Gemaza
Gemaza: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. Use in childhood
- 11. In case of impaired renal function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Gemase
ATX code: B01AD
Active ingredient: prourokinase (Prourokinase)
Manufacturer: Technogen NPP (Russia)
Description and photo updated: 2019-27-08
Prices in pharmacies: from 845 rubles.
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Gemaza is a fibrinolytic drug for use in ophthalmology.
Release form and composition
Dosage form - lyophilisate for preparation of solution for injection: porous mass or odorless white amorphous powder (in glass transparent ampoules with a capacity of 1 or 2 ml, in a blister strip packaging 5 ampoules, in a cardboard box 1 package and instructions for use of Gemaza).
The active substance is recombinant prourokinase, in 1 ampoule - 5000 international units (ME).
Auxiliary components: dextran 40, sodium chloride.
Pharmacological properties
Pharmacodynamics
The active substance of Gemaza is prourokinase - a fibrinolytic, a recombinant plasminogen activator of the urokinase type. It is a recombinant prourokinase (RPK) that catalyzes the conversion of plasminogen to plasmin, which has the ability to lyse fibrin clots.
The specificity of the drug is mainly due to the activation of fibrin-bound plasminogen, which has a different conformation compared to plasminogen circulating in the bloodstream into plasmin. At the same time, in the area of the fibrin clot, RPU is not sensitive to specific inhibitors that are present in the blood plasma.
Under the influence of plasmin, the single-stranded RPU molecule is converted into a double-stranded molecule, which is more active in relation to fibrin-bound plasminogen. As a result, a chain reaction of RPU interaction with fibrin-bound plasminogen is formed, which leads to the destruction of the fibrin clot.
Specific enzymatic activity of Gemaza is 4500–5500 IU per 1 ampoule.
Pharmacokinetics
After periocular administration, the concentration of prourokinase in the tissues of the eye reaches a maximum after 1–2 hours, then gradually decreases. After 12-24 hours, only trace amounts of the drug are detected.
With intraocular administration of Gemaza, the drug in maximum concentrations is determined in the intraocular structures.
The half-life is 4-6 hours.
When applied topically, the drug is prescribed in small doses (up to 5000 IU), therefore it does not create plasma concentrations that are significant for the development of systemic effects.
Indications for use
- Fibrinoid syndrome of various etiologies;
- Hemophthalmos, hyphema;
- Subretinal, preretinal and intraretinal hemorrhages;
- Occlusion of the central retinal artery, including its branches;
- Thrombosis of the central retinal vein, including its branches;
- Prevention of adhesion formation after surgery for glaucoma.
Contraindications
- Age under 18;
- Active tuberculosis;
- Pathologies with an increased risk of bleeding, including hemorrhagic diathesis;
- Hypertensive crisis (risk of recurrence of intraocular hemorrhage);
- Gastrointestinal bleeding;
- Proliferative stage of diabetic retinopathy (III-IV degree);
- Bacterial endocarditis;
- Arterial hypertension (diastolic blood pressure more than 105 mm Hg);
- Severe hepatocellular insufficiency (blood albumin less than 3 g / l);
- Chronic renal failure (blood urea level more than 0.5 g / l, serum creatinine more than 0.02 g / l);
- During pregnancy and breastfeeding;
- Individual hypersensitivity to drug components.
Gemaza, instructions for use: method and dosage
Hemase is injected parabulbar, subconjunctivally, intravitreally.
Before use, the contents of 1 ampoule must be diluted in 0.9% sodium chloride solution.
For parabulbar or subconjunctival administration, 0.5 ml of 0.9% sodium chloride solution is added to 1 ampoule of the drug, the finished solution corresponds to 5000 ME. The course of treatment is no more than 10 injections.
For intravitreal administration, 1 ampoule of the lyophilisate is diluted in 1 ml of 0.9% sodium chloride solution, then 0.1 ml of the resulting solution should be diluted in 0.1-0.2 ml of 0.9% sodium chloride solution, the resulting dose (0.2 -0.3 ml) is injected once.
The dosage regimen, the period of treatment is prescribed by the doctor.
The method of administration of Gemaza injections depends on the clinical indications:
- Hemorrhage into the retina or vitreous body, occlusive lesion of the vessels of the optic nerve and retina - the drug is administered parabulbar;
- Hyphema, presence of fibrin effusion after cataract removal - parabulbar, subconjunctival or in the anterior chamber;
- Hemophthalmos, fibrinoid syndrome of various etiology - intravitreal;
- Prevention of adhesions in the postoperative period - in the filtration pad in the amount of 1-3 injections (the administration should be started immediately after the operation, using the concentration of the solution for subconjunctival injections).
In addition, Gemaza is used to flush the anterior chamber of the eye with a strong effusion of fibrin or hyphema. For the procedure, the contents of 1 ampoule are diluted in 1 ml of 0.9% sodium chloride solution, then 0.1 or 0.2 ml of the resulting solution is additionally diluted with 0.9% sodium chloride solution to 0.5 ml.
Side effects
- Possibly: an allergic reaction in the form of edema and hyperemia of the facial skin on the side of the sore eye, inflammatory tenonitis of allergic genesis (conjunctival hyperemia, chemosis, decreased mobility of the eyeball);
- Others: in case of overdose - recurrence of intraocular hemorrhage.
Overdose
When using Gemaza in recommended doses, overdose is unlikely. In case of exceeding the optimal therapeutic doses, a relapse of intraocular hemorrhage is possible.
As a result of a single injection of the drug in a dose of more than 5000 IU, allergic reactions may develop.
In case of an overdose of prourokinase and during surgery during the period of drug administration, in order to reduce the risk of hemorrhage, intramuscular administration of etamsylate at a dose of 250–500 mg is recommended.
special instructions
Influence on the ability to drive vehicles and complex mechanisms
During the period of application of Gemaza, it is recommended to be careful when driving vehicles and mechanisms.
Application during pregnancy and lactation
Gemaza injections are contraindicated in pregnant women and women who are breastfeeding.
Pediatric use
The drug is not used in children and adolescents (under 18).
With impaired renal function
Gemaza should not be administered to patients with chronic renal failure.
Drug interactions
The simultaneous use of the drug with collalizin injections is not recommended.
With caution, it should be combined with other thrombolytic agents.
Combination therapy with emoxipin or dexamethasone is indicated.
Analogs
Analogs of Gemaza are: Aktilize, Metalize, Fibrinolysin, Trombovazim, Purolaza.
Terms and conditions of storage
Keep out of the reach of children.
Store at 2-20 ° C in a dark place.
Shelf life is 4 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reviews about Gemaz
The few reviews about Gemaz are mostly positive. More often, there are reports of the appointment of the drug for hemorrhages. Despite the painfulness of the procedure, patients are advised to be patient and undergo a course of treatment, rather than wait for the condition to worsen when the vitreous body needs to be removed.
Price for Gemaza in pharmacies
The approximate price for Gemaza, 5000 IU injection solution, is 908-1000 rubles. for a package of 5 ampoules.
Gemaza: prices in online pharmacies
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Drug name Price Pharmacy |
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Gemaza 5000 IU lyophilisate for preparation of a solution for intravenous administration 1 ml 5 pcs. 845 RUB Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
