Dosing & Uses
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
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (1)
- mifepristone
mifepristone, antithrombin III. Other (see comment). Contraindicated. Comment: Mifepristone may lead to excessive post abortion bleeding in pts. on anticoagulant therapy.
Serious - Use Alternative (54)
- abciximab
antithrombin III, abciximab. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- amobarbital
amobarbital decreases effects of antithrombin III by increasing metabolism. Avoid or Use Alternate Drug.
- anagrelide
antithrombin III, anagrelide. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- antithrombin alfa
antithrombin alfa and antithrombin III both increase anticoagulation. Avoid or Use Alternate Drug.
- argatroban
antithrombin III and argatroban both increase anticoagulation. Avoid or Use Alternate Drug.
- azithromycin
azithromycin increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
- bazedoxifene/conjugated estrogens
bazedoxifene/conjugated estrogens decreases effects of antithrombin III by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- bemiparin
antithrombin III and bemiparin both increase anticoagulation. Avoid or Use Alternate Drug.
- bivalirudin
antithrombin III and bivalirudin both increase anticoagulation. Avoid or Use Alternate Drug.
- butabarbital
butabarbital decreases effects of antithrombin III by increasing metabolism. Avoid or Use Alternate Drug.
- butalbital
butalbital decreases effects of antithrombin III by increasing metabolism. Avoid or Use Alternate Drug.
- caplacizumab
caplacizumab, antithrombin III. Either increases effects of the other by anticoagulation. Avoid or Use Alternate Drug.
- cefamandole
cefamandole increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- cefazolin
cefazolin increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- cilostazol
antithrombin III, cilostazol. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- clarithromycin
clarithromycin increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
- clopidogrel
antithrombin III, clopidogrel. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- conjugated estrogens
conjugated estrogens decreases effects of antithrombin III by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- dabigatran
antithrombin III 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 III and dalteparin both increase anticoagulation. Avoid or Use Alternate Drug.
- dipyridamole
antithrombin III, dipyridamole. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- enoxaparin
antithrombin III and enoxaparin both increase anticoagulation. Avoid or Use Alternate Drug.
- eptifibatide
antithrombin III, eptifibatide. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- erythromycin base
erythromycin base increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin ethylsuccinate
erythromycin ethylsuccinate increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin lactobionate
erythromycin lactobionate increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
- erythromycin stearate
erythromycin stearate increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
- estradiol
estradiol decreases effects of antithrombin III by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- estrogens conjugated synthetic
estrogens conjugated synthetic decreases effects of antithrombin III by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- estropipate
estropipate decreases effects of antithrombin III by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- Factor X, human
antithrombin III 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 III and fondaparinux both increase anticoagulation. Avoid or Use Alternate Drug.
- heparin
antithrombin III and heparin both increase anticoagulation. Avoid or Use Alternate Drug.
- levonorgestrel intrauterine
levonorgestrel intrauterine, antithrombin III. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.
- levonorgestrel oral
levonorgestrel oral, antithrombin III. Either decreases effects of the other by pharmacodynamic antagonism. Avoid or Use Alternate Drug. Risk of thromboembolic disorders.
- levothyroxine
levothyroxine increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- liothyronine
liothyronine increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- mestranol
mestranol decreases effects of antithrombin III by pharmacodynamic antagonism. Contraindicated. Risk of thromboembolic disorders.
- pentobarbital
pentobarbital decreases effects of antithrombin III by increasing metabolism. Avoid or Use Alternate Drug.
- phenindione
antithrombin III and phenindione both increase anticoagulation. Avoid or Use Alternate Drug.
- phenobarbital
phenobarbital decreases effects of antithrombin III by increasing metabolism. Avoid or Use Alternate Drug.
- piperacillin
piperacillin increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- primidone
primidone decreases effects of antithrombin III by increasing metabolism. Avoid or Use Alternate Drug.
- protamine
antithrombin III and protamine both increase anticoagulation. Avoid or Use Alternate Drug.
