Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 1750 International Unit/vial
Therapeutic Goal
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
Surgical Patients
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
Pregnant
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
Dose Adjustments
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%
No experience
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- mifepristone
mifepristone, antithrombin alfa. Other (see comment). Contraindicated. Comment: Mifepristone may lead to excessive post abortion bleeding in pts. on anticoagulant therapy.
Serious - Use Alternative (56)
- abciximab
antithrombin alfa, abciximab. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- amobarbital
amobarbital decreases effects of antithrombin alfa by increasing metabolism. Avoid or Use Alternate Drug.
- anagrelide
antithrombin alfa, anagrelide. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- antithrombin III
antithrombin alfa and antithrombin III both increase anticoagulation. Avoid or Use Alternate Drug.
- apixaban
antithrombin alfa and apixaban both increase anticoagulation. Avoid or Use Alternate Drug.
- argatroban
antithrombin alfa and argatroban both increase anticoagulation. Avoid or Use Alternate Drug.
- azithromycin
azithromycin increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
- bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens decreases effects of antithrombin alfa by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- bemiparin
antithrombin alfa and bemiparin both increase anticoagulation. Avoid or Use Alternate Drug.
- bivalirudin
antithrombin alfa and bivalirudin both increase anticoagulation. Avoid or Use Alternate Drug.
- butabarbital
butabarbital decreases effects of antithrombin alfa by increasing metabolism. Avoid or Use Alternate Drug.
- butalbital
butalbital decreases effects of antithrombin alfa by increasing metabolism. Avoid or Use Alternate Drug.
- caplacizumab
caplacizumab, antithrombin alfa. Either increases effects of the other by anticoagulation. Avoid or Use Alternate Drug.
- cefamandole
cefamandole increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- cefazolin
cefazolin increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- cilostazol
antithrombin alfa, cilostazol. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- clarithromycin
clarithromycin increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
- clopidogrel
antithrombin alfa, clopidogrel. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- conjugated estrogens
conjugated estrogens decreases effects of antithrombin alfa by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- dabigatran
antithrombin alfa and dabigatran both increase anticoagulation. Avoid or Use Alternate Drug. Both drugs have the potential to cause bleeding. Concomitant use may increase risk of bleeding.
- dalteparin
antithrombin alfa and dalteparin both increase anticoagulation. Avoid or Use Alternate Drug.
- dipyridamole
antithrombin alfa, dipyridamole. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- enoxaparin
antithrombin alfa and enoxaparin both increase anticoagulation. Avoid or Use Alternate Drug.
- eptifibatide
antithrombin alfa, eptifibatide. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- erythromycin base
erythromycin base increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin lactobionate
erythromycin lactobionate increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin stearate
erythromycin stearate increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
- estradiol
estradiol decreases effects of antithrombin alfa by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- estrogens conjugated synthetic
estrogens conjugated synthetic decreases effects of antithrombin alfa by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- estrogens esterified
estrogens esterified decreases effects of antithrombin alfa by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- estropipate
estropipate decreases effects of antithrombin alfa by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- Factor X, human
antithrombin alfa will decrease the level or effect of Factor X, human by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Based on the mechanism of action, Factor X is likely to be counteracted by direct and indirect Factor Xa inhibitors.
- fondaparinux
antithrombin alfa and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- heparin
antithrombin alfa and heparin both increase anticoagulation. Avoid or Use Alternate Drug.
- levonorgestrel intrauterine
levonorgestrel intrauterine, antithrombin alfa. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.
- levonorgestrel oral
levonorgestrel oral, antithrombin alfa. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.
- levothyroxine
levothyroxine increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- liothyronine
liothyronine increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- mestranol
mestranol decreases effects of antithrombin alfa by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- pentobarbital
pentobarbital decreases effects of antithrombin alfa by increasing metabolism. Avoid or Use Alternate Drug.
- phenindione
antithrombin alfa and phenindione both increase anticoagulation. Avoid or Use Alternate Drug.
- phenobarbital
phenobarbital decreases effects of antithrombin alfa by increasing metabolism. Avoid or Use Alternate Drug.
- piperacillin
piperacillin increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- primidone
primidone decreases effects of antithrombin alfa by increasing metabolism. Avoid or Use Alternate Drug.
