antithrombin (human)

REMS

Prevention of peri-operative and peri-partum thromboembolic events in patients with hereditary antithrombin deficiency; not used for treatment.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Hypersensitivity to goat/goat milk proteins.

Use Cautiously in:

Geri: Use lower initial dose, consider age-related decrease in hepatic, renal, or cardiac function, concurrent diseases or other drug therapy.;
OB: Has been used safely in pregnant women, use only if clearly needed;
Lactation: Use only if clearly needed, enters breast milk;
Pedi: Safety and effectiveness in children have not been established. .

Adv. Reactions/Side Effects ⬆ ⬇

Derm: flushing

GI: abnormal liver function

GU: hematuria

Hemat: hematoma, HEMORRHAGE

Local: infusion site reactions

MS: hemarthosis

Misc: allergic reactions including anaphylaxis, non-cardiac chest pain

Interactions ⬆ ⬇

Drug-drug:

↑anticoagulant effect of heparin and low molecular weight heparin.
Half-life may be altered by concurrent use of anticoagulants that use antithrombin to exert their effect.

Availability ⬆ ⬇

Sterile lyophilized powder for reconstitution. : 1750 IU/single dose vial. (

Route/Dosage ⬆ ⬇

Surgical patients (dose expressed in International Units (IU)

IV (Adults and Children ): Loading dose as a 15 min infusion: [(100 - baseline AT activity)/ 2.3] x Body Wt (kg) followed by maintenance infusion: [(100 - baseline AT activity)/ 10.2] x Body Wt (kg) per hour. Goal is to restore/maintain functional antithrombin (AT) activity levels between 80% - 120% of normal AT activity monitoring will determine changes in dosing/infusion rates.

Pregnant women (dose expressed in International Units (IU)

IV (Adults and Children ): Loading dose as a 15 min infusion: [(100 – baseline AT activity)/ 1.3] x Body Wt (kg) followed by maintenance infusion: [(100 - baseline AT activity)/ 5.4] x Body Wt (kg) per hour. Goal is to restore/maintain functional antithrombin (AT) activity levels between 80% - 120% of normal. AT activity monitoring will determine changes in dosing/infusion rates.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Antithrombin inhibits thrombin and Factor Xa5, which play major roles in coagulation.
Recombinant antithrombin (AT) replaces antithrombin missing in deficient patients.

Therapeutic effects:

Prevention of clotting in deficient patients.

Classifications ⬆ ⬇

Therapeutic Classification: anticoagulants

Pharmacologic Classification: antithrombotics

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Enters breast milk; volume of distribution is greater in pregnant patients.

Metabolism/Excretion: Clearance is higher in pregnant patients.

Half-Life: 12–18 hr (dose related).

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Indications ⬇