Hemase - instructions for use, analogs, reviews and release forms (injections in ampoules for injection 5000 IU) drugs for the treatment of myocardial infarction, hemophthalmia, eye hemorrhages in adults, children and pregnancy. Composition

In this article, you can read the instructions for using the drug Gemase. Presented are the opinions of visitors to the site - consumers of this medication, as well as the opinions of medical experts on the use of Gemaza in their practice. A big request is to actively add their feedback on the drug: the medicine helped or did not help get rid of the disease, which were observed complications and side effects, possibly not declared by the manufacturer in the annotation. Analogues of Gemase in the presence of existing structural analogues. Use for the treatment of myocardial infarction, hemophthalmia, eye hemorrhages in adults, children, as well as during pregnancy and lactation. Composition of the preparation.

Gemase - a thrombolytic agent that is a serine protease in the form of a single-chain molecule with a molecular weight of 54,000 daltons, consisting of 2 polypeptide chains with molecular masses of 20 and 34 thousand Da, which are connected by a disulfide bridge. Specifically stimulates the conversion of profibrinolysin (plasminogen) to fibrinolysin (plasmin), an enzyme capable of lysing fibrin clots.

Composition

Prourokinase recombinant + excipients.

Indications

For intravenous administration:

• occlusion of coronary vessels (acute myocardial infarction).

For the introduction of subconjunctival, parabulbar, into the anterior chamber of the eye, intravitreal:

• hyphema, hemophthalmus;
• preretinal, subretinal and intra-retinal hemorrhages;
• fibrinoid syndrome of different genesis;
• occlusion of the central artery of the retina and its branches;
• thrombosis of the central vein of the retina and its branches;
• prevention of adhesions in the postoperative period with antiglaucoma operations.

Forms of release

Liofilizate for the preparation of solution for injection 5000 IU (injections in ampoules).

Other dosage forms, be it eye drops or tablets, do not exist.

Instructions for use and dosing regimen

The contents of 1 ampoule must be diluted in 0.5 ml of saline. The resulting solution is used in ophthalmology parabulbar and subconjunctival, as well as introduction into the anterior chamber of the eye. Duration of treatment - up to 10 injections.

For washing the anterior chamber of the eye with hyphema or massive fibrin efflorescence, 1 ampoule should be diluted in 1 ml of saline, after which 0.2 ml or 0.1 ml of the resulting solution is again diluted to 0.5 ml with saline. With intravitreal administration, 1 Gemase ampoule is diluted according to the instructions in 1 ml of saline solution, after which 0.1-0.2 ml of saline is added to 0.1 ml of the resulting solution. The resulting ready-made solution is once administered intravitreally.

With the exhalation of fibrin and hyphema, parabulbar or subconjunctival administration of the drug is used.

With occlusal lesions of the optic nerve and retina, hemorrhages in the retina or vitreous, parabulbar injection is recommended.

With fibrinoid syndrome and hemophthalmia of various etiologies, it is possible to use intramuscular Gemase in ophthalmology.

For preventive purposes, from the adhesive process after antiglaucoma operations, 1 ampoule of the drug is diluted in a ratio, as for subconjunctival use.It takes from one to three injections of the solution obtained in the early postoperative period.

Side effect

• skin manifestations, as well as edema and hyperemia of the facial skin on the side of the drug administration;
• allergic tenonitis (chemosis, conjunctival hyperemia, decreased mobility of the eyeball);
• a decrease in blood pressure;
• bleeding of varying severity from puncture sites and surgical incisions.

Contraindications

• tendency to hemorrhage (including hemorrhagic diathesis, hemophilia, thrombocytopenia, etc.);
• increased risk of bleeding (GI bleeding up to 4 weeks, extensive surgery or extensive trauma up to 4 weeks, intracranial or intraspinal interventions up to 8 weeks old, head trauma up to 4 weeks);
• resuscitation (including cardiopulmonary resuscitation for more than 10 minutes);
• liver disease with a marked violation of the hemostasis system;
• puncture of large vessels (eg, subclavian vein);
• diabetic hemorrhagic retinopathy;
• a condition after a hemorrhagic stroke (including in the anamnesis);
• increase systolic blood pressure to 180 mm Hg. and above or diastolic blood pressure to 110 mm Hg. and higher;
• cardiogenic shock (class 4 according to Kiplip);
• suspicion of aortic aneurysm stratification;
• septic endocarditis;
• pregnancy;
• hypersensitivity to prourokinase.

Application in pregnancy and lactation

The drug Hemaz is contraindicated in pregnancy.

Use in children

Not noted.

special instructions

With the development of hypotension (systolic blood pressure less than 90 mmHg) and bradycardia (heart rate less than 50 bpm. / Min) suspension recommended administration to normalization of blood pressure and heart rate. Cross-reactions with streptazoy-streptokinase and allergic sensitization at streptococcal usually does not arise.

In carrying out surgical interventions on the background of Gemazy to reduce bleeding risk is recommended intramuscular etamzilata at a dose of 250-500 mg.

Drug Interactions

While the use of prourokinase Aspirin and anticoagulants increases the risk of bleeding.

With caution apply Gemase in combination with other thrombolytic agents.

Analogues of the drug Gemase

Structural analogs for the active substance:

• Prourokinase recombinant;
• Puroolase.

Analogues on the pharmacological group (fibrinolytic drugs):

• Aveliesin Brown;
• Actylase;
• Alteplase;
• Metalase;
• Ophthalmic films with fibrinolysin;
• Prourokinase recombinant;
• Puroolase;
• Streptase;
• Streptokinase;
• Thrombovazim;
• Thromboflux;
• Ukidan;
• Urokinase medak;
• Fibrinolysin;
• Fortylysine;
• Eberkinaza (recombinant streptokinase).

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