Contrymax

Contrymax is a polyvalent inhibitor of plasma proteinases obtained from the lungs of cattle. It has antiproteolytic, antifibrinolytic, hemostatic effects. By forming complexes with enzymes such as plasmin, trypsin, chymotrypsin, kallikrein inactivates the main proteinases in plasma, blood cells and tissues, which play a role in the pathophysiological processes of hemostasis disorders. The therapeutic effect of Contrymax is associated primarily with inhibition of plasmin and blockade of plasminogen activation by endogenous activators.

• Each bottle of lyophilized powder contains: aprotinin USP 10,000 KIE.
• Each ampoule with solvent contains: 2 ml of 0.9% sodium chloride solution.

• pancreatitis (acute, exacerbation of chronic, postoperative prevention), pancreatic necrosis;
• performing diagnostic studies and operations on the pancreas (prevention of enzymatic autolysis of the pancreas during operations on it and nearby abdominal organs);
• prevention of acute nonspecific postoperative mumps;
• open heart surgery using artificial blood circulation machines, etc.;
• bleeding due to hyperfibrinolysis: post-traumatic, postoperative (especially during operations on the prostate gland, lungs), before and after, during childbirth (including with amniotic fluid embolism), polymenorrhea;
• angioedema;
• shock (toxic, traumatic, burn, hemorrhagic);
• extensive and deep traumatic tissue damage;
• as an adjuvant therapy - coagulopathies characterized by secondary hyperfibrinolysis (in the initial phase, before the onset of effect after the use of heparin and replacement of coagulation factors);
• massive bleeding (during thrombolytic therapy), during extracorporeal circulation;
• prevention of postoperative pulmonary embolism and bleeding, fat embolism in polytrauma, especially in fractures of the lower extremities and skull bones.

Directions for use and dosage: The dose is selected individually, depending on the diagnosis, the patient’s condition, and the surgical situation. It should be administered through the main veins; do not use them to administer other drugs. The drug is administered only in the “lying down” position, intravenously, in a stream, slowly (maximum - 5 ml per minute) or drip into 300 - 500 ml of isotonic sodium chloride solution.
 Acute pancreatitis: 300 thousand - 10 thousand KIU (0.5-1 million KIU, followed by a decrease over 2-6 days to 50-300 thousand KIU until complete cancellation (after the disappearance of enzymatic toxemia) per day for 2-6 days.

During exacerbation of chronic pancreatitis: 25-50 thousand KIU per day for 3-6 days, for the prevention of traumatic pancreatitis 200 thousand KIU before surgery and then 100 thousand KIU every 6 hours for 2 days after the intervention.

For bleeding and hemorrhages associated with hyperfibrinolysis: 100-200 thousand KIU intravenously, if necessary, up to 500 thousand KIU (depending on the intensity of bleeding).

Hyperfibrinolytic coagulopathy: initial dose - 1 million, maintenance dose of 50 thousand KIU per hour.

During surgical interventions for the purpose of prevention before and during, after surgery: 200 - 400 thousand KIU, then within 2 days 100 thousand KIU.

In obstetric practice:  the initial dose is 1 million KIU, then every hour 200 thousand KIU until the bleeding stops.

In case of shock: in the initial dose of 300 thousand KIU - 400 thousand KIU, then 200 thousand KIU intravenously, in a stream, every 4 hours.

Heart surgery: 2 million KIU at the beginning of anesthesia for 30 minutes, then 500 thousand KIU per hour until the end of surgery.

During open-heart surgery (with a heart-lung machine) to reduce blood loss and the need for blood transfusion:   an initial dose of  1-2 million KIU is administered IV slowly over 20-30 minutes after the onset of anesthesia and before sternotomy . The next 1-2 million KIU are added to the primary volume of the heart-lung apparatus. Aprotinin should be added to the primary volume during the recirculation period to ensure sufficient dilution of the drug and prevent interaction with heparin. After the end of the bolus injection, a constant infusion at an administration rate of 250-500 thousand KIU/hour until the end of the operation. The total amount of aprotinin should not exceed 7 million KIU.