This is an automatically translated article.
The Polish drug cyclonamine is effective in preventing bleeding in surgery. Cyclonamine is used until there is no risk of bleeding, while Cyclonamine syringes are used in bleeding emergencies. The following article will provide detailed information about the best uses of cyclonamine, as well as how to use cyclonamine medicine.
1. What is cyclonamine?
Cyclonamine has the brand name Etamsylate, which is prepared in the form of 250 mg tablets or 250mg/2ml injection solution. Is a product of Pharmaceutical Manufacturing Cooperative Galena - Poland.
Each Cyclonamine tablet contains: active ingredient Etamsylate - 250mg In addition, there are other excipients, including: Microcrystalline Cellulose 18 mg, Potato Starch 9 mg, Magnesium Stearate 7 mg, Anhydrous Colloidal Silica 7 mg, Sodium Starch Sodium Metabisulfite 0.3 mg. Glycolate (type A) 9 mg.
Each 2ml Cyclonamine syringe contains: Etamsylate - 250mg Excipients: Sodium metabisulfite, Anhydrous sodium sulphite, distilled water for injection
Cyclonamine has hemostatic effect and shortens bleeding time, increases platelet count. The composition acts on the vessel wall, increasing the strength and reducing the permeability of the capillary wall. The drug reduces the brittleness and fragility of capillaries, which is demonstrated by a reduction in the number of new hemorrhagic spots under the skin and mucous membranes. The drug does not cause excessive blood clotting and has no vasoconstrictor effect, and therefore does not increase the risk of thrombosis. Cyclonamine has no effect in bleeding conditions due to deficiency of plasma coagulation factors and has no effect on hemostasis from large vessels.
Cyclonamine well absorbed orally
Absorption: The drug is well absorbed from the oral route. After oral administration of 500 mg, the maximum concentration (60 pmol/L) is reached 4 hours after dosing. Distribution: The drug is bound to plasma proteins to about 95%. Elimination: The drug is eliminated unchanged by the kidneys up to 80%. Orally, the half-life of the drug is 8 hours. Cyclonamine parenteral
Absorption: 1 hour after intravenous or intramuscular administration of 500 mg Etamsylate, peak plasma concentrations reached 30 mcg/ml. The plasma half-life after intravenous administration is 1.9 hours and after intramuscular injection is 2.1 hours. Distribution: The drug is up to 95% bound to plasma proteins. The drug passes into breast milk. Elimination: Etamsylate is eliminated mainly unchanged in the urine (>80%).
2. What are the uses of Cyclonamine?
2.1. Cyclonamine Cyclonamine has the ability to reduce bleeding time and limit blood loss by increasing platelet aggregation and restoring capillary strength.
Published studies have shown that etamsylate acts to increase membrane p-selectin expression, which plays an important role in the formation of platelet aggregation, other membrane proteins associated with membrane P-selectin , not taking into account the PSGL-1 protein on the surface of leukocytes, and membrane p-selectin which also plays a role in platelet interaction and aggregation. Etamsylate also increased PSGL-I expression without platelet activation. Depending on the dose and amount used for the patient, the drug will act to increase the aggregation of platelets and white blood cells only at the damaged sites on the vessel wall, thereby creating an interaction between the 3 components of the blood: leukocytes, platelets, and epithelium. This is the mechanism underlying the balanced anti-bleeding effect of etamsylate without the increased risk of thrombosis.
Another hypothesized mechanism: The mechanism of increased capillary strength is due to the antagonism of Etamsylate with a component that increases the synthesis of long-term glycosaminoglycan chains (hyaluronidase). Etamsylate inhibits prostaglandin synthesis but does not affect cyclooxygenase activity. This hypothesis is supported by studies showing a decrease in prostacyclin and its metabolite thromboxane following administration of etamsylate. Etamsylate inhibits platelet aggregation by epinephrine, a mechanism dependent on prostacyclin activation. The efficacy of etamsylate in the treatment of intraventricular bleeding is related to a decrease in the synthesis of thromboxane A2 and prostacyclin. Studies have shown that the effect on prostaglandin synthesis is not related to inhibition of the enzyme cyclooxygenase. The mechanism of inhibition of prostaglandin synthesis is partly related to the action of etamsylate but is not the predominant mechanism. Anti-inflammatory and antioxidant effects of etamsylate have also been suggested.
Etamsylate has no significant effect on cerebral blood circulation. This is contrary to the scientific view of the primary cause of the protective effect on periventricular bleeding.
The effect of Etamsylate on increasing platelet count has not been clearly established. Cyclonamine has no effect on the chain components of the coagulation reaction as demonstrated by no change in prothrombin time following cyclonamine administration.
Etamsylate does not cause vasoconstriction, fibrinolysis is not affected as well as the conversion of coagulation factors or does not stop bleeding from large vessels.
Etamsylate is particularly active against hydroxyl radicals (OH.), which are eliminated at therapeutic concentrations of Etamsylate (0.1–10 μM). Higher concentrations of Etamsylate are required to scavenge superoxide radicals. Etamsylate enhances human platelet aggregation and ATP release induced by arachidonic acid, thromboxane A2, collagen and calcium ionophore A23187.
