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خرید پکیج
تعداد آیتم قابل مشاهده باقیمانده : 3 مورد
نسخه الکترونیک
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Treatment of acute episodes of angioedema in acquired angioedema (also known as acquired C1 inhibitor deficiency)

Treatment of acute episodes of angioedema in acquired angioedema (also known as acquired C1 inhibitor deficiency)
Medication Availability Dosing Precautions

C1 inhibitor concentrate (plasma derived)

(Berinert, Berinert P, Cinryze)		 In the United States:
  • Berinert
  • Cinryze

Other countries:

  • Berinert P
  • Cinryze
 20 units per kg body weight given intravenously over 10 minutes. Symptoms usually stabilize in 30 minutes. Second dose uncommonly needed but may be given 30 minutes to 2 hours after first dose. Do not shake solution, because protein will denature. Cinryze is not US FDA approved for acute attacks but has efficacy.

Recombinant C1 inhibitor

Conestat alfa (Ruconest, Rhucin)		 Europe, United States, some other countries. 50 units per kg body weight for patients <84 kg. 4200 units (two vials) for those ≥84 kg. Second dose rarely needed. Patients should be screened for rabbit allergy prior to receiving with rabbit-specific IgE immunoassay and should not receive drug if positive.

Bradykinin B2-receptor antagonist

Icatibant (Firazyr)

United States and many other countries.

Approved in the United States for individuals over the age of 18 years.		 30 mg slow subcutaneous infusion (because of volume) in abdominal area. Second dose needed in approximately 10% of patients and can be given 6 hours after first dose. Maximum of 3 doses in 24 hours. Caution in patients with unstable angina. Mild injection-site reactions are common.

Kallikrein inhibitor

Ecallantide (Kalbitor)

United States only.

Approved in the United States for individuals over the age of 16 years.		 30 mg (3 doses of 10 mg each) given at 3 separate sites subcutaneously in abdomen, upper arm, or thigh and away from site of angioedema. Rare allergy reaction reported, usually in <1 hour. Should be administered by a clinician or nurse in a medical facility equipped to treat anaphylaxis.
Plasma
  • Solvent detergent-treated plasma (preferred)
  • Fresh frozen plasma
 2 units initially. Can be repeated every 2 to 4 hours, if needed. Monitor for volume overload in patients with underlying conditions predisposing to volume overload. Theoretical risk of transmission of bloodborne pathogens.
The use of the therapies in the table for acquired angioedema (ie, acquired C1 inhibitor deficiency) is extrapolated from hereditary angioedema. Evidence supporting the use of the agents in the acquired forms of the disease is limited to case reports and clinical experience. Plasma-derived C1 inhibitor concentrate is the agent with which there is the most clinical experience.
US FDA: US Food and Drug Administration; IgE: immunoglobulin E.
Graphic 99435 Version 11.0

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