- protamine
antithrombin alfa and protamine both increase anticoagulation. Avoid or Use Alternate Drug.
- quinine
quinine increases effects of antithrombin alfa by unknown mechanism. Avoid or Use Alternate Drug.
- roxithromycin
roxithromycin increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
- secobarbital
secobarbital decreases effects of antithrombin alfa by increasing metabolism. Avoid or Use Alternate Drug.
- sulfadiazine
sulfadiazine increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of antithrombin alfa by plasma protein binding competition. Avoid or Use Alternate Drug. - sulfamethoxazole
sulfamethoxazole increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
sulfamethoxazole increases effects of antithrombin alfa by plasma protein binding competition. Avoid or Use Alternate Drug. - sulfisoxazole
sulfisoxazole increases effects of antithrombin alfa by decreasing metabolism. Avoid or Use Alternate Drug.
sulfisoxazole increases effects of antithrombin alfa by plasma protein binding competition. Avoid or Use Alternate Drug. - thyroid desiccated
thyroid desiccated increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- tibolone
tibolone increases effects of antithrombin alfa by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- ticlopidine
antithrombin alfa, ticlopidine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- tirofiban
antithrombin alfa, tirofiban. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
Monitor Closely (107)
- aceclofenac
antithrombin alfa and aceclofenac both increase anticoagulation. Modify Therapy/Monitor Closely.
- acemetacin
antithrombin alfa and acemetacin both increase anticoagulation. Modify Therapy/Monitor Closely.
- agrimony
antithrombin alfa and agrimony both increase anticoagulation. Modify Therapy/Monitor Closely.
- alfalfa
antithrombin alfa and alfalfa both increase anticoagulation. Modify Therapy/Monitor Closely.
- alteplase
antithrombin alfa and alteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- American ginseng
antithrombin alfa and American ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- anamu
antithrombin alfa and anamu both increase anticoagulation. Use Caution/Monitor.
- aspirin
antithrombin alfa and aspirin both increase anticoagulation. Modify Therapy/Monitor Closely.
aspirin, antithrombin alfa. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely. - aspirin rectal
antithrombin alfa and aspirin rectal both increase anticoagulation. Modify Therapy/Monitor Closely.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate, antithrombin alfa. Either increases toxicity of the other by anticoagulation. Use Caution/Monitor. The need for simultaneous use of low-dose aspirin and anticoagulant or antiplatelet agents are common for patients with cardiovascular disease; monitor closely.
antithrombin alfa and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely. - azapropazone
azapropazone increases effects of antithrombin alfa by plasma protein binding competition. Use Caution/Monitor.
- azathioprine
azathioprine decreases effects of antithrombin alfa by unknown mechanism. Use Caution/Monitor.
- betrixaban
antithrombin alfa, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.
- budesonide
budesonide, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- capecitabine
capecitabine increases effects of antithrombin alfa by unspecified interaction mechanism. Use Caution/Monitor.
- carbamazepine
carbamazepine decreases levels of antithrombin alfa by increasing metabolism. Use Caution/Monitor.
- celecoxib
antithrombin alfa and celecoxib both increase anticoagulation. Modify Therapy/Monitor Closely.
- chitosan
chitosan increases effects of antithrombin alfa by Other (see comment). Use Caution/Monitor. Comment: Chitosan can decrease GI absorption of vitamin K, enhancing anticoagulant effects.
- choline magnesium trisalicylate
antithrombin alfa and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.
- cinnamon
antithrombin alfa and cinnamon both increase anticoagulation. Modify Therapy/Monitor Closely.
- collagenase clostridium histolyticum
antithrombin alfa increases toxicity of collagenase clostridium histolyticum by anticoagulation. Use Caution/Monitor. Collagenase clostridium histolyticum has high incidence of ecchymosis/contusion at injection site; avoid concomitant anticoagulants (except for low-dose aspirin, ie, up to 150 mg/day).
- conjugated estrogens, vaginal
conjugated estrogens, vaginal decreases effects of antithrombin alfa by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Risk of thromboembolic disorders.
- cordyceps
antithrombin alfa and cordyceps both increase anticoagulation. Modify Therapy/Monitor Closely.
- cornsilk
cornsilk decreases effects of antithrombin alfa by pharmacodynamic antagonism. Use Caution/Monitor. Cornsilk contains vitamin K; consume a consistent amount daily.