- quinine
quinine increases effects of antithrombin III by unknown mechanism. Avoid or Use Alternate Drug.
- roxithromycin
roxithromycin increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
- secobarbital
secobarbital decreases effects of antithrombin III by increasing metabolism. Avoid or Use Alternate Drug.
- sulfadiazine
sulfadiazine increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
sulfadiazine increases effects of antithrombin III by plasma protein binding competition. Avoid or Use Alternate Drug. - sulfamethoxazole
sulfamethoxazole increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
sulfamethoxazole increases effects of antithrombin III by plasma protein binding competition. Avoid or Use Alternate Drug. - sulfisoxazole
sulfisoxazole increases effects of antithrombin III by decreasing metabolism. Avoid or Use Alternate Drug.
sulfisoxazole increases effects of antithrombin III by plasma protein binding competition. Avoid or Use Alternate Drug. - thyroid desiccated
thyroid desiccated increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- tibolone
tibolone increases effects of antithrombin III by pharmacodynamic synergism. Avoid or Use Alternate Drug.
- ticlopidine
antithrombin III, ticlopidine. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
- tirofiban
antithrombin III, tirofiban. Either increases effects of the other by pharmacodynamic synergism. Contraindicated. Enhanced risk of hemorrhage.
Monitor Closely (116)
- aceclofenac
antithrombin III and aceclofenac both increase anticoagulation. Modify Therapy/Monitor Closely.
- acemetacin
antithrombin III and acemetacin both increase anticoagulation. Modify Therapy/Monitor Closely.
- agrimony
antithrombin III and agrimony both increase anticoagulation. Modify Therapy/Monitor Closely.
- alfalfa
antithrombin III and alfalfa both increase anticoagulation. Modify Therapy/Monitor Closely.
- alteplase
antithrombin III and alteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- American ginseng
antithrombin III and American ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- anamu
antithrombin III and anamu both increase anticoagulation. Use Caution/Monitor.
- aspirin
antithrombin III and aspirin both increase anticoagulation. Modify Therapy/Monitor Closely.
aspirin, antithrombin III. 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 III and aspirin rectal both increase anticoagulation. Modify Therapy/Monitor Closely.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate, antithrombin III. 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 III and aspirin/citric acid/sodium bicarbonate both increase anticoagulation. Modify Therapy/Monitor Closely. - azapropazone
azapropazone increases effects of antithrombin III by plasma protein binding competition. Use Caution/Monitor.
- azathioprine
azathioprine decreases effects of antithrombin III by unknown mechanism. Use Caution/Monitor.
- azficel-T
azficel-T, antithrombin III. Other (see comment). Use Caution/Monitor. Comment: Coadministration with anticoagulants or antiplatelets may increase bruising or bleeding at biopsy and/or injection sites; concomitant use not recommended. Decisions regarding continued use or cessation of anticoagulants or antiplatelets should be made by a physician.
- betrixaban
antithrombin III, betrixaban. Either increases levels of the other by anticoagulation. Use Caution/Monitor.
- budesonide
budesonide, antithrombin III. 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 III by unspecified interaction mechanism. Use Caution/Monitor.
- carbamazepine
carbamazepine decreases levels of antithrombin III by increasing metabolism. Use Caution/Monitor.
- celecoxib
antithrombin III and celecoxib both increase anticoagulation. Modify Therapy/Monitor Closely.
- chitosan
chitosan increases effects of antithrombin III by Other (see comment). Use Caution/Monitor. Comment: Chitosan can decrease GI absorption of vitamin K, enhancing anticoagulant effects.
- choline magnesium trisalicylate
antithrombin III and choline magnesium trisalicylate both increase anticoagulation. Modify Therapy/Monitor Closely.
- cinnamon
antithrombin III and cinnamon both increase anticoagulation. Modify Therapy/Monitor Closely.
- citalopram
citalopram increases effects of antithrombin III by pharmacodynamic synergism. Use Caution/Monitor. Combination may increase risk of bleeding.
