Kontrykal - a drug with antiproteolytic, hemostatic effect.
Release form and composition
Contrykal is produced in the form of a lyophilisate for preparing a solution for intravenous and intracavitary administration (5 bottles in blister packs, 2 packs in a carton bundle complete with solvent (10 ampoules)).
The composition of 1 bottle includes:
- Active substance: aprotinin - 10 thousand ATRE;
- Auxiliary component: mannitol.
Solvent: isotonic solution of sodium chloride - 2 ml.
Indications for use
- Pancreatitis (acute, exacerbation of chronic), pancreatonecrosis. Conducting operations and diagnostic studies on the pancreas (prevention of the development of enzymatic autolysis of the pancreas during operations on it and adjacent abdominal organs);
- Bleeding due to hyperfibrinolysis: postoperative (especially during operations on the lungs, prostate gland), post-traumatic, before, during and after childbirth (including amniotic fluid embolism), polymenorrhea;
- Shock (traumatic, toxic, hemorrhagic, burn);
- Deep and extensive traumatic tissue damage.
As an adjunct therapy, Contrycal is used:
- Massive bleeding (during thrombolytic treatment);
- Coagulopathy, characterized by secondary hyperfibrinolysis (in the initial phase, before the onset of the effect after the application of heparin and replacement of coagulation factors);
- Extracorporeal circulation.
Also, the drug is prescribed for the prevention of acute nonspecific postoperative mumps, postoperative pulmonary emboli and bleeding, fat embolism with polytrauma, especially for fractures of the skull and lower extremities.
- DIC syndrome (except the phase of coagulopathy);
- 1st and 3rd trimesters of pregnancy and breastfeeding (lactation);
- Hypersensitivity to the components of the drug and to the protein of cattle.
Dosing and Administration
The drug is administered intravenously, streamed, in the prone position (slowly, maximum speed - 5 ml per minute) or drip (long or short).
Patients with acute necrosis of the pancreas and effusion containing enzymes, the drug is injected intraperitoneally into the abdominal cavity.
Before use, the contents of 1 bottle must be dissolved in 2 ml of isotonic sodium chloride solution.
As a rule, the following dosing regimens are prescribed:
- Acute pancreatitis: intravenously slowly - 200-300 thousand ATRE (150376-225564 KIE), then the same dose within a day intravenously drip. Therapy is carried out before normalization of the clinical picture of the disease and indicators of laboratory tests;
- Bleeding: the initial dose is 300 thousand ATRE (225564 KIE), subsequent - 140 thousand ATRE (105263 KIE) every 4 hours intravenously slowly;
- Shock states: intravenously slowly, the initial dose - 200-300 thousand ATRE (150376-225564 KIE) Kontrikala, then - 140 thousand ATRE (105263 KIE) every 4 hours;
- Prevention of postoperative pancreatitis: as an auxiliary treatment - intravenously slowly, 200 thousand ATRE (150,376 KIE) per day;
- Prevention of fat embolism: intravenously slowly, the initial dose - 200 thousand ATRE (150376 KIE), then the drug is used daily intravenously slowly in the same dose as an auxiliary treatment.
Contrycal is administered to children at a dose of 14 thousand APre / kg per day.
During therapy may develop disorders of some body systems:
- Cardiovascular system: tachycardia and / or arterial hypotension;
- The digestive system: with a quick introduction - vomiting, nausea;
- Central nervous system: hallucinations, psychotic reactions, confusion;
- Allergic reactions: urticaria, myalgia, skin rash, rhinitis, bronchospasm, conjunctivitis, symptoms of anaphylactic reactions up to the development of anaphylactic shock (most often they appear after repeated infusions of Kontrikala);
- Local reactions: with prolonged infusion - thrombophlebitis.
Before starting treatment, it is desirable to conduct skin tests that determine the patient's individual sensitivity to aprotinin.
In case of indications of a history of allergic reactions, it is recommended to prescribe histamine H1 receptor blockers and glucocorticosteroids before starting to use Kontrikal.
With DIC and hyperfibrinolysis, Contrycal can be used only after elimination of all manifestations of DIC and simultaneously with the prophylactic effect of heparin.
Kontrykal should be used with caution in patients who were injected with muscle relaxants within the previous 2-3 days.
Adding aprotinin to heparinized blood may increase the clotting time of whole blood.
At simultaneous use of Kontrikal with reomacrodex, mutual sensitizing action is possible.
Depending on the dose, aprotinin can inhibit the action of urokinase, streptokinase, alteplase.
Aprotinin is a weak serum pseudocholinesterase inhibitor. With the simultaneous use of a possible slowdown in the metabolism of Suxamethonia chloride and increased muscle relaxation, there is also a risk of developing apnea.
Terms and conditions of storage
Keep out of reach of children at temperature up to 25 ° C.
Shelf life - 3 years.