Etamsylate

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[edit] BRAND NAMES

[edit] STRUCTURE

File:Etamsylate.jpg

[edit] MECHANISM OF ACTION

Etamsylate is a synthetic antihemorrhagic and angioprotective drug acting on the first step of hemostasis (endothelium – platelet interaction). By improving platelet adhesiveness and restoring capillary resistance, it reduces the bleeding time and blood losses. Etamsylate has no vasoconstrictor action, it does not influence fibrinolysis nor modify the plasma coagulation factors.

[edit] INDICATIONS

  • In surgery: Prevention and treatment of pre- or postsurgical capillary hemorrhages in all delicate operations and in those affecting highly vascularised tissues: E.N.T., gynecology, obstetrics, urology, odontostomatology, ophthalmology, plastic and reconstructive surgery.
  • In internal medicine: Prevention and treatment of capillary hemorrhages of whatever origin or localization: hematuria, hematemesis, melena, epistaxis, gingivorrhagia.
  • In gynecology: Metrorrhagia, primary or IUD-related menorrhagia in the absence of organic pathology.

[edit] DOSAGE

  • Adults:
    • Pre-surgical: 1 tablet (500 mg) orally or 1-2 ampoules (200-400 mg) IV or IM, 1 hour before surqery
    • Post-surgical: 1 tablet (500 mg) orally or 1-2 ampoules (200-400 mg) IV or IM, every 4 – 6 hours as long as the risk of bleeding persists.
    • Internal medicine: Generally 1 tablet 2 – 3 times a day (1000 – 1500 mg), treatment duration depends on the results obtained.
    • Gynecology, in meno-metrorrhagia: 1 tablet 3 times a day (1500 mg). Treatment lasts 10 days and starts 5 days before the expected onset of menses.
    • Local treatment: soak a swab with the contents of one ampoule (200 mg) and apply to haemorrhagic area, or in the tooth socket after dental extraction. The application may be repeated if necessary; it may be associated with oral or parenteral administration
  • Children: Half the adult dose

[edit] CONTRAINDICATIONS

Acute porphyria.

[edit] PRECAUTIONS

  • Parenteral administration may induce a drop in blood pressure. Pressure returns to normal values within the next hours.
  • If Etamsylate is administered for a reduction of excessive and or prolonged menstrual hemorrhages, and no improvement is observed, possible pathological causes should be looked for and excluded.

[edit] INTERACTIONS

No interaction is known

[edit] PREGNANCY AND LACTATION

Pregnancy Category C (US): studies in pregnant women or animals are not available. as a precaution, Etamsylate should not be administered during the first trimester of pregnancy, whereas during the second and third trimesters, it should be adminstered only if the expected therapeutic benefit is judged as superior to the potential risk for the foetus.

Lactation: In the absence of data regarding passage into maternal milk, lactations during treatment is not advisable or, if lactation is to be continued, the treatment must be stopped.

[edit] SIDE EFFECTS

Rare: Gastralgia. nausea, headache, skin rash. In most cases, these symptoms disappear spontaneously. If they persist, the dosage should be reduced or the treatment withdrawn.

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[edit] BIBLIOGRAPHY

[edit] REFERENCES