Gemaza ampoules 5 thousand IU 1 ml, 5 pcs. (Prourokynaza)

Release form

Lyophilisate for solution for injection.

Packing

5 amp.

Pharmacological action

Gemaza - thrombolytic agent, which is a serine protease in the form of a single chain molecule with a molecular weight of 54,000 daltons, consisting of 2 polypeptide chains with molar masses of 20 and 34 thousand Da, which are connected by a disulfide bridge. Specifically stimulates the conversion of profibrinolysin (plasminogen) to fibrinolysin (plasmin), an enzyme that can lyse fibrin clots.

Contraindications

Tendency to bleeding (including hemorrhagic diathesis, hemophilia, thrombocytopenia, etc.), an increased risk of bleeding (gastrointestinal bleeding up to 4 weeks old, extensive surgery or extensive trauma up to 4 weeks old, intracranial or intracranial interventions up to 8 weeks old, head injury up to 4 weeks old), resuscitation measures (including cardiopulmonary resuscitation for more than 10 min), liver diseases with severe hemostasis, puncture of large vessels (e.g. subclavian vein), diabetic hemorrhagic retinopathy, condition after orragicheskogo stroke (including history) increase in systolic blood pressure to 180 mm Hg and above or diastolic blood pressure up to 110 mm Hg and higher, cardiogenic shock (IV class according to Killip), suspected dissection of aortic aneurysm, septic endocarditis, pregnancy, hypersensitivity to prourokinase.

Use during pregnancy and lactation

Contraindicated in pregnancy.

Special instructions

With the development of arterial hypotension (systolic blood pressure less than 90 mm Hg) and bradycardia (heart rate less than 50 beats / min), it is recommended to suspend administration of the drug until the normalization of blood pressure and heart rate. Cross reactions with streptase-streptokinase and allergies with streptococcal allergization, as a rule, do not occur.

When carrying out surgical interventions against the background of the action of prourokinase, in order to reduce the risk of hemorrhage, the introduction of ethamsylate at a dose of 250-500 mg is recommended.

Use with caution in combination with other trobolytic agents.

Composition

1 amp. contains recombinant prourokinase 5 thousand IU.

Dosage and administration

The contents of 1 ampoule of the Gemaza preparation are diluted in 0.5 ml of 0.9% sodium chloride solution. The resulting solution contains a dose corresponding to 5000 ME. The drug is administered parabulbularly or subconjunctively up to 10 injections per course.

To rinse the anterior chamber of the eye with a massive effusion of fibrin into the anterior chamber or hyphema, the lyophilized substance (5000 ME) is diluted in 1 ml of 0.9% sodium chloride solution, after which 0.2 ml (1000 ME) or 0.1 ml are taken ( 500 ME) of the resulting solution and diluted to 0.5 ml with 0.9% sodium chloride solution.

For intravitreal administration of 5000 ME, the lyophilisate is diluted in 1 ml of 0.9% sodium chloride solution, 0.1 ml (500 ME) of the resulting solution is taken and diluted with 0.1-0.2 ml of 0.9% sodium chloride solution. The resulting volume (0.2-0.3 ml) is administered intravitreal once.

In the presence of a hyphema and effusion of fibrin after cataract extraction, subconjunctival or parabulbar administration of Gemaza is recommended, as well as administration into the anterior chamber. For hemorrhages in the vitreous body, retina, occlusal lesions of the vessels of the retina and optic nerve, parabulbar administration of the Gemaza preparation is indicated. With hemophthalmus of various etiologies and fibrinoid syndrome, intravitreal administration of the drug is possible.

For the prevention of adhesions in the postoperative period with antiglaucomatous operations, the Gemaza preparation is diluted in the ratio indicated for subconjunctival injections and injected into the filtration pad in the early postoperative period in the amount of 1-3 injections (at the discretion of the surgeon).

Side effects

An allergic reaction may occur, expressed in edema and hyperemia of the skin of the face on the side of the drug, allergic tenonitis (chemosis, conjunctival hyperemia, decreased eyeball mobility).

Drug Interactions

The combined use of the drug with proteolytic agents has shown that it is not advisable to combine Gemaza® with injections of collalysin. The combination of Gemaza with other thrombolytics should be used with caution. Perhaps the combined use of solutions of the drug "Hemase" and emoxipin, as well as the drug "Hemase" and dexamethasone.

Overdose

There is no risk of systemic bleeding with topical administration of Hemase at 5000 ME.

With an overdose of the drug that, when using the recommended doses (up to 5000 ME once) is unlikely, recurrence of intraocular hemorrhage is possible.

At single administration of the drug at a dose exceeding 5000 ME, the risk of allergic reactions indicated in the side effects is increased.

In case of overdose of the drug and during surgery on the background of the course of treatment with the drug "Hemaz" to reduce the risk of hemorrhage, the general use of etamzilat in injections of 250-500 mg intramuscularly is recommended.

Storage Conditions

In a dark place, out of the reach of children, at 2 to 20 ° C.

Shelf life

4 years.

Deystvuyushtee substance

Prourokinase

Terms and conditions

prescription

Dosage form

injection for injection

Prescribing

Prescribing

Adults prescribing a doctor



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