- collagenase clostridium histolyticum
antithrombin III 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 III by pharmacodynamic antagonism. Modify Therapy/Monitor Closely. Risk of thromboembolic disorders.
- cordyceps
antithrombin III and cordyceps both increase anticoagulation. Modify Therapy/Monitor Closely.
- cornsilk
cornsilk decreases effects of antithrombin III by pharmacodynamic antagonism. Use Caution/Monitor. Cornsilk contains vitamin K; consume a consistent amount daily.
- cortisone
cortisone, antithrombin III. 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.
- cyclophosphamide
cyclophosphamide increases effects of antithrombin III by unknown mechanism. Use Caution/Monitor.
- danshen
antithrombin III and danshen both increase anticoagulation. Use Caution/Monitor.
- deferasirox
deferasirox, antithrombin III. 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 III. 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 III and devil's claw both increase anticoagulation. Use Caution/Monitor.
- dexamethasone
dexamethasone, antithrombin III. 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 III and diclofenac both increase anticoagulation. Modify Therapy/Monitor Closely.
- diflunisal
antithrombin III and diflunisal both increase anticoagulation. Modify Therapy/Monitor Closely.
diflunisal increases effects of antithrombin III by plasma protein binding competition. Use Caution/Monitor. - dong quai
antithrombin III and dong quai both increase anticoagulation. Modify Therapy/Monitor Closely.
- epoprostenol
antithrombin III and epoprostenol both increase anticoagulation. Modify Therapy/Monitor Closely.
- ethanol
ethanol increases effects of antithrombin III by unknown mechanism. Use Caution/Monitor. Acute EtOH intoxication.
- ethotoin
antithrombin III increases levels of ethotoin by unknown mechanism. Use Caution/Monitor.
ethotoin, antithrombin III. 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 III and etodolac both increase anticoagulation. Modify Therapy/Monitor Closely.
- fenbufen
antithrombin III and fenbufen both increase anticoagulation. Modify Therapy/Monitor Closely.
- fennel
antithrombin III and fennel both increase anticoagulation. Modify Therapy/Monitor Closely.
- fenoprofen
antithrombin III and fenoprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- feverfew
antithrombin III and feverfew both increase anticoagulation. Modify Therapy/Monitor Closely.
- fish oil
fish oil, antithrombin III. 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. 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 III 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 III. 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.
- fluorouracil
fluorouracil increases effects of antithrombin III by unspecified interaction mechanism. Use Caution/Monitor. Due to the thrombocytopenic effects of fluorouracil, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants.
- flurbiprofen
antithrombin III and flurbiprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- forskolin
antithrombin III and forskolin both increase anticoagulation. Modify Therapy/Monitor Closely.
- fosphenytoin
antithrombin III increases levels of fosphenytoin by unknown mechanism. Use Caution/Monitor.
fosphenytoin, antithrombin III. 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 III and garlic both increase anticoagulation. Modify Therapy/Monitor Closely.
- gemcitabine
gemcitabine increases effects of antithrombin III by unspecified interaction mechanism. Use Caution/Monitor. Due to the thrombocytopenic effects of gemcitabine, an additive risk of bleeding may be seen in patients receiving concomitant anticoagulants.
- ginger
antithrombin III and ginger both increase anticoagulation. Modify Therapy/Monitor Closely.
- ginkgo biloba
antithrombin III and ginkgo biloba both increase anticoagulation. Modify Therapy/Monitor Closely.
- glucagon intranasal
glucagon intranasal increases effects of antithrombin III by unknown mechanism. Use Caution/Monitor.
- green tea
green tea, antithrombin III. Other (see comment). Use Caution/Monitor. Comment: Combination may increase risk of bleeding, caution is advised.
- heparin
antithrombin III increases effects of heparin by pharmacodynamic synergism. Use Caution/Monitor. Use reduced dose of heparin during antithrombin III therapy to avoid bleeding.
- horse chestnut seed
antithrombin III and horse chestnut seed both increase anticoagulation. Modify Therapy/Monitor Closely.
