anacaulase

Contraindicated in:

Hypersensitivity to anacaulase, bromelain, or pineapples;
Hypersensitivity to papayas or papain (due to cross-sensitivity);
Burn wounds where medical devices or vital structures (e.g., large vessels) could become exposed during eschar removal;
Uncontrolled coagulation disorder.

Use Cautiously in:

Thrombocytopenia, ↑ risk of bleeding, or concurrent use of antithrombotic therapy;
OB: Safety not established in pregnancy;
Lactation: Safety not established in breastfeeding;
Pedi: Safety and effectiveness not established in children.

Adv. Reactions/Side Effects ⬆ ⬇

CV: hypotension, tachycardia

Derm: pruritus, decubitus ulcer, rash, scar, wound complication

GI: hepatic impairment, vomiting

Hemat: anemia, BLEEDING, hematoma, leukocytosis

Neuro: insomnia

Misc: fever, HYPERSENSITIVITY REACTIONS (INCLUDING ANAPHYLAXIS), INFECTION

Interactions ⬆ ⬇

Drug-drug:

Anticoagulants, antiplatelet agents, fibrinolytics, and heparins may ↑ risk of bleeding; avoid concurrent use.

Availability ⬆ ⬇

Topical gel: 8.8%

Route/Dosage ⬆ ⬇

(Adults ): Apply 3-mm thick layer to affected area of up to 15% body surface area (BSA) in a single application. Remove after 4 hr. A second application may be applied 24 hr after the first application to the same or new wound area if: (1) wound area >15% BSA; (2) multiple wound areas on different body surfaces require two treatments for logistical reasons, such as body position; or (3) first application's eschar removal was incomplete. Do not exceed 20% BSA (40 g) across two treatment sessions.
(Children ≥6 yr): Apply 3-mm thick layer to affected area of up to 15% BSA in a single application. Remove after 4 hr.
(Children <6 yr): Apply 3-mm thick layer to affected area of up to 10% BSA in a single application. Remove after 4 hr.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Acts as a proteolytic enzyme to dissolve burn wound eschar.

Therapeutic effects:

Eschar removal.

Classifications ⬆ ⬇

Therapeutic Classification: none assigned

Pharmacologic Classification: enzymes

Pharmacokinetics ⬆ ⬇

Absorption: Rapidly absorbed into burn wound following topical administration.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: 12 hr.

Time/Action Profile ⬆ ⬇

(plasma concentrations)

ROUTE	ONSET	PEAK	DURATION
Topical	unknown	4 hr	unknown

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of anacaulase to patient. Side effects may include pruritus, pyrexia, wound complication, anemia, vomiting, and insomnia. Advise patient to read Medication Guide before starting and periodically during therapy in case of changes.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