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drotrecogin alfa (activated)

B01AD10

Forms & Strengths

Intravenous powder for injection: 5 mg
Intravenous powder for injection: 20 mg

Adult Dosing

Severe sepsis with high risk of death: 24 mcg/kg/hr as a continuous intravenous infusion for a total duration of 96 hours
Initiation of infusion should be linked to organ dysfunction secondary to severe sepsis
Note: Withdrawn from the global market due to lack of efficacy in clinical trials (PROWESS-SHOCK)

Pediatric Dosing

Safety and efficacy have not been established in pediatric patients
Not recommended for use in children

Indications

Reduction of mortality in adult patients with severe sepsis associated with acute organ dysfunction (historically indicated, withdrawn)

Mechanism of Action

Recombinant form of human activated protein C
Exerts antithrombotic effects by inactivation of activated forms of coagulation factors V and VIII
Exerts anti-inflammatory effects by inhibiting tumor necrosis factor production and limiting leukocyte adhesion

Contraindications

Active internal bleeding
Conditions with high risk of bleeding (e.g., recent hemorrhagic stroke, intracranial surgery, severe head trauma)
Known hypersensitivity to drotrecogin alfa or product components
Epidural catheter in place

Adverse Reactions

Bleeding (major adverse effect, including intracranial hemorrhage)
Hypersensitivity reactions including anaphylaxis
Ecchymosis and injection site reactions

Drug Interactions

Anticoagulants (e.g., heparin, warfarin): Increased risk of severe bleeding
Antiplatelet agents (e.g., aspirin, clopidogrel, NSAIDs): Increased risk of bleeding complications
Thrombolytic agents: Concomitant use significantly increases the risk of hemorrhage

Curated Content: Needs Vetting Before Put to Clinical Use