- hydrocortisone
hydrocortisone, antithrombin III. 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 III. 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 III and ibuprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- ibuprofen IV
antithrombin III and ibuprofen IV both increase anticoagulation. Modify Therapy/Monitor Closely.
- icosapent
icosapent, antithrombin III. 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 III and indomethacin both increase anticoagulation. Modify Therapy/Monitor Closely.
- iodine (radioactive)
iodine (radioactive) decreases effects of antithrombin III by pharmacodynamic antagonism. Use Caution/Monitor.
- ketoprofen
antithrombin III and ketoprofen both increase anticoagulation. Modify Therapy/Monitor Closely.
- ketorolac
antithrombin III and ketorolac both increase anticoagulation. Modify Therapy/Monitor Closely.
- ketorolac intranasal
antithrombin III and ketorolac intranasal both increase anticoagulation. Modify Therapy/Monitor Closely.
- lofepramine
lofepramine increases levels of antithrombin III by decreasing metabolism. Use Caution/Monitor.
- lornoxicam
antithrombin III and lornoxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- meclofenamate
antithrombin III and meclofenamate both increase anticoagulation. Modify Therapy/Monitor Closely.
- mefenamic acid
antithrombin III and mefenamic acid both increase anticoagulation. Modify Therapy/Monitor Closely.
- melatonin
melatonin increases effects of antithrombin III by anticoagulation. Use Caution/Monitor. Melatonin may decrease prothrombin time.
- meloxicam
antithrombin III and meloxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- methimazole
methimazole decreases effects of antithrombin III by pharmacodynamic antagonism. Use Caution/Monitor.
- methylprednisolone
methylprednisolone, antithrombin III. 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 III increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Modify Therapy/Monitor Closely.
- nabumetone
antithrombin III and nabumetone both increase anticoagulation. Modify Therapy/Monitor Closely.
- naproxen
antithrombin III and naproxen both increase anticoagulation. Modify Therapy/Monitor Closely.
- nettle
antithrombin III 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 III. 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 III. 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 III and oxaprozin both increase anticoagulation. Modify Therapy/Monitor Closely.
- panax ginseng
antithrombin III and panax ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- parecoxib
antithrombin III and parecoxib both increase anticoagulation. Modify Therapy/Monitor Closely.
- pau d'arco
antithrombin III and pau d'arco both increase anticoagulation. Modify Therapy/Monitor Closely.
- pegaspargase
pegaspargase increases effects of antithrombin III by pharmacodynamic synergism. Use Caution/Monitor. Increased risk of bleeding events.
- phenytoin
antithrombin III increases levels of phenytoin by unknown mechanism. Use Caution/Monitor.
phenytoin, antithrombin III. 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 III and phytoestrogens both increase anticoagulation. Modify Therapy/Monitor Closely.
- piroxicam
antithrombin III and piroxicam both increase anticoagulation. Modify Therapy/Monitor Closely.
- porfimer
antithrombin III decreases effects of porfimer by pharmacodynamic antagonism. Use Caution/Monitor.
- prasugrel
antithrombin III, prasugrel. Either increases effects of the other by pharmacodynamic synergism. Use Caution/Monitor. Enhanced risk of hemorrhage.
- prednisolone
prednisolone, antithrombin III. 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 III. 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 III by decreasing metabolism. Use Caution/Monitor.
- propylthiouracil
propylthiouracil decreases effects of antithrombin III by pharmacodynamic antagonism. Use Caution/Monitor.
- reishi
antithrombin III and reishi both increase anticoagulation. Modify Therapy/Monitor Closely.
- reteplase
antithrombin III and reteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- rifabutin
rifabutin decreases levels of antithrombin III by increasing metabolism. Use Caution/Monitor.
- rivaroxaban
rivaroxaban, antithrombin III. 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 III and salicylates (non-asa) both increase anticoagulation. Modify Therapy/Monitor Closely.
- salsalate
antithrombin III and salsalate both increase anticoagulation. Modify Therapy/Monitor Closely.
- Siberian ginseng
antithrombin III and Siberian ginseng both increase anticoagulation. Modify Therapy/Monitor Closely.