- cortisone
cortisone, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- danshen
antithrombin alfa and danshen both increase anticoagulation. Use Caution/Monitor.
- deferasirox
deferasirox, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Gastric ulceration and GI bleeding have been reported in patients taking deferasirox, use caution when coadministering with other drugs known to increase the risk of peptic ulcers or gastric hemorrhage including anticoagulants.
- deflazacort
deflazacort, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- devil's claw
antithrombin alfa and devil's claw both increase anticoagulation. Use Caution/Monitor.
- dexamethasone
dexamethasone, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- diclofenac
antithrombin alfa and diclofenac both increase anticoagulation. Modify Therapy/Monitor Closely.
- diflunisal
antithrombin alfa and diflunisal both increase anticoagulation. Modify Therapy/Monitor Closely.
diflunisal increases effects of antithrombin alfa by plasma protein binding competition. Use Caution/Monitor. - dong quai
antithrombin alfa and dong quai both increase anticoagulation. Modify Therapy/Monitor Closely.
- epoprostenol
antithrombin alfa and epoprostenol both increase anticoagulation. Modify Therapy/Monitor Closely.
- ethanol
ethanol increases effects of antithrombin alfa by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.
- ethotoin
antithrombin alfa increases levels of ethotoin by unknown mechanism. Use Caution/Monitor.
ethotoin, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Hydantoin anticonvulsants increase anticoagulant effects at first, then decrease those effects with continued use (2+ wks). There are multiple mechanisms involved, including enzyme induction, plasma protein binding site competition, and additive effects on prothrombin time. - etodolac
antithrombin alfa and etodolac both increase anticoagulation. Modify Therapy/Monitor Closely.
- fenbufen
antithrombin alfa and fenbufen both increase anticoagulation. Modify Therapy/Monitor Closely.
- fennel
antithrombin alfa and fennel both increase anticoagulation. Modify Therapy/Monitor Closely.
- fenoprofen
antithrombin alfa and fenoprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- feverfew
antithrombin alfa and feverfew both increase anticoagulation. Modify Therapy/Monitor Closely.
- fish oil
fish oil, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Patients taking fish oil and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .
- fish oil triglycerides
fish oil triglycerides will increase the level or effect of antithrombin alfa by anticoagulation. Use Caution/Monitor. Prolonged bleeding reported in patients taking antiplatelet agents or anticoagulants and oral omega-3 fatty acids. Periodically monitor bleeding time in patients receiving fish oil triglycerides and concomitant antiplatelet agents or anticoagulants.
- fludrocortisone
fludrocortisone, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- flurbiprofen
antithrombin alfa and flurbiprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- forskolin
antithrombin alfa and forskolin both increase anticoagulation. Modify Therapy/Monitor Closely.
- fosphenytoin
antithrombin alfa increases levels of fosphenytoin by unknown mechanism. Use Caution/Monitor.
fosphenytoin, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Hydantoin anticonvulsants increase anticoagulant effects at first, then decrease those effects with continued use (2+ wks). There are multiple mechanisms involved, including enzyme induction, plasma protein binding site competition, and additive effects on prothrombin time. - garlic
antithrombin alfa and garlic both increase anticoagulation. Modify Therapy/Monitor Closely.
- ginger
antithrombin alfa and ginger both increase anticoagulation. Modify Therapy/Monitor Closely.
- ginkgo biloba
antithrombin alfa and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- glucagon intranasal
glucagon intranasal increases effects of antithrombin alfa by unknown mechanism. Use Caution/Monitor.
- green tea
green tea, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding, caution is advised.
- horse chestnut seed
antithrombin alfa and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
- hydrocortisone
hydrocortisone, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- ibrutinib
ibrutinib, antithrombin alfa. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Ibrutinib may potentiate the effects of anticoagulant agents such as warfarin may increase the risk of bleeding; monitor for signs of bleeding.
- ibuprofen
antithrombin alfa and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- ibuprofen IV
antithrombin alfa and ibuprofen IV both increase anticoagulation. Modify Therapy/Monitor Closely.
- icosapent
icosapent, antithrombin alfa. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Icosapent may prolong bleeding time; monitor periodically if coadministered with other drugs that affect bleeding.
