml of a 5% dextrose solution or 0.9% sodium chloride solution for 30 minutes, then maintaining a dose of 100,000 IU / h before lysis of the thrombus, but no more than 5 days.
Application in pediatrics.
Special studies on the use of Eberkina in children have not been conducted. However, there are separate observations on the use of the drug in children aged 1 month to 16 years, indicating the efficacy and safety of its use in pediatrics at a dose of 1,000 to 5,000 IU / kg in the form of an intravenous infusion lasting from 5 to 30 minutes, with followed by continuous infusion at a dose of 1,000 to 5,000 IU / kg before the onset of thrombus lysis, with strict monitoring of possible side effects.
Side effect
'Bleeding, as a rule, is limited to the place of administration, recent punctures, incisions, bleeding gums are possible in some cases; hemorrhages in the skin, periomyocardium, in the brain, hematoma; internal bleeding (gastrointestinal tract, urogenital, retroperitoneal, etc.); rupture of the spleen. Severe bleeding with the use of Eberkinase i was noted in 0.3% of patients, moderate bleeding at 0.6% and minor at 2.2%.
g From the side of the cardiovascular system are possible Reduced blood pressure, reperfusion arrhythmia, brady or tachycardia,non-cardiogenic pulmonary edema (with intracoronary administration), thromboembolism (due to thrombus mobilization or fragmentation), incl. pulmonary artery (with deep vein thrombosis), distal artery (cholesterol embolus with local thrombolysis), embolic stroke.
Allergic reactions can account for up to 3% of all side effects,
including anaphylactic reactions (1-2%) and angioedema (0.2%), less often such manifestations as dyspnea, bronchospasm, skin rashes, urticaria, pruritus, hemorrhagic vasculitis (Shenlaine-Henoch syndrome) and serum sickness.
| | Other reactions: fever, chills, tremor, vomiting, nausea and pain in the lumbar region, arthralgia, increased ESR, acute renal failure (up to 6-16 days after streptokinase administration); with repeated administration - increased activity of liver transaminases and alkaline phosphatase, gamma-glutamyl transpeptidase and creatine phosphokinase; hyperbilirubinemia, decreased activity of cholinesterase.