antithrombin (human)

Contraindicated in:

Hypersensitivity to goat/goat milk proteins.

Use Cautiously in:

Lactation: Use while breastfeeding only if clearly needed;;
Pedi: Safety and effectiveness not established in children. .
Geri: Use lower initial dose; consider age-related ↓ in hepatic, renal, or cardiac function, concurrent diseases or other drug therapy.;

Adv. Reactions/Side Effects ⬆ ⬇

Derm: flushing

GI: ↑liver enzymes

GU: hematuria

Hemat: hematoma, HEMORRHAGE

MS: hemarthosis

Misc: infusion site reactions, HYPERSENSITIVITY 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 ⬆ ⬇

Lyophilized powder for injection: 1,750 units/vial. (

Route/Dosage ⬆ ⬇

Surgical Patients

IV (Adults and Children ): Loading dose (units): [(100 - baseline antithrombin activity)/ 2.3] x weight (kg); Maintenance infusion (units/hr): [(100 - baseline antithrombin activity)/ 10.2] x body weight (kg). Goal is to restore/maintain functional antithrombin activity levels between 80–120% of normal antithrombin; antithrombin activity monitoring will determine changes in dosing/infusion rates.

Pregnant Women

IV (Adults and Children ): Loading dose (units): [(100 – baseline antithrombin activity)/ 1.3] x weight (kg); Maintenance infusion (units/hr): [(100 - baseline antithrombin activity)/ 5.4] x weight (kg). Goal is to restore/maintain functional antithrombin activity levels between 80–120% of normal; antithrombin activity monitoring will determine changes in dosing/infusion rates.

US Brand Names ⬆ ⬇

Action ⬆ ⬇

Antithrombin inhibits thrombin and Factor Xa, which play major roles in coagulation. Recombinant antithrombin replaces antithrombin missing in deficient patients.

Therapeutic effects:

Prevention of clotting.

Classifications ⬆ ⬇

Therapeutic Classification: anticoagulants

Pharmacologic Classification: antithrombotics

Pharmacokinetics ⬆ ⬇

Absorption: IV administration results in complete bioavailability.

Distribution: Volume of distribution is greater in pregnant patients.

Metabolism/Excretion: Clearance is higher in pregnant patients.

Half-Life: 12–18 hr (dose related).

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
IV	rapid	2 hr	end of infusion

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of antithrombin human. Do not stop receiving drug without consulting health care provider. If an appointment is missed, reschedule as soon as possible. Advise patient to read Medication Guide before starting and periodically during therapy in case of changes.
Advise patients and family to call 911 and seek urgent treatment for signs/symptoms of hypersensitivity reactions.
Tell patient to report and seek treatment for signs/symptoms of bleeding such as weakness, fast heart beat, trouble breathing, dizziness, pale skin, tiredness, obvious bleeding in urine, stool, mouth, or nose.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult with health care professional before taking other medications.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

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Indications ⬇

Contraind./Precautions ⬆ ⬇