Gemaza lyophilisate for injection 5000me ampoules №5

Lyophilisate for solution for injection

Adverse reactions

There may be an allergic reaction, which is expressed in swelling and flushing of the skin of the face on the side of drug administration, symptoms of allergic tenonitis (chemosis, conjunctival hyperemia, reduced mobility of the eyeball).

Drug Interactions

The combined use of the drug with proteolytic agents has shown that combining the drug "Gemaza®" with injections of collalisin is impractical. The combination of the drug "Gemaza" with other thrombolytics should be used with caution. Perhaps the combined use of solutions of the drug "Gemaza" and Emoxypine, as well as the drug "Gemaza" and Dexamethasone.

Overdosage

With the local administration of the drug "Gemaza" in doses of 5000 ME, there is no risk of systemic bleeding.

With an overdose of the drug, that when using the recommended doses (up to 5000 IU once) is unlikely, a recurrence of intraocular hemorrhage is possible.
With a single dose of the drug in excess of 5000 IU, the risk of allergic reactions indicated in the side effects increases.

In case of overdose of the drug and during surgical interventions on the background of the course of treatment with the drug "Gemaza" to reduce the risk of hemorrhage, the general use of etamzilat in injections of 250-500 mg intramuscularly is recommended.

Storage conditions

In the dark, out of reach of children at a temperature of from 2 to 20 ° C.

Packaging

5 amp.

Mechanism of action

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

Indications and usage

The drug "Gemaza" is used in ophthalmology for the treatment of the following pathology:

• hyphema, hemophthalmus;

• preretinal, subretinal and intraretinal hemorrhages;

• fibrinoid syndrome of various origins;

• occlusion of the central retinal artery and its branches;

• thrombosis of the central retinal vein and its branches;

• prevention of adhesions in the postoperative period with antiglaucomatous
  operations;

Contraindications

Tendency to bleeding (including hemorrhagic diathesis, hemophilia, thrombocytopenia, etc.), increased risk of bleeding (gastrointestinal bleeding up to 4 weeks old, extensive surgical intervention or extensive trauma older than 4 weeks, intracranial or intracranial cerebral interventions up to 8 weeks, head injury up to 4 weeks), resuscitation (including cardiopulmonary resuscitation for more than 10 minutes), liver disease with severe hemostasis, puncture of large vessels (eg Vienna-lingual), diabetic retinopathy haemorrhagic condition after hemorrhagic stroke (including history) increase in systolic blood pressure to 180 mm Hg and higher or diastolic blood pressure up to 110 mm Hg. and above, cardiogenic shock (class IV according to Killip), suspicion of dissection of an aortic aneurysm, septic endocarditis, pregnancy, hypersensitivity to prourokinase.

Dosage and administration

The contents of 1 ampoule of the drug "Gemaza" diluted in 0.5 ml of 0.9% sodium chloride solution. The resulting solution contains a dose corresponding to 5000 ME. The drug is administered parabulbarno or subconjunctival up to 10 injections per course.
To flush the anterior chamber of the eye with massive fibrin effusion into the anterior chamber or hyphema, the lyophilized substance (5000 ME) is diluted in 1 ml of 0.9% sodium chloride solution, after which 0.2 ml (1000 ME) or 0.1 ml (500 ME) of the resulting solution and diluted with 0.5 ml of 0.9% sodium chloride solution.

For intravitreal administration of 5,000 IU of lyophilisate, it is diluted in 1 ml of 0.9% sodium chloride solution, 0.1 ml (500 IU) of the resulting solution is taken and diluted with 0.1-0.2 ml of 0.9% sodium chloride solution. The resulting volume (0.2-0.3 ml) is administered intravitreal once.

In the presence of hyphema and effusion of fibrin after cataract extraction, subconjunctival or parabulbar administration of the preparation Gemaza is recommended, as well as introduction into the anterior chamber.In case of hemorrhages in the vitreous body, retina, occlusive lesions of retinal vessels and optic nerve, parabulbar administration of the preparation Hemaza is indicated. With hemophthalmia of various etiology and fibrinoid syndrome, intravitreal administration of the drug is possible.

For prophylaxis of adhesions in the postoperative period with antiglaucomatous operations, the drug Gemaza is diluted in the ratio specified for subconjunctival injections and injected into the filtration bag in the early postoperative period in the amount of 1-3 injections (at the discretion of the surgeon).

Gemaza Lyophilisate