Etamsylate reduces mean bleeding time when administered systemic or orally to rabbits. Intravenously, Etamsylate halves bleeding time at doses >5 mg/kg. The effect begins 5 minutes after injection, reaches a maximum from 30 minutes to 4 hours after injection, and disappears after 6 hours. Following oral administration, the same maximal effect was also observed at a dose of 10 mg/kg. The effectiveness of Etamsylate to reduce intraventricular hemorrhage is associated with decreased biosynthesis of thromboxane A2 and prostacyclin. Oral etamsylate (>25 mg/kg) also inhibited carrageenan-induced paw edema.
It has a hemostatic effect by acting on the first step of hemostasis by improving platelet adhesion and restoring capillary resistance. It reduces bleeding time and increases platelet aggregation. It reduces capillary bleeding when the platelet count is adequate. The drug has an antihyaluronidase effect and improves the stability of the capillary walls. It inhibits PGI-2 synthesis and regulates abnormal platelet function.
2.2 Indications for taking Cyclonamine Injections
Short-term treatment of blood loss due to polymenorrhea Prevention and reduction of the risk of blood loss due to surgery Prevention and treatment of periventricular hemorrhage in neonates with crutch weight less than 1500 g Bleeding due to thin capillaries In surgery in general or in specialties (ENT, ophthalmology, gynecology) with the aim of: Reducing blood loss during surgery, especially in case of bleeding veins and patients on anticoagulant therapy. Oral medicine
In surgery: Prevention and treatment of capillary bleeding before and after surgery with surgeries affecting vascular tissues: ENT, maxillofacial, plastic surgery, obstetrics, gynecology, urology... In gynecology: after excluding the cause of the disease such as bleeding between menstrual periods, excessive bleeding during menstruation, bleeding due to the IUD... 2.3. You are allergic to any ingredient of the drug Cyclonamine Porphyria is an inherited disorder caused by the accumulation of certain chemicals related to hemoglobin, the protein of red blood cells. Women with uterine fibroids (abnormal growth in the uterus). 2.4. Undesirable effects of cyclonamine Etamsylate is a safe drug, side effects rarely occur. When using the drug can occur headaches, allergic skin reactions, rarely nausea.
Cyclonamine tablets contain sulphites with an antioxidant role that may cause allergic reactions, nausea and diarrhea in susceptible patients. Allergic reactions can lead to anaphylaxis or cause life-threatening asthma. The probability of experiencing these side effects is small, but not nonexistent. However, hypersensitivity to sulfates is more common in asthmatic patients than in other patients.
These side effects can occur, but are not always present and are not the same for many people. Some side effects can be rare but serious. Consult your doctor if you observe the following side effects, especially if they do not go away.
With injections there are slightly more side effects, including:
Inflammation of the veins of the veins Flushing of the face Cardiovascular failure Sweating Injection site reactions Bronchospasm Risk of arterial thrombosis Skin changes bluish 2.5. Interactions with other drugs The interaction of oral etamsylate is unknown, Thiamine (vitamin B1) is inactivated by the sulphites contained in Cyclonamine tablets.
If dextran infusion is required, Cyclonamine must be administered first.
3. How to use Cyclonamine
Oral drugs:
Recommended dose: A day should be from 250 mg x 2 times to 500 mg x 3 times until bleeding stops. In the treatment of menorrhagia: 250mg a day. Increase dosage to 500mg if necessary depending on the condition of the patient. In case of persistent menorrhagia: 500mg 3 times a day starting 5 days before menstruation and continuing up to 5 days after menstruation. Children: 1/2 adult dose. Injection route:
Short-term treatment of blood loss due to polymenorrhea: take 1 to 2 tablets each time x 4 times in a day, during menstruation. Prevention and reduction of the risk of surgical blood loss: Intramuscular or intravenous injection in an adult dose of 250 to 500 mg, this dose may be repeated in 4 to 6 hours if needed. Prevention and treatment of periventricular hemorrhage in neonates weighing less than 1500 grams: 12.5 mg/kg body weight intravenously or intramuscularly within 1 hour after birth, then repeated once for 4 days until the total dose is 200 mg/kg. For emergency: Intramuscular or intravenous 500 mg to 750 mg once x 3 times in a day. Preoperative treatment: 500 mg intramuscularly or intravenously 1 hour before surgery. Postoperative treatment: Prior intravenous or intramuscular injection of 250 mg x 2 times daily. Children: duration of treatment is similar to that of adults with the dose halved. Note: The solution for injection can be dissolved in a cup of hot water to drink, and bandages can also be used to bandage the wound.
Caution when using Cyclonamine:
Caution should be used when administering the drug to patients with existing or history of thrombophlebitis (stroke, pulmonary embolism, deep vein thrombosis) because of its association with an increased incidence of thrombosis. Deep vein thrombosis in patients undergoing vaginal surgery. Caution should be exercised when using the drug in patients with asthma, allergies or a history of allergic reactions to the drug because etamsylate preparations containing sodium sulphate may cause or aggravate anaphylactic reactions. Caution should be exercised when administering the drug to patients with renal impairment because the drug is eliminated mostly unchanged by the kidneys. Blood replacement therapy using colloidal solutions should be started only after the injection of etamsylate and not before. Vinmec International General Hospital is one of the hospitals that not only ensures professional quality with a team of leading doctors, modern equipment and technology, but also stands out for its examination and consulting services. and comprehensive, professional medical treatment; civilized, polite, safe and sterile medical examination and treatment space.
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