- indomethacin
antithrombin alfa and indomethacin both increase anticoagulation. Modify Therapy/Monitor Closely.
- iodine (radioactive)
iodine (radioactive) decreases effects of antithrombin alfa by pharmacodynamic antagonism. Use Caution/Monitor.
- ketoprofen
antithrombin alfa and ketoprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- ketorolac
antithrombin alfa and ketorolac both increase anticoagulation. Modify Therapy/Monitor Closely.
- ketorolac intranasal
antithrombin alfa and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- lofepramine
lofepramine increases levels of antithrombin alfa by decreasing metabolism. Use Caution/Monitor.
- lornoxicam
antithrombin alfa and lornoxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- meclofenamate
antithrombin alfa and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.
- mefenamic acid
antithrombin alfa and mefenamic acid both increase anticoagulation. Modify Therapy/Monitor Closely.
- meloxicam
antithrombin alfa and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- methimazole
methimazole decreases effects of antithrombin alfa by pharmacodynamic antagonism. Use Caution/Monitor.
- methylprednisolone
methylprednisolone, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- mistletoe
antithrombin alfa increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- nabumetone
antithrombin alfa and nabumetone both increase anticoagulation. Modify Therapy/Monitor Closely.
- naproxen
antithrombin alfa and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- nettle
antithrombin alfa increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- omega 3 carboxylic acids
omega 3 carboxylic acids, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3 acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.
- omega 3 fatty acids
omega 3 fatty acids, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Patients taking omega-3-fatty acids and an anticoagulant or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding. .
- oxaprozin
antithrombin alfa and oxaprozin both increase anticoagulation. Modify Therapy/Monitor Closely.
- panax ginseng
antithrombin alfa and panax ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- parecoxib
antithrombin alfa and parecoxib both increase anticoagulation. Modify Therapy/Monitor Closely.
- pau d'arco
antithrombin alfa and pau d'arco both increase anticoagulation. Modify Therapy/Monitor Closely.
- pegaspargase
pegaspargase increases effects of antithrombin alfa by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.
- phenytoin
antithrombin alfa increases levels of phenytoin by unknown mechanism. Use Caution/Monitor.
phenytoin, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Hydantoin anticonvulsants increase anticoagulant effects at first, then decrease those effects with continued use (2+ wks). There are multiple mechanisms involved, including enzyme induction, plasma protein binding site competition, and additive effects on prothrombin time. - phytoestrogens
antithrombin alfa and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.
- piroxicam
antithrombin alfa and piroxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- prasugrel
antithrombin alfa, prasugrel. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced risk of hemorrhage.
- prednisolone
prednisolone, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- prednisone
prednisone, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- propafenone
propafenone increases effects of antithrombin alfa by decreasing metabolism. Use Caution/Monitor.
- propylthiouracil
propylthiouracil decreases effects of antithrombin alfa by pharmacodynamic antagonism. Use Caution/Monitor.
- reishi
antithrombin alfa and reishi both increase anticoagulation. Modify Therapy/Monitor Closely.
- reteplase
antithrombin alfa and reteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- rifabutin
rifabutin decreases levels of antithrombin alfa by increasing metabolism. Use Caution/Monitor.
- rivaroxaban
rivaroxaban, antithrombin alfa. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Avoid concurrent use of rivaroxaban with other anticoagulants due to increased bleeding risk other than during therapeutic transition periods where patients should be observed closely. Monitor for signs/symptoms of blood loss.
- salicylates (non-asa)
antithrombin alfa and salicylates (non-asa) both increase anticoagulation. Modify Therapy/Monitor Closely.
- salsalate
antithrombin alfa and salsalate both increase anticoagulation. Modify Therapy/Monitor Closely.
- saw palmetto
saw palmetto increases toxicity of antithrombin alfa by unspecified interaction mechanism. Use Caution/Monitor. May increase risk of bleeding.
- Siberian ginseng
antithrombin alfa and Siberian ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- sulfasalazine
antithrombin alfa and sulfasalazine both increase anticoagulation. Modify Therapy/Monitor Closely.
- sulindac
antithrombin alfa and sulindac both increase anticoagulation. Modify Therapy/Monitor Closely.
- tenecteplase
antithrombin alfa and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- ticagrelor
ticagrelor, antithrombin alfa. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Increased risk of bleeding during concomitant use of medications that increase potential for bleeding.
