Etamsylate - instructions for use, doses, side effects, contraindications

Antihemorrhagic means. Normalizes the permeability of the vascular wall, improves microcirculation. The effect is apparently associated with an activating effect on the formation of thromboplastin. Does not affect prothrombin time, does not possess hypercoagulable properties and does not promote formation of thrombi.

The onset of action is 5-15 minutes after intravenous injection, the maximum effect is 1-2 hours after the injection. The duration of the action is 4-6 hours.

Pharmacokinetics:

About 72% of the administered dose is excreted in the urine for the first 24 hours unchanged. Half-lifeafter intravenous administration for about 2 hours.

Penetrates through the placental barrier, excreted in breast milk.

Indications:

Prevention and stopping of bleeding: parenchymal and capillary hemorrhages, including traumatic, in surgery with operations on well-vascularized organs and tissues, surgical interventions in the dental (removal of cysts, granulomas, extraction of teeth, etc.), urological (prostatectomy, ), ophthalmologic (keratoplasty, cataract removal, antiglaucomatous surgeries and other surgical interventions), otolaryngological practice (tonsillectomy, microsurgical operations on the ear, etc.); intestinal, renal, pulmonary hemorrhage, metro and menorrhagia in fibroids, secondary bleeding against thrombocytopenia and thrombocytopathy, hypocoagulation, hematuria, intracranial hemorrhage (including in newborns and premature infants),nose bleeds with hypertension, hemorrhages (if they are not caused by anticoagulants), hemorrhagic vasculitis, hemorrhagic diathesis (including Verlhof disease, Willebrand-Jurgens disease, thrombocytopathy), vascular disease with hemorrhagic syndrome, diabetic microangiopathy (hemorrhagic diabetic retinopathy, re-hemorrhage in the retina, hemophthalmus).

ICD-10

III.D65-D69.D68.0 Von Willebrand's Disease

XIV.N80-N98.N92.1 Abundant and frequent menstruation with an irregular cycle

XIV.N80-N98.N92.0 Abundant and frequent menstruation with a regular cycle

XIX.T80-T88.T81.0 Bleeding and hematoma complicating the procedure, not elsewhere classified

XVIII.R50-R69.R58 Bleeding, not elsewhere classified

XVIII.R00-R09.R04.8 Bleeding from other parts of the respiratory tract

XVIII.R00-R09.R04.0 Nose bleed

XVI.P50-P61.P52.9 Intracranial (non-traumatic) hemorrhage in fetus and newborn, unspecified

XI.K90-K93.K92.2 Gastrointestinal bleeding, unspecified

IX.I60-I69.I62.9 Intracranial hemorrhage (non-traumatic), unspecified

VII.H30-H36.H35.6 Retinal hemorrhage

III.D65-D69.D69.3 Idiopathic thrombocytopenic purpura

III.D65-D69.D69.1 Qualitative defects of thrombocytes

VII.H30-H36.H36.0 * Diabetic retinopathy (E10-E14 + with common fourth sign .3)

VII.H43-H45.H44.8 Other diseases of the eyeball

IX.I70-I79.I77.6 Arteritis, unspecified

XVIII.R30-R39.R31 Nonspecific hematuria

Contraindications:

Thrombosis, thromboembolism, hypersensitivity to etamzilate, acute porphyria, hemoblastosis in children, lactation.

Etamsylate can not be used as the only remedy if the patient has haemorrhages caused by anticoagulants.

Carefully:

Hemorrhages against the background of anticoagulants. Pregnancy.

Pregnancy and lactation:

Category of recommendations for FDA is not defined. In pregnancy, use is possible if the expected effect of therapy exceeds the potential risk to the fetus (safety of etamzilate during pregnancy is not established).

For the duration of treatment, breastfeeding should be discontinued.

Dosing and Administration:

Inside, intravenously, intramuscularly. The dosage regimen is set individually, depending on the indications. Inside - an average single dose for adults 250-500 mg (if necessary, can be increased to 750 mg) 3-4 times a day. Intravenous or intramuscular - the optimal daily dose for adults 10-20 mg / kg, divided into 3-4 injections. Children are prescribed at a dose of 10-15 mg / kg per day in 3-4 divided doses.

The solution for injections can be applied topically (tooth extraction, etc.) - a sterile swab is impregnated and applied to the wound.

In ophthalmic practice - subconjunctival in the form of eye drops and retrobulbarno.

Side effects:

Dizziness, headache, hyperemia of the facial skin, paresthesia of the lower extremities, a decrease in systolic blood pressure, heartburn, weight in the epigastric region, allergic reactions.

Overdose:

Not described. Treatment is symptomatic.

Interaction:

Pharmaceutically incompatible (in one syringe) with other medicines.

Introduction at a dose of 10 mg / kg for 1 hour before dextran (the average molecular weight of 30-40 thousand) prevents their anti-aggregation effect (administration after dextran does not have a haemostatic effect).

Special instructions:

Caution should be used in appointing patients with a history of thrombosis or thromboembolism.

When hemorrhagic complications associated with an overdose of anticoagulants, it is recommended to use specific antidotes.

Application in patients with impaired blood coagulation system indicators is possible, but should be supplemented by the management of medicines,eliminating the revealed deficiency or defect factors of the coagulation system.

Instructions

Etamsylate (Etamsylatum)