Recombinant Factor VIIa

INDICATIONS:  Treatment of bleeding in Hemophilia patients.

LIKELY TO BE OF BENEFIT IN :  Patients with thrombocytopenia, Functional platelet defects, Surgical bleeding situations with dilutional or consumptive coagulopathies , Patients with impaired liver function.

MECHANISM OF ACTION : Enhance thrombin generation on activated platelets.

DOSE :  70-90 microgram/Kg OR on a non-weight basis- 4.8 mg vial to an adult [50-100 kg wt]
CLINICAL SITUATIONS :Patients receiving anticoagulant therapy : to reverse the effect of warfarin and other vitamin K antagonists, especially when treatment with vit-K alone has been found to be insufficient. DOSE - 1.2 mg or 20 microgram/ Kg

Patients with impaired liver function : Procedures like laparoscopic liver biopsy can be performed safely when it is contraindicated due to coagulopathy.

Patients with hemorrhagic stroke : Efficacy not clearly proven.

SIDE EFFECTS:  Thrombotic complications like DVT , CVA , M.I.,Pulmonary embolism ,Arterial Thrombus , Clotted devices.

CAUTION IN:  Patients with history of thrombotic complications , factor V Leiden , antiphospholipid syndrome , excessive bleeding in the setting of DIC, situations where there is generalised activation of the coagulation system e.g. Patients on ECMO and Ventricular Assist Devices.

AVOID IN: Patients being treated with activated Prothrombin complex.