- tipranavir
tipranavir increases effects of antithrombin alfa by pharmacodynamic synergism. Use Caution/Monitor. Tipranavir has mild antiplatelet activity that may incr bleeding risk.
- tolfenamic acid
antithrombin alfa and tolfenamic acid both increase anticoagulation. Modify Therapy/Monitor Closely.
- tolmetin
antithrombin alfa and tolmetin both increase anticoagulation. Modify Therapy/Monitor Closely.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, antithrombin alfa. Other (see comment). Use Caution/Monitor. Comment: Corticosteroids may decrease anticoagulant effects by increasing blood coagulability; conversely, they may impair vascular integrity, thus increasing bleeding risk. Monitor INR closely.
- triclofos
triclofos increases effects of antithrombin alfa by unspecified interaction mechanism. Use Caution/Monitor.
- vorapaxar
antithrombin alfa, vorapaxar. Either increases effects of the other by anticoagulation. Use Caution/Monitor. Coadministration of anticoagulants, antiplatelets, or other drug affecting coagulation should be monitored periodically due to potential increased risk of bleeding.
Minor (17)
- acetaminophen
acetaminophen increases effects of antithrombin alfa by unknown mechanism. Minor/Significance Unknown.
- acetaminophen IV
acetaminophen IV increases effects of antithrombin alfa by unknown mechanism. Minor/Significance Unknown.
- acetaminophen rectal
acetaminophen rectal increases effects of antithrombin alfa by unknown mechanism. Minor/Significance Unknown.
- alprostadil intracavernous/urethral
alprostadil intracavernous/urethral increases effects of antithrombin alfa by pharmacodynamic synergism. Minor/Significance Unknown.
- chlorella
chlorella decreases effects of antithrombin alfa by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical, due to vitamin K content.
- demeclocycline
demeclocycline increases effects of antithrombin alfa by pharmacodynamic synergism. Minor/Significance Unknown.
- dexmethylphenidate
dexmethylphenidate increases effects of antithrombin alfa by decreasing metabolism. Minor/Significance Unknown.
- doxycycline
doxycycline increases effects of antithrombin alfa by pharmacodynamic synergism. Minor/Significance Unknown.
- glyburide
glyburide increases effects of antithrombin alfa by unspecified interaction mechanism. Minor/Significance Unknown.
- mineral oil
mineral oil decreases levels of antithrombin alfa by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- minocycline
minocycline increases effects of antithrombin alfa by pharmacodynamic synergism. Minor/Significance Unknown.
- oxytetracycline
oxytetracycline increases effects of antithrombin alfa by pharmacodynamic synergism. Minor/Significance Unknown.
- quinidine
quinidine increases effects of antithrombin alfa by decreasing metabolism. Minor/Significance Unknown.
- serdexmethylphenidate/dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate increases effects of antithrombin alfa by decreasing metabolism. Minor/Significance Unknown.
- tetracycline
tetracycline increases effects of antithrombin alfa by pharmacodynamic synergism. Minor/Significance Unknown.
- verteporfin
antithrombin alfa decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- vitamin E
vitamin E, antithrombin alfa. Mechanism: pharmacodynamic synergism. Minor/Significance Unknown. Vitamin E at RDA does not change INR in pts. on chronic warfarin therapy; megadoses (~10x RDA) may enhance anticoagulant effects in vitamin K deficient pts.
Adverse Effects
1-10%
Application site pruritus (≥5%)
Chest pain; non cardiac (≤2%)
Dizziness (2%)
Hemorrhage (≥5%)
Hematoma (<2%)
Hepatic enzyme changes ( ≤ 2%)
Post procedural hemorrhage (≥5%)
Hematuria (≥2%)
<1%
Chest tightness
Nausea
Foul taste
Cramps
Chills
Film over eyes
Hives
Lightheadedness
Bowel fullness
Warnings
Contraindications
Hypersensitivity to goat protein or goat milk components
Cautions
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
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.Pharmacology
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.
Pharmacokinetics
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)
Administration
IV Preparation
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
IV Administration
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
Storage
Store in refrigerator (2-8°C)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| ATryn intravenous - | 1,750 unit vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
antithrombin III, human recombinant intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
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.
- 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.
