E-DRUG: RFI: Ethamsylate efficacy? (3)
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Greetings,
Here is a brief overview from Micromedex Drugdex and I am sending the full
monograph to Dr Vikrant. I cannot find any evidence of its use in Malaysia
since 2000 and in France though it is still registered under the generic
name
Etamsylate or brand name Dicynone it is classified as "insufficient medical
service given", which means basically that there is not enough proof of its
usefulness as a medicine compared to other hemostatic agents available, and
it
is not included in the formulary of the Lyon hospitals for example (which
lists more than 2000 items).
Best regards,
Kae Ting Trouilloud
Pharmacist
kaecherie@yahoo.co.uk
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DRUGDEX DRUG EVALUATIONS
ETHAMSYLATE
a.. 0.0 OVERVIEW
a.. A. Ethamsylate is a systemic hemostatic agent.
b.. B. DOSING INFORMATION: The recommended adult oral dose for surgical
bleeding prophylaxis is 1 to 1.5 grams (g) daily for two to three days prior
to surgery, with an additional 500 to 750 milligrams (mg) several hours
prior
to the procedure; a parenteral regimen has also been given (500 mg
intravenously or intramuscularly one hour before surgery, then 500 mg just
prior to surgery). For prevention of neonatal periventricular hemorrhage,
12.5
mg/kg intravenously during the first hour of life, then the same dose every
6
hours for 4 days, has been administered.
c.. C. PHARMACOKINETICS: Peak plasma levels of ethamsylate occur
approximately 4 hours after oral doses. Ethamsylate is highly protein-bound
(90%) and eliminated largely unchanged via the kidney. The plasma
elimination
half-life is about 8 hours after oral doses and 2 hours after intravenous
dosing.
d.. D. CAUTIONS: Ethamsylate may occasionally produce nausea or
abdominal
discomfort after oral doses; headache and skin rash have been observed in
some
patients. A convincing association between ethamsylate therapy and deep-vein
thrombosis has not been established.
e.. E. CLINICAL APPLICATIONS: Oral or parenteral ethamsylate has been
investigated in numerous conditions, mainly in relation to its hemostatic
effects. Some degree of efficacy has been observed in menorrhagia, neonatal
periventricular hemorrhage prophylaxis, and patent ductus arteriosus
prophylaxis in infants treated with surfactant; for most other disorders the
drug has lacked efficacy.
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