antithrombin III (Rx)

Brand and Other Names:Thrombate III
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

powder for injection

  • 500 Units
  • 1000 Units

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

Determine Dosage on an Individual Basis

Base on pre-therapy plasma antithrombin III (AT-III) level

In order to increase plasma AT-III levels to that found in normal human plasma

Surgical Patients

Initial dose should raise AT levels to 120%

Load = [(120 - baseline AT activity level in %) x kg Body Weight]/1.4 = units of antithrombin required IV

Maintenance

  • Target subsequent dosing to keep levels between 80-120%, which may be achieved by administering 60% of initial loading dose q24hr
  • May adjust therapy by changing the dose or interval
  • Maintain target level for 2-8 days depending on type of procedure/situation

Heparin Resistance (Orphan)

Treatment of antithrombin III dependent heparin resistance requiring anticoagulation

Orphan indication sponsor

  • AT III LLC; c/o Genzyme Corporation,15 Pleasant St. Connector, P.O. Box 9322; Framingham, MA 01701

Safety & efficacy not established

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Interactions

Interaction Checker

and antithrombin III

No Results

     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            1-10%

            Dizziness (7%)

            Chest pain (≤2%)

            Hemorrhage (≥5%)

            Hematoma (≤2%)

            Liver enzyme abnormalities (≤2%)

            Hematuria (≤2%)

            Hemarthrosis (≤2%)

            Infusion site reaction (≥5%)

            <1%

            Bowel fullness

            Chills

            Cramps

            Dysgeusia

            Dyspnea

            Hives

            Fever

            Foul taste

            Film over eye

            Lightheadedness

            Nausea

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            Warnings

            Contraindications

            None listed in the FDA approved manufacturing labeling

            Cautions

            Hypersensitivity, including anaphylactic reactions my occur; monitor closely; discontinue immediately and administer appropriate care if symptoms occur

            Theoretical risk of blood-borne pathogens as it is a plasma product; risk is reduced by screening of donors and testing and/or inactivation or removal of viruses; report to manufacturer infections suspected from product

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            Pregnancy & Lactation

            Pregnancy Category: B

            Lactation: Not known if distributed into breast milk, use 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.

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            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: 2.5-3.8 days; surgery, acute thrombosis, and/or concomitant heparin may shorten half-life

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            Administration

            IV Preparation

            Reconstitute aseptically w/ SWI (supplied: 10 mL for 500 U & 20 mL for 1000 U)

            Bring to room temperature prior to administration

            Administer within 3 hr after reconstitution; do not refrigerate after reconstitution

            Contents of multiple vials may be drawn into same syringe through filter needles provided, if patient needs more than one vial

            IV Administration

            Administer within 3 hr after reconstitution

            Rate of administration should be adapted to response of patient; generally infusion over 10-20 min well tolerated

            Storage

            Room temp upto 25°C (77°F)

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            Formulary

            FormularyPatient Discounts

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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.

            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.
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.