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Recothrom, Thrombogen (thrombin)
2015-07-25 16:17:29 来源: 作者: 【 】 浏览:396次 评论:0
  • HIGHLIGHTS OF PRESCRIBING INFORMATION
    These highlights do not include all the information needed to use RECOTHROM safely and effectively. See full prescribing information for RECOTHROM.

    RECOTHROM, Thrombin topical (Recombinant)
    Lyophilized Powder for Solution - For Topical Use Only
    Initial U.S. Approval: 2008
    RECENT MAJOR CHANGES

    Indications and Usage (1)      03/2013

    Warnings and Precautions

    Thrombosis (5.1)      03/2013

    Hypersensitivity Reactions (5.2)      03/2013

    INDICATIONS AND USAGE

    RECOTHROM, Thrombin topical (Recombinant), is a topical thrombin indicated to aid hemostasis whenever oozing blood and minor bleeding from capillaries and small venules is accessible and control of bleeding by standard surgical techniques (such as suture, ligature, or cautery) is ineffective or impractical in adults and pediatric populations greater than or equal to one month of age. (1)

    RECOTHROM may be used in conjunction with an absorbable gelatin sponge, USP.(1)
    DOSAGE AND ADMINISTRATION

    • For topical use only. DO NOT INJECT.(2)
    • Reconstitute RECOTHROM powder with sterile 0.9% sodium chloride, USP, yielding a solution containing 1000 units (international units of potency) per mL. (2.1)
    • Apply RECOTHROM solution directly to bleeding site surface or in conjunction with absorbable gelatin sponge. The amount required depends upon the area of tissue to be treated. (2.2)
    DOSAGE FORMS AND STRENGTHS

    RECOTHROM is available as 5000-unit and 20,000-unit vials of sterile recombinant topical thrombin lyophilized powder for solution. When reconstituted as directed, the final solution contains 1000 units/mL of RECOTHROM. (3)CONTRAINDICATIONS

    • Do not inject directly into the circulatory system. (4)
    • Do not use for the treatment of massive or brisk arterial bleeding. (4)
    • Do not administer to patients with a history of hypersensitivity to RECOTHROM, any components of RECOTHROM or hamster proteins. (4)

    WARNINGS AND PRECAUTIONS

    • RECOTHROM may cause thrombosis if it enters the circulatory system. (5.1)
    • Hypersensitivity reactions, including anaphylaxis, may occur. (5.2)

    ADVERSE REACTIONS

    • The most common adverse reaction (incidence 6%) was thromboembolic events. (5.1,6)
    • Antibody formation to RECOTHROM occurred in <1% of patients. None of the antibodies detected neutralized native human thrombin. (6.2)

    To report SUSPECTED ADVERSE REACTIONS, contact ZymoGenetics, Inc. at 1-888-784-7662 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
    USE IN SPECIFIC POPULATIONS

    Pregnancy: No human or animal data. Use only if clearly needed. (8.1

    See 17 for PATIENT COUNSELING INFORMATION.

    Revised: 5/2013

  • FULL PRESCRIBING INFORMATION: CONTENTS*
  • 1 INDICATIONS AND USAGE

    RECOTHROM ®, Thrombin topical (Recombinant), is a topical thrombin indicated to aid hemostasis whenever oozing blood and minor bleeding from capillaries and small venules is accessible and control of bleeding by standard surgical techniques (such as suture, ligature, or cautery) is ineffective or impractical in adults and pediatric populations greater than or equal to one month of age.

    RECOTHROM may be used in conjunction with an absorbable gelatin sponge, USP.

  • 2 DOSAGE AND ADMINISTRATION

    For topical use only. DO NOT INJECT.

    2.1 Reconstitution of RECOTHROM

    The volume of reconstituted RECOTHROM required will vary depending on the size and number of bleeding sites to be treated and the method of application.

    Inspect the integrity of the RECOTHROM package and contents. Do not use if the packaging or contents have been damaged or opened.

    Reconstitute the lyophilized powder using the supplied diluent.

    Use aseptic technique when handling vials and syringes.

    5000-unit RECOTHROM Reconstitution

    Units used herein represent international units of potency determined using a reference standard that has been calibrated against the World Health Organization Second International Standard for Thrombin.

    1. Remove flip-off cap from the top of the RECOTHROM vial.
    2. Attach the needle-free transfer device and snap it into place on the vial by placing the vial on a flat surface and attaching the transfer device straight into the center of the vial stopper.
    3. Attach the prefilled diluent syringe to the needle-free transfer device.
    4. Inject the 5 mL of diluent from the syringe into the product vial. Keep the syringe plunger depressed.
    5. DO NOT reuse the diluent syringe for transfer of the reconstituted product. Remove and discard the diluent syringe.
    6. Gently swirl and invert the product vial until the powder is completely dissolved. Avoid excessive agitation. The powder should dissolve in less than one minute at room temperature.
    7. Apply the pre-printed "DO NOT INJECT" label to the sterile, empty transfer syringe provided, then draw up the RECOTHROM solution.

    20,000-unit RECOTHROM Reconstitution

    1. Remove the flip-off cap from the top of the RECOTHROM vial and the diluent vial.
    2. Attach a needle-free transfer device (one each) to the RECOTHROM and diluent vials and snap them into place by placing the vial on a flat surface and attaching the transfer device straight into the center of the vial stopper.
    3. Open the sterile, empty 20-mL syringe package and apply the pre-printed "DO NOT INJECT" label to the syringe.
    4. Attach the labeled 20-mL syringe to the needle-free transfer device on the diluent vial (injection of air into the diluent vial may facilitate withdrawal of the diluent).
    5. Draw up 20 mL of diluent from the vial into the syringe.
    6. Remove the diluent-filled syringe from the diluent vial and attach it to the transfer device on the RECOTHROM vial.
    7. Transfer the 20 mL of diluent from the syringe into the RECOTHROM vial; the vacuum in the vial facilitates transfer.
    8. Leave the syringe attached and gently swirl and invert the RECOTHROM vial until the powder is completely dissolved. Avoid excessive agitation. The powder should dissolve in less than one minute at room temperature.
    9. With the same syringe, draw up the RECOTHROM solution.

    2.2 Application Techniques

    Topically apply RECOTHROM solution directly or in conjunction with absorbable gelatin sponge onto the bleeding site. DO NOT INJECT.

    The amount required depends upon the area of tissue to be treated and the method of application.

    Vials are for single use only. Discard unused contents.

    Use with Absorbable Gelatin Sponge

    Refer to the absorbable gelatin sponge labeling for safety information and instructions on appropriate use.

    1. Transfer solution from syringe to a sterile bowl or basin.
    2. Place the desired size pieces of the absorbable gelatin sponge i
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