Hemostatic drugs.
| Drug . | Indication . | Dose . | Onset . | Duration . | Caveat . |
|---|---|---|---|---|---|
| * f/b, “followed by” | |||||
| Desmopressin | Acute bleeding before biopsy or emergency surgery | 0.3 μg/kg (IV, SC) | 30–60 min | 6–12 hours | Tachyphylaxis |
| 300 μg (Intranasal) | 60–90 min | 6–12 hours | |||
| q 12–24 hour x 4–5 doses | |||||
| Conjugated estrogens | Chronic, recurrent bleeding or before elective surgery, esp. from uremia | 0.6 mg/kg IV infusion or 50 mg po q day x 5–7 days | 7 days | 2 weeks | Use for < 7 days |
| Antifibrinolytic agents | Intractactable mennorhagia, oral bleeding or GI bleeding | Aminocaproic acid: 5 g IV over 1 hour *f/b 1 g/h infusion for 8 hours | 30 min | 2–4 hours after discontinuation | Enters the extravascular or GI bleeding compartments; |
| or 5 g po x 1 f/b 1 gm po hourly for 8 hours | 1.5 hours | Renal clearance; contraindicated in DIC and with | |||
| Tranexamic acid (TA): 10–15 mg/kg body weight po or IV q 8 hours | 30–60 min | hematuria; TA not available in US | |||
| Aprotonin | Coronary bypass surgery | Test dose of 1.4 mg f/b 140 or 280 mg load f/b 140 or 280 mg pump prime dose f/b 35 or 70 mg/hr intra-operative infusion | 15 min | Hours after discontinuation | Requires central line; monitor for thrombosis |
| Recombinant activated factor VII | Hemophilia-related inhibitors; other uses are off-label | 90 (50–100) μg/kg IV bolus every 2 hours or as needed | Immediately | 2 hours | Monitor for thrombosis |
| Drug . | Indication . | Dose . | Onset . | Duration . | Caveat . |
|---|---|---|---|---|---|
| * f/b, “followed by” | |||||
| Desmopressin | Acute bleeding before biopsy or emergency surgery | 0.3 μg/kg (IV, SC) | 30–60 min | 6–12 hours | Tachyphylaxis |
| 300 μg (Intranasal) | 60–90 min | 6–12 hours | |||
| q 12–24 hour x 4–5 doses | |||||
| Conjugated estrogens | Chronic, recurrent bleeding or before elective surgery, esp. from uremia | 0.6 mg/kg IV infusion or 50 mg po q day x 5–7 days | 7 days | 2 weeks | Use for < 7 days |
| Antifibrinolytic agents | Intractactable mennorhagia, oral bleeding or GI bleeding | Aminocaproic acid: 5 g IV over 1 hour *f/b 1 g/h infusion for 8 hours | 30 min | 2–4 hours after discontinuation | Enters the extravascular or GI bleeding compartments; |
| or 5 g po x 1 f/b 1 gm po hourly for 8 hours | 1.5 hours | Renal clearance; contraindicated in DIC and with | |||
| Tranexamic acid (TA): 10–15 mg/kg body weight po or IV q 8 hours | 30–60 min | hematuria; TA not available in US | |||
| Aprotonin | Coronary bypass surgery | Test dose of 1.4 mg f/b 140 or 280 mg load f/b 140 or 280 mg pump prime dose f/b 35 or 70 mg/hr intra-operative infusion | 15 min | Hours after discontinuation | Requires central line; monitor for thrombosis |
| Recombinant activated factor VII | Hemophilia-related inhibitors; other uses are off-label | 90 (50–100) μg/kg IV bolus every 2 hours or as needed | Immediately | 2 hours | Monitor for thrombosis |