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Etamsylate (Sylate) Pharmacology, Mechanism of Action, Indication and Dosage

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Etamsylate is a synthetic antihaemorrhagic agent that acts on the first stage of blood clotting or hemostasis known as endothelium platelet interaction.

By improving platelet adhesiveness and restoring capillary resistance, it reduces the bleeding time and blood loss.

Sylate does not have a vasoconstriction effect. It does not influence the process of fibrinolysis or breakdown of fibrin mesh nor does it modify the plasma coagulation factor.

Etamsylate is one of the drugs that cross the placental barrier and enters into fetal circulation. Therefore maternal and cord blood contain a pharmacological similar concentration of etamsylate.

Pharmacological effects of etamsylate usually appear after one to five minutes of parenteral administration of this agent.

The drug is then excreted in an unchanged state via the biliary, urinary and intestinal routes. After one hour the concentration that remains in the blood is about 6.5% to 11.5%.

Etamsylate does not have any teratogenic effects when studied in experimental lab animals in over three generations.

What are the indications for etamsylate?

Etamsylate is indicated for conditions in general surgery, internal medicine and pediatrics.

Internal medicine

The drug is indicated for;

  • Prevention of capillary hemorrhages of whatever origin of localization.
  • Hematuria(blood in urine),
  • Hematemesis (vomiting of blood),
  • Melena (blood in stool),
  • Metrorrhagia ( abnormally heavy uterine bleeding that occurs at regular intervals),
  • Primary or IUD related metrorrhagia and hemorrhagic gingivitis.

In surgery

Etamsylate is indicated for surgical conditions including:

  • Prevention and treatment of post surgical oozing in all delicate operations and those surgeries affecting highly vascularized tissues.
  • Ear,nose and throat surgeries,
  • Urology surgical procedures,
  • Opthalmology,
  • Odontostomatology,
  • Plastic and reconstructive surgery.
  • Gynaecology and obstetric surgeries

In pediatrics, sylate is indicated for prevention of hemorrhages in premature babies or preterm babies.

Dosages

Etamsylate is administered parenteraly via intramuscular or intravenous route. For IV use it is preferable that you dilute the solution in a 1:2 ratio with dextrose or saline.

In adults;

  • Preoperatively use 1-2 ampoules I.V or I.M one hour before surgery.
  • Perioperatively use 1-2 ampoules I.V and you can repeat the dose if necessary.
  • Postoperatively 1-2 ampoules are administered via I.V or I.M . The dose can be repeated every four to six hours as long as the bleeding risk persists.

In emergency cases sylate can be administered according to the severity of the case, 1-2 ampoules every 4-6 hours as long as the risk of bleeding persists.

When etamsylate is used for local treatment, a swab soaked in the contents of the ampoule is applied on the hemorrhagic area or in the tooth socket after extraction. the application may be repeated if necessary. This may be associated with an oral or parenteral administration.

For children a half adult dose is used.

Neonates:

The dosage for neonates is 10mg per kg body weight (0.1 ml ie 12.5 mg) injected intramuscularly within 2 hours after birth, then every 6 hours for 4 days.

What are the limitations for use?

Etamsylate should not be administered or used during the first trimester of pregnancy.

Adverse Effects

Sylate does not induce any serological or allergic reactions when used. However there may be associated nausea, vomiting, headache and skin rash although they occur infrequently.


Post References

  • Atlas of pharmacology, BRS Pharmacology

  • Revised on: 2021-06-24 09:39:14