- sulfasalazine
antithrombin III and sulfasalazine both increase anticoagulation. Modify Therapy/Monitor Closely.
- sulindac
antithrombin III and sulindac both increase anticoagulation. Modify Therapy/Monitor Closely.
- tenecteplase
antithrombin III and tenecteplase both increase anticoagulation. Modify Therapy/Monitor Closely.
- ticagrelor
ticagrelor, antithrombin III. 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 III by pharmacodynamic synergism. Use Caution/Monitor. Tipranavir has mild antiplatelet activity that may incr bleeding risk.
- tolfenamic acid
antithrombin III and tolfenamic acid both increase anticoagulation. Modify Therapy/Monitor Closely.
- tolmetin
antithrombin III and tolmetin both increase anticoagulation. Modify Therapy/Monitor Closely.
- triamcinolone acetonide injectable suspension
triamcinolone acetonide injectable suspension, antithrombin III. 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 III by unspecified interaction mechanism. Use Caution/Monitor.
- vorapaxar
antithrombin III, 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.
- vortioxetine
vortioxetine and antithrombin III both increase anticoagulation. Use Caution/Monitor.
- zanubrutinib
antithrombin III, zanubrutinib. Either increases effects of the other by anticoagulation. Modify Therapy/Monitor Closely. Zanubrutinib-induced cytopenias increases risk of hemorrhage. Coadministration of zanubritinib with antiplatelets or anticoagulants may further increase this risk.
Minor (18)
- acetaminophen
acetaminophen increases effects of antithrombin III by unknown mechanism. Minor/Significance Unknown.
- acetaminophen IV
acetaminophen IV increases effects of antithrombin III by unknown mechanism. Minor/Significance Unknown.
- acetaminophen rectal
acetaminophen rectal increases effects of antithrombin III by unknown mechanism. Minor/Significance Unknown.
- alprostadil intracavernous/urethral
alprostadil intracavernous/urethral increases effects of antithrombin III by pharmacodynamic synergism. Minor/Significance Unknown.
- ceftaroline
ceftaroline increases effects of antithrombin III by Other (see comment). Minor/Significance Unknown. Comment: Cephalosporins with a methylthiotetrazole (MTT) side ring (eg, cefotetan, cefoperazone) are more frequently associated with hypoprothrombinemic activity.
- chlorella
chlorella decreases effects of antithrombin III by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical, due to vitamin K content.
- demeclocycline
demeclocycline increases effects of antithrombin III by pharmacodynamic synergism. Minor/Significance Unknown.
- dexmethylphenidate
dexmethylphenidate increases effects of antithrombin III by decreasing metabolism. Minor/Significance Unknown.
- doxycycline
doxycycline increases effects of antithrombin III by pharmacodynamic synergism. Minor/Significance Unknown.
- glyburide
glyburide increases effects of antithrombin III by unspecified interaction mechanism. Minor/Significance Unknown.
- mineral oil
mineral oil decreases levels of antithrombin III by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown.
- minocycline
minocycline increases effects of antithrombin III by pharmacodynamic synergism. Minor/Significance Unknown.
- oxytetracycline
oxytetracycline increases effects of antithrombin III by pharmacodynamic synergism. Minor/Significance Unknown.
- quinidine
quinidine increases effects of antithrombin III by decreasing metabolism. Minor/Significance Unknown.
- serdexmethylphenidate/dexmethylphenidate
serdexmethylphenidate/dexmethylphenidate increases effects of antithrombin III by decreasing metabolism. Minor/Significance Unknown.
- tetracycline
tetracycline increases effects of antithrombin III by pharmacodynamic synergism. Minor/Significance Unknown.
- verteporfin
antithrombin III decreases effects of verteporfin by pharmacodynamic antagonism. Minor/Significance Unknown.
- vitamin E
vitamin E, antithrombin III. 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%
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
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
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.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
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)
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| Thrombate III intravenous - | 500 (+/-) unit vial |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
antithrombin III (human) 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.
