Etamsylate: Indication, Dosage, Side Effect, Precaution

This information is not country-specific. Please refer to the Indonesia prescribing information.

Generic Medicine Info

Indications and Dosage

Oral
Menorrhagia

Adult: For primary cases: 500 mg tid for 10 days, starting 5 days before the onset of menstruation. Alternatively, 500 mg 4 times daily during menses. For intrauterine-device (IUD)-induced cases: 500 mg tid for 10 days, starting 5 days before the onset of menstruation.

Oral
Diffuse perioperative haemorrhage

Adult: Prophylaxis and treatment: Preoperative: 500 mg given 1 hour prior to surgery. Postoperative: 500 mg 4-6 hourly as long as bleeding risk persists.

Parenteral
Diffuse perioperative haemorrhage

Adult: Prophylaxis and treatment: Preoperative: 250-500 mg given 1 hour prior to surgery, additional doses may be necessary during operation. Postoperative: 250 mg bid. Alternatively, up to 250-500 mg 4-6 hourly may be given as long as bleeding risk persists. Doses are given via IV or IM.

Parenteral
Acute capillary haemorrhage

Adult: Prophylaxis and treatment: 500-750 mg tid via IV or IM.

Administration

May be taken with or without food. May be taken w/ meals to minimise GI upset.

Contraindications

Hypersensitivity to etamsylate. Known hypersensitivity to sulfites, bronchial asthma; acute porphyria. Lactation.

Special Precautions

Patient with hypotension or unstable blood pressure. Pregnancy.

Adverse Reactions

Significant: Hypotension (parenteral). Rarely, severe hypersensitivity reaction, including anaphylaxis.
Blood and lymphatic system disorders: Parenteral: Rarely, neutropenia, agranulocytosis, thrombocytopenia.
Gastrointestinal disorders: Nausea, vomiting, diarrhoea, abdominal pain or discomfort.
General disorders and administration site conditions: Asthenia (parenteral). Rarely, fever.
Musculoskeletal and connective tissue disorders: Rarely, arthralgia.
Nervous system disorders: Headache.
Skin and subcutaneous tissue disorders: Rash.
Vascular disorders: Rarely, thromboembolism (parenteral).

Action

Description:
Mechanism of Action: Etamsylate is an antihaemorrhagic and vasoprotective agent. It increases platelet adhesiveness and capillary vascular wall resistance, thereby reducing capillary exudation and blood loss.
Synonym: ethamsylate.
Pharmacokinetics:
Absorption: Slowly and completely absorbed from the gastrointestinal tract. Time to peak plasma concentration: Approx 4-5 hours.
Distribution: Crosses the placenta and enters breast milk. Volume of distribution: 86.6 L. Plasma protein binding: Approx 90-95%.
Excretion: Via urine (approx 72% as unchanged drug). Elimination half-life: Approx 3.7-9.4 hours (oral); 2 hours (IV).

Chemical Structure

Storage

Tab: Store between 15-25°C. Parenteral: Store below 30°C. Protect from light.

MIMS Class

Haemostatics

ATC Classification

B02BX01 - etamsylate ; Belongs to the class of other systemic hemostatics. Used in the treatment of hemorrhage.

References

Anon. Etamsylate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/03/2021.

Buckingham R (ed). Etamsylate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/03/2021.

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