The drug "Hemaz": instructions for use in ophthalmology and reviews

What is the purpose of using the drug "Gemaza" in ophthalmology? Instructions for use and the purpose of this medication will be listed below. Also you will learn about the form of release of the said remedy, contraindications to its use and side effects.

Composition, description of the drug and its form

The drug "Hemaz" (instructions for the use of this drug is mandatory for study) contains recombinant prourokinase, as well as additional substances such as dextran 40 and sodium chloride.

The drug in question is sold in the form of a lyophilizate, which is a white amorphous or porous mass, which has no odor and is intended for the preparation of an intravenous solution.

The drug "Hemaz" in ampoules of glass is placed in contour cells or plastic pallets, which are sealed in packs of cardboard.

Also it should be said that this medication presupposes the presence of a special substance - a liquid that is diffused in vials.

Pharmacology of ophthalmic preparation

How does the "Hemaz" medication work? The instruction for use states that the action of this enzyme agent is due to its active component - prourokinase. It is an enzyme - a serine protease. According to the chemical structure, this substance is a single-molecule molecule (with molecular weight 54 thousand Daltons), which includes two polypeptide chains that are connected by a disulfide bridge with molecular masses of 20 and 34 thousand Dalton.

The principle of action of this remedy is based on the specific stimulation of the conversion of profibrinolysin into the fibrinolytic component of plasma - fibrinolysin, and also in the ability to destroy fibrin clots.

Kinetic characteristics of the drug

How does local absorption of the "Hemaz" drug occur? Instructions for use asserts that the peak concentration of this drug in the tissues of the optic organs is achieved after two hours, and half a day later its traces can be found in the patient's blood.

The half-life of recombinant prourokinase is about 6 hours. It should be noted that due to the use of small dosages of the drug, it is impossible to achieve its systemic influence.

The drug "Hemaz": the appointment (indication)

The use of this agent in ophthalmic practice is due to its high effectiveness in the following cases:

• With subretinal, preretinal and intra-retinal hemorrhages;
• With hemophthalmia and hyphema;
• With thrombosis of the central veins in the branches of the retina or occlusion of the central arteries;
• With an identified fibrinoid syndrome of different origin;
• With the aim of preventing adhesions after antiglaucomatous interventions.

Prohibitions to use the solution

In what cases should you not prescribe a "Hemaz" medication? Instructions for use (injections should only be carried out by an experienced specialist) indicates the following prohibitions:

• Liver diseases, which are accompanied by severe hemostasis disorders;
• Tendency to hemorrhage, including the presence of hemorrhagic diathesis, hemophilia, thrombocytopenia and so on;
• Cardiopulmonary resuscitation, as well as other resuscitation procedures conducted for more than 10 minutes;

• Bleeding from the gastrointestinal tract, including up to 28 days old, spinal or intracranial interventions up to 56 days old, extensive surgical interventions or injuries up to 28 days old;
• Cardiogenic shock of the fourth class (according to the classification of Killip);
• Active form of tuberculosis;
• Renal failure, occurring in chronic form;
• Puncture of large vessels, including subclavian veins;
• Hemorrhagic (diabetic) lesions of the retina;
• A recent history of hemorrhagic stroke or history;
• hypertensive crisis;
• High systolic or diastolic blood pressure;
• Bacterial or septic endocarditis;
• Hypersensitivity to sodium chloride, prourokinase or dextran 40;
• Exfoliating aneurysm of the aorta or suspected of it;
• Period of pregnancy.

The drug "Hemaz": instructions for use

How should the drug be used? To do this, the contents of 1 ampoule must be diluted in 0.5 ml of 0.9% sodium chloride solution. The resulting solution will be equal to a dose of 5 thousand ME.

The introduction of such a drug should be subconjunctival (that is, under the conjunctiva) or parabulbar (that is, in the region of the lower eyelid).

The duration of therapy with this drug is 10 injections per course (not more).

How should I apply "Hemazu" for the purpose of washing with hyphema or massive swilling of fibrin in the front of the visual organ? To do this, take 0.2 ml of the drug with diluted lyophilizate and bring it to 0.5 ml with 0.9% sodium chloride solution.

For intravitreal administration of this medication, 0.1 ml of solution should be used and diluted with 0.1-0.2 ml with 0.9% sodium chloride solution. Such a drug can be used once for hemophthalms of different genesis and fibrinoid syndrome.

One can not help saying that the drug "Gamaz" (the description of the drug was presented above) is often used as a preventive agent in the adhesion process after antiglaucomatous interventions. To do this, it is bred in the same ratio as for subconjunctival administration. After that, the medication is introduced into the filtration pad at the very beginning of the postoperative period.

Side effects of the drug

In the process of treatment with the drug "Hemaz" the patient can develop allergic reactions in the form of:

• Hyperemia of the skin in the face or injection site;
• Edema;
• Allergic tenonitis in the form of chemosis, reduced mobility of the eyeball and conjunctival hyperemia.

Overdose and Interaction

With a single administration of the drug in question at a dosage of more than 5,000 IU, the risk of developing allergic reactions that have been described in adverse events is significantly increased.

In case of surgical interventions and in case of overdose against the background of treatment with this remedy, in order to reduce the risk of hemorrhage development, it is recommended to additionally apply the medication "Etamsilat" in the form of intramuscular injections (in a dosage of 250-500 mg).

It is strictly forbidden to use "Gemazu" with injections of "Collalysin". With other thrombolytics, use this medication with extreme caution.

In one syringe, you can not mix two drugs at once (except Dexamethasone).

Special Information

With the development of bradycardia or arterial hypotension, it is necessary to suspend the introduction of the medication before the normalization of heart rate and blood pressure.

Ophthalmic preparation "Gemaza": reviews and similar means

What can replace the drug in question? Its analogues are such drugs as "Aktilis", "Fibrinolizin", "Metalez" and "Trombovazim".

What do people say about this drug that suffer from problems with the visual organs? Most often reviews about this drug are left by those who use it for hemorrhages in ophthalmic practice. In this case, patients claim that such injections are very effective and effective. They are good at helping and fully coping with the task.

Despite all the unpleasantness of the treatment procedure (such injections are quite painful), patients are advised to wait a little, and not to bring their condition to the removal of the vitreous.

As for negative reviews about this drug, they are most often associated with the development of side effects, as well as the presence of a huge number of contraindications. In addition, many patients believe that the cost of the drug "Gemaza" is too high (it costs about 750-850 rubles).