Dosing & Uses
Dosage Forms & Strengths
- 1750 International Unit/vial
Prophylaxis of thrombosis during surgical or obstetrical procedures
Increase & maintain antithrombin activity between 80-120% (0.8-1.2 International Unit/mL) during treatment
Loading dose should target 100% AT activity level based on weight & pretreatment AT activity level
Load = [(100 - baseline AT activity level in %)/2.3] x kg Body Weight = units of antithrombin required IV; infuse over 15 minutes
Maintenance (International Unit/hr) = [(100 - baseline AT activity level in %)/10.2] x kg BW = units of antithrombin required/hr IV
Load = [(100 - baseline AT activity level in %)/1.3] x kg Body Weight = units of antithrombin required IV infuse over 15 minutes
Maintenance (International Unit/hr) = [(100 - baseline AT activity level in %)/5.4] x kg BW = units of antithrombin required/hr IV
Draw AT activity levels 2 hours after start of loading dose, AFTER start of maintenance dose infusion
IF AT activity level 80%-120% (0.8-1.2 International Unit/mL): NO dose adjustment
If AT activity level <80%: Increase maintenance infusion rate by 30%; recheck AT level 2 hr after adjustment
If AT activity level >120%: Decrease infusion rate by 30%
Serious - Use Alternative
Significant - Monitor Closely
Application site pruritus (≥5%)
Chest pain; non cardiac (≤2%)
Hepatic enzyme changes ( ≤ 2%)
Post procedural hemorrhage (≥5%)
Film over eyes
Hypersensitivity to goat protein or goat milk components
May increase risk of bleeding
Not for treatment of thromboembolic activity in hereditary antithrombin deficient patients
Monitor patients for possible immunological reactions, including antibody status
Provide appropriate clinical testing when antithrombin is used with heparin or other anticoagulants
Half-life and clearance differs significantly (7-9 times) between plasma derived and recombinant derived product
Perform anticoagulation studies (APTT, anti-Factor Xa) at close intervals when starting antithrombin treatment
Measure antithrombin levels daily, in order to adjust individual dose
Risk of diminishing antithrombin levels with prolonged treatment with non-fractionated heparin
Pregnancy & Lactation
Pregnancy Category: C
Lactation: Enters breast milk; use with caution
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Mechanism of Action
Serine protease inhibitor; important natural inhibitor of blood coagulation; inactivation of thrombin, plasmin, and other active serine proteases of coagulation including factors IXa, Xa, XIa, and XIIa.
Half-life: 12-18 hr; childbirth hemorrhage, surgery, and/or concomitant heparin may shorten half-life
Vd: 14.3 L (pregnant women); 7.7L (nonpregnant patients)
Bring vial to room temp prior to reconstitution; keep no longer than 3 hr
Reconstitute preparation with 10 mL SWI injected along side wall
Gently swirl, don't shake
Inspect visually for particulate matter & discoloration prior to administration
- do NOT use if deposits or cloudiness present
Draw reconstituted product into sterile disposable syringe
Administer by IV infusion using sterile syringe or infusion bag w/ 0.22 micron pore inline filter
May add NS to dilute for admininistration purposes
Use infusion soln within 8 hr of preparation
Compatible w/ PVC infusion lines with inline filters
Initial infusion over 15 min, then continuous infusion
Store in refrigerator (2-8°C)
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
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The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.
|1||This drug is available at the lowest co-pay. Most commonly, these are generic drugs.|
|2||This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.|
|3||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.|
|4||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|5||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|6||This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.|
|NC||NOT COVERED – Drugs that are not covered by the plan.|
Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.