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Indications and Dosage
Intravenous
Prophylaxis of thromboembolism associated with surgical and obstetric procedures, Thromboembolic disorders Adult: In patients with hereditary antithrombin (AT) III deficiency: Doses are individualised and calculated according to prescribed formula (refer to detailed product guideline). Loading: Dose targeted to achieve 120% of normal AT level. Maintenance: Dose targeted to achieve 80-120% of normal AT level given 24 hourly as needed. All doses are given via infusion over 10-20 minutes.
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Reconstitution
Add 10 mL or 20 mL of sterile water for inj to a vial labelled as containing 500 international units or 1,000 international units, respectively. Direct the stream of diluent against the vial wall to minimise foaming, gently swirl to dissolve completely.
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Special Precautions
May carry a risk of transmitting infectious agents (e.g. HCV, HBV, Creutzfeldt Jakob disease agents). Pregnancy and lactation.
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Adverse Reactions
Significant: Hypersensitivity reactions (e.g. anaphylaxis).
Cardiac disorders: Chest pain. Gastrointestinal disorders: Dysgeusia, nausea, abdominal cramps. General disorders and administration site conditions: Chills, fever. Immune system disorders: Hives. Nervous system disorders: Headache, dizziness, lightheadedness. Vascular disorders: Flushing, haematoma. |
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IV/Parenteral: C (manufacturer specific), B (manufacturer specific)
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Monitoring Parameters
Monitor AT level at baseline, then 20 minutes (peak) and 12-hour post-infusion (during loading dose); every 24 hours as needed (during maintenance dose). Measure peak and trough AT levels with each subsequent dose until desired levels are achieved. Monitor vital signs, cardiac and CNS status during and after therapy.
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Drug Interactions
May enhance anticoagulant effect and increase the risk of bleeding complications with heparin.
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Action
Description:
Mechanism of Action: Antithrombin III is an α2-globulin which is the major exogenous inhibitor of in vivo coagulation. It inactivates thrombin, plasmin, and activated coagulation factors IXa, Xa, XIa, and XIIa, preventing the conversion of fibrinogen to fibrin, thereby inhibiting thrombus formation. Additionally, it is the cofactor through which heparin exerts in effect. Pharmacokinetics: Distribution: Distributed into plasma (39%), extravascular space (49%), and vascular endothelial cells (11%). Metabolism: Metabolised (<5%) to low molecular weight breakdown products. Excretion: Via urine (as complexes of antithrombin III with thrombin or other proteinases). Terminal half-life: Biphasic; 2.5-4.8 days. |
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Storage
Store below 25°C. Do not freeze. Protect from light.
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ATC Classification
B01AB02 - antithrombin III ; Belongs to the class of heparin group. Used in the treatment of thrombosis.
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References
Anon. Antithrombin III. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 24/05/2023. Anon. Antithrombin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 24/05/2023. Buckingham R (ed). Antithrombin III. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 24/05/2023. CSL Behring (NZ) Limited. Thrombotrol-VF 1,000 IU Powder and Diluent for Solution for Injection data sheet 22 November 2018. Medsafe. http://www.medsafe.govt.nz. Accessed 24/05/2023. Kybernin P (CSL Behring). MIMS Indonesia. http://www.mims.com/indonesia. Accessed 24/05/2023. Thrombate III (Human) (Grifols Therapeutics, Inc.). MIMS Hong Kong. http://www.mims.com/hongkong. Accessed 24/05/2023. Thrombate III (Human) (Grifols USA, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 24/05/2023.
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