Close
New

Medscape is available in 5 Language Editions – Choose your Edition here.

 

aprotinin (Rx)Brand and Other Names:Trasylol

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 10,000,000 International Units/mL
more...

Regimen A

Administer test dose (10,000 KIU) IV at least 10 minutes before loading dose

Load: 2 million KIU IV over 20-30 minutes, THEN

Pump Prime (added during recirculation of priming fluid): 2 million KIU IV, THEN

500,000 KIU/hour IV continuous infusion during operation

Regimen B

Each dose half of regimen A

Administer test dose (10,000 KIU) IV at least 10 minutes before loading dose

Load: 1 million KIU IV over 20-30 minutes, THEN

Pump Prime (added during recirculation of priming fluid): 1 million KIU IV, THEN

250,000 KIU/hour IV continuous infusion during operation

Other Information

No safety/efficacy difference between regimens in low-risk patients

Other Indications & Uses

Blood loss prophylaxis in patients undergoing CABG

Safety & efficacy not established

Next

Interactions

Interaction Checker

aprotinin and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

            Sort by :  
             activity indicator 
            Previous
            Next

            Adverse Effects

            >10%

            Atrial fibrillation (21%)

            Fever (15%)

            Elevated ALT (14%)

            Nausea (11%)

            1-10%

            Hypotension (8%)

            Lung disorder (8%)

            Pleural effusion (7%)

            Myocardial infarction (6%)

            Tachycardia (6%)

            Infection (6%)

            Ventricular extrasystoles (6%)

            Ventricular tachycardia (5%)

            Atelectasis (5%)

            Heart failure (5%)

            Pericarditis (5%)

            peripheral edema (5%)

            Supraventricular tachycardia (4%)

            Arrhythmia (4%)

            Constipation (4%)

            Dyspnea (4%)

            Pneumothorax (4%)

            Hypertension (4%)

            Atrial arrhythmia (3%)

            Vomiting (3%)

            Uurinary retention (3%)

            Diarrhea (3%)

            LFT abnormalities (3%)

            Kidney function abnormal (3%)

            Asthenia (2%)

            Asthma (2%)

            Anemia (2%)

            Chest pain (2%)

            Creatine phosphokinase increased (2%)

            Hypoxia (2%)

            Musculoskeletal event (2%)

            Rash (2%)

            Urinary tract infection (2%)

            Frequency Not Defined

            Cardiovascular symptoms most likely sequelae of open-heart surgery

            Previous
            Next

            Warnings

            Black Box Warnings

            Aprotinin administration may cause fatal anaphylactic or anaphylactoid reactions. Fatal reactions have occurred with an initial test dose as well as with any of the components of the dose regimen. Fatal reactions have also occurred in situations where the initial test dose was tolerated. The risk for anaphylactic or anaphylactoid reactions is increased among patients with prior aprotinin exposure. A history of any prior aprotinin exposure must be sought prior to administration of this agent

            The risk for a fatal reaction appears to be greater upon re-exposure within 12 months of the most recent prior aprotinin exposure. Aprotinin should be administered only in operative settings where cardiopulmonary bypass can be rapidly initiated. The benefit of aprotinin to patients undergoing primary CABG surgery should be weighed against the risk of anaphylaxis associated with any subsequent exposure to aprotinin

            Contraindications

            Hypersensitivity

            Cautions

            Use test dose first to determine anaphylactic rxn possibility

            Has been linked to serious kidney problems, heart attacks & stroke

            Previous
            Next

            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: not applicable

            Pregnancy Categories

            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.

            more...
            Previous
            Next

            Pharmacology

            Half-Life: 2.5-10 hr

            Absorption: rapid

            Excretion: urine

            Mechanism of Action

            Proteinase inhibitor, blocks fibrinolysis through inhibition of plasmin, kallikrein

            Previous
            Next

            Administration

            IV Incompatibilities

            Do not administer any other drug using the same line

            IV Administration

            Administer through a central line

            Follow either regimen A or B

            Both regimens include a 1 mL test dose, a loading dose, a dose to be added while recirculating the priming fluid of the cardiopulmonary bypass circuit ("pump prime" dose), & a constant infusion dose

            To avoid physical incompatibility of Trasylol and heparin when adding to pump prime solution, each agent must be added during recirculation of pump prime to assure adequate dilution prior to admixture with other component

            Storage

            Store between 2-25°C

            Protect from freezing

            Previous
            Next

            Images

            Previous
            Next

            Formulary

            FormularyPatient Discounts

            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.
            • Manage and view all your plans together – even plans in different states.
            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            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.

            Tier Description
            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.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
            Add or Remove Plans
            Plans for
            Select State:
            Non-Medicare PlansMedicare Plans

            Select a box to add or remove a plan.

            Select a class to view formulary status for similar drugs

            Additional Offers
            Email to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Email Forms to Patient

            From:

            To:

            The recipient will receive more details and instructions to access this offer.

            By clicking send, you acknowledge that you have permission to email the recipient with this information.

            Previous
             
             
             
            All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.