Haemorrhage or risk of haemorrhage in increased fibrinolysis or fibrinogenolysis that may occur in conditions:
Menorrhagia
Prostatectomy and bladder surgery
Epistaxis
Conisation of the cervix
Management of dental extraction in patients with coagulopathies
Ulcerative colitis
Haematuria
Gastrointestinal haemorrhage
General fibrinolysis as in prostatic and pancreatic cancer, after thoracic and other major surgery, in obstetrical complications such as abruptio placentae and post-partum haemorrhage, in leukaemia and liver diseases and in connection with thrombolytic therapy with streptokinase.
Hereditary angioneurotic oedema.
Intravenous administration is necessary only if it is difficult to give adequate doses by mouth. The recommended standard dose is 1 to 1.5 gm or 5-10 ml by slow intravenous injection at a rate of 1ml/minute, two to three times daily. For the indications listed below the following doses are recommended.
Menorrhagia
1-1.5 gm orally three to four times daily for three to four days.
Prostatectomy
5-10 ml by slow intravenous injection every eight hours (the first injection being given during the operation) for the first three days after surgery; thereafter 1-1.5 gm orally three to four times daily until macroscopic haematuria is no longer present.
Epistaxis
1.5 gm orally three times daily for four to ten days. Intrax injection may be applied topically to the nasal mucosa of patients suffering from epistaxis. This can be done by soaking a gauze strip in the solution, and then packing the nasal cavity.
Hematuria
1-1.5 gm orally 2-3 times daily until macroscopic haematuria is no longer present.
Conisation of the cervix
1.5 gm orally 3 times a day for 12 to 14 days post-operatively.
Dental surgery in patients with coagulopathies
Immediately before surgery, 10 mg per kg body-weight should be given intravenously. After surgery, 25 mg per kg body-weight are given orally three to four times daily for six to eight days. Coagulation factor concentrate might be necessary to administrate.
General fibrinolysis
1.0 gm (10 ml) by slow intravenous injection three to four times daily. With fibrinolysis in conjunction with diagnosed, increased intravascular coagulation i.e. defibrillation syndrome, an anticoagulant such as heparin may be given with caution.
Hereditary angioneurotic oedema
1-1.5 gm orally two to three times daily as intermittent or continuous treatment depending on whether the patient has prodromal symptoms or not.
Renal insufficiency
For patients with impaired renal function, the following dosages are recommended:
Serum creatinine Dose IV Dose Orally Dose frequency
(micromol/L)
120-249 10mg/kg 15 mg/kg twice daily
250-500 10 mg/kg 15 mg/kg daily
>500 5 mg/kg 7.5mg/kg daily
Children
Oral dose: 25 mg/kg 2 to 3 times daily for 7 to 10 days.
Injection: 10 mg/kg 6 to 8 hours for 7 to 10 days.
Dose-dependent gastrointestinal discomfort is the most commonly reported undesirable effect, but it is usually of mild and temporary in nature. Allergic skin reactions have been reported as an uncommon undesirable effect. Hypotension may occur after fast injection.
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