Drotrecogin Alfa
Synonym :
Recombinant Human activated Protein C
Mechanism :
Activated protein C combines with protein S on platelet surfaces and then degrades factor Va and factor VIIIa, thereby reducing blood coagulability.
Indication :
- For reduction of mortality in patients with severe sepsis.
Contraindications :
Active internal bleeding.
Recent (within 3 months) hemorrhagic stroke.
Recent (within 2 months) intracranial/intraspinal surgery/severe head trauma.
Trauma patients with an increased risk of life-threatening bleeding.
Presence of an epidural catheter.
Known or suspected intracranial neoplasm or mass lesion.
Known hypersensitivity to drotrecogin or any component.
Dosing :
IV infusion rate:
24 mcg/kg/hr for 96 hours. Maximum allowed infusion time is 168 hours.
Adverse Effect :
Intracranial, GI, genitourinary or skin hemorrhages.
Interaction :
Antiplatelet agents: Such as clopidogrel and other anticoagulants(Heparin, warfarin) may enhance the adverse/toxic effect of Drotrecogin Alfa.
Renal Dose :
Dose in Renal Impairment GFR (mL/min)
| 20-50 | Dose as in normal renal function |
| 10-20 | Dose as in normal renal function |
| <10 | Dose as in normal renal function |
Dose in Patients undergoing Renal Replacement Therapies
| CAPD | Unlikely to be dialysed. Dose as in normal renal function |
| HD | Unlikely to be dialysed. Dose as in normal renal function |
| HDF/High flux | Unlikely to be dialysed. Dose as in normal renal function |
| CAV/VVHD | Unlikely to be dialysed. Dose as in normal renal function |
Hepatic Dose :
Use is contraindicated in severe hepatic impairment.