Gordox is a drug that has antifibrinolytic, antiproteolytic and hemostatic effects.
Release form and composition
The dosage form of Gordox is a concentrate for preparing a solution for intravenous administration.
The active ingredient of the drug is aprotinin. In 1 ml of it contains 10 000 KIE (units of obstruction of kallikrein), sold in 10 ml ampoules, i.e. containing 100 000 KIE.
Auxiliary substances of the drug are benzyl alcohol, sodium chloride, and injectable water.
Indications for use
According to the instructions to Gordoks, the drug is intended:
- For the treatment of primary hyperfibrinolytic hemorrhage: post-traumatic and postoperative (especially during surgical interventions on the lungs and prostate gland);
- To reduce bleeding and reduce the need for blood products during open heart surgery, including coronary artery bypass surgery;
- For the treatment of pancreatitis (acute and chronic exacerbations), pancreatic necrosis;
- For the prevention of postoperative pulmonary embolism and bleeding;
- To prevent massive bleeding during extracorporeal circulation;
- For the prevention of fat embolism in multiple injuries, especially fractures of the skull and lower extremities;
- For the treatment of shock of any genesis: traumatic, toxic, hemorrhagic, burn.
In addition, Gordoks apply
- With extensive and deep traumatic tissue damage;
- When conducting diagnostic operations on the pancreas.
The use of Gordox is contraindicated:
- With increased sensitivity to aprotinin;
- During pregnancy, especially in the I and III trimesters;
- During lactation.
It is possible to use the drug, but with extreme caution and under close supervision of doctors with:
- A history of indications of allergic reactions;
- Repeated use of aprotinin;
- Deep hypotheses;
- Cardiopulmonary bypass operation (using the heart-lung machine and pulmonary ventilation);
- Circulatory arrest.
Dosing and Administration
According to the instructions to Gordoks, the drug is intended for slow intravenous administration only in the supine position.
No less than 10 minutes before the scheduled use of Gordox, a test dose (1 ml) must be administered to determine the sensitivity to aprotinin.
The initial therapeutic dose of the drug is 50 000 KIE, which is administered at a rate of not more than 5 ml / minute. Next, the solution is injected intravenously at 50 000 KIE per hour.
For hemorrhages and bleeding associated with hyperfibrinolysis, the drug is prescribed in a dose of 100-200 thousand KIE, depending on the intensity of bleeding, if necessary, the dosage is increased to 500 thousand KIE.
In the treatment of primary hyperfibrinolytic hemorrhage, Gordox is administered intravenously at a rate of up to 5 ml per minute in a dose: for adults - 500 thousand KIE, for children - 20 000 / kg / day.
In order to prevent blood loss during surgical interventions, the drug is used before, during and after surgery. It is administered in a dose of 200-400 thousand KIE intravenously, drip or slow, then for another 2 days, 100 thousand KIE each.
In acute pancreatitis, the drug is started to be applied at a dose of 500 thousand – 1 million KIE, then it is reduced to 50–300 thousand KIE within 2–6 days. Treatment is stopped after the disappearance of enzyme toxemia.
During exacerbation of chronic pancreatitis, Gordox is administered once a day at a dose of 25-50 thousand KIE, the course of treatment is from 3 to 6 days.
For disorders of hemostasis in children, Gordox is prescribed at the rate of 20,000 KIE per kilogram of body weight per day. It is possible and local use of the drug - gauze, soaked in a solution (100 thousand KIE), applied to the site of bleeding.
To reduce blood loss and reduce the need for blood products in cardiac surgery, Gordox is gradually added to the fluid that fills the oxygenator. In the course of a standard operation, the patient produces approximately 5 million ETC. Aprotinin.
Possible side effects of Gordox:
- Creation confusion, hallucinations, psychotic reactions;
- Myocardial ischemia, pericardial effusion, thrombosis / occlusion of the coronary arteries, thrombosis, myocardial infarction;
- Impaired renal function.
With the rapid introduction of possible nausea and vomiting, with prolonged or repeated administration at the injection site may develop thrombophlebitis.
Allergic reactions are sometimes noted: itching, urticaria, conjunctivitis, rhinitis, bronchospasm, anaphylaxis, anaphylactoid reactions or anaphylactic shock, potentially life-threatening.
It is important to note that in patients who receive aprotinin for the first time, the development of allergic / anaphylactic reactions is unlikely. When reintroduced, if no more than 6 months have passed since the last application of Gordox, the risk increases to 5%, if more than half a year has passed, the probability is 0.9%. The risk of severe reactions increases if during the last 6 months aprotinin is used more than two times. It is worth noting that even if the second use of Gordox was not accompanied by allergic reactions, the third administration can lead to the development of severe reactions or anaphylactic shock, possibly fatal.
In hyperfibrinolysis and DIC (disseminated intravascular coagulation) syndrome, aprotinin can be used only against the background of adequate heparin therapy.
With the same active ingredient, the following drugs are manufactured: Aprotex, Aerus, Vero-Narcap, Ingiprol, Ingitril, Kontrikal, Trasilol 5000000.
Terms and conditions of storage
Gordox is a medicinal product sold by prescription.
According to the instructions, ampoules should be stored in a dark place at temperatures up to 30 ºC. The shelf life of the solution under these conditions is 5 years.