Fibrinogen (intravenous)

Overview

Fibrinogen is a glycoprotein which is produced in the liver. It circulates around the blood. During vascular and/or tissue injuries, it is enzymatically converted to fibrin, a substance which causes the blood to clot therefore reducing the risk of excess blood loss.

In healthy individuals, the blood levels of Fibrinogen rise as a response to tissue injuries, systemic inflammation and other events. Certain cancers can also cause fibrinogen levels to become elevated.

In certain patients, dysfunctional or reduced Fibrinogen can occur. These disorders can result in severe pathological bleeding or thrombosis, but can be treated by supplementing fibrinogen levels in the blood. Because Fibrinogen is produced in the liver, hepatic issues are often a source of these clotting problems, although kidney diseases can also play a part in the lack of fibrinogen circulating around the blood.

Type Of Medicine

  • Glycoprotein

Conditions Treated

  • Acquired hypofibrinogenemia
  • Congenital hypodysfibrinogenemia
  • Cryofibrinogenemia
  • Acquired dysfibrinogenemia
  • Hereditary fibrinogen A?-Chain amyloidosis
  • Fibrinogen storage disease
  • Congenital dysfibrinogenemia
  • Congenital hypofibrinogenemia
  • Congenital afibrinogenemia

Side Effects

Along with its required effects, Fibrinogen can also cause unwanted side effects in some patients. The most commonly reported side effects by individuals undergoing treatment with Fibrinogen include the following:

  • Fever
  • Chest pain and/or discomfort
  • Coughing
  • Chills
  • Anxiety
  • Difficulty swallowing
  • Lightheadedness or dizziness
  • Labored or difficult breathing
  • Fainting
  • Loss of co-ordination
  • Nausea
  • Fast heartbeat
  • Discomfort or pain in the jaw, back, arms or neck
  • Swelling, redness or pain in the arms or legs
  • Sudden vision changes
  • Sudden onset of slurred or difficult speech
  • Swelling or puffiness of the eyelids and eyes, or the face, lips and tongue
  • Sudden onset of severe headaches

Most patients generally only experience minimal side effects while taking Fibrinogen, if they observe any untoward symptoms whatsoever. Most healthcare professionals agree that the benefits of treating a blood clotting disorder far outweigh the risks of unpleasant or temporary side effects. As the patient continues to take Fibrinogen as prescribed, the majority of the previously mentioned symptoms should subside. If side effects persist over time or appear to worsen, the patient is advised to mention this to their doctor as soon as is practical. In many instances, side effects can be alleviated with over the counter remedies, natural supplements or prescribed drugs.

Other side effects mentioned less frequently, albeit enough to warrant mentioning, include the following:

  • Sweating
  • Unusual weakness or tiredness
  • Tightness within the chest
  • Headaches
  • Vomiting

Because Fibrinogen can affect the co-ordination, speech and concentration of the patient (and in some cases cause dizziness or faintness), those who take this medicine are therefore advised against driving or operating heavy machinery. This is because the sudden onset of dizziness or loss of co-ordination could potentially put the patient or other road users at risk of injury or even death. For further information, patients are advised to contact their doctor or healthcare provider.

Not all side effects may be listed here. Although it has been reported that general, cardiovascular and hypersensitive reactions to this medication occur, other side effects may not yet be documented. Patients who experience unlisted side effects are advised to consult their doctor and report their findings to the FDA.

Dosage

As with all medicines, it is important for patients to take Fibrinogen only as advised by their prescribing physician. This means that patients must avoid administering more Fibrinogen than they have been advised, both in terms of dose size and frequency. In addition to this, patients should be prepared to discontinue use of this medicine when advised to do so by their doctor, even if they still have a supply of the drug remaining.

Fibrinogen is administered intravenously, most often in a clinical setting such as a hospital or doctor's surgery. However, occasions may arise where the patient is expected to self-administer, although they should only do this when fully confident on how to do so. A doctor or healthcare provider should be able to explain fully how to administer this medicine.

Standard dosage for Fibrinogen deficiency:

In many cases, a patient's natural Fibrinogen levels will be unknown, particularly if it has only been discovered that they have issues with blood clotting (in a scenario where they have injured themselves, for example). In this instance, a doctor should work out a dosage based on the following formula:

Dose (mg per kg of body weight) equals target level (mg per dL) minus the measured level (mg per dL)/1.7 (mg per dL per mg/kg body weight). However, injection rates must not exceed 5ml per minute.

In patients where Fibrinogen levels are known, doctors may use their own calculations in order to ascertain the optimal dose. While the manufacturer provides general dose instructions, it should be reiterated that these can be altered at the discretion of the patient's doctor. A doctor will take into account various criteria when determining the optimal dose, including the age, height, weight, condition and fibrinogen levels of the patient.

Although there is no strict dosage schedule for the use of Fibrinogen, Patients are warned against taking double doses of this medicine in order to avoid an overdose. While Fibrinogen is generally administered in a clinical setting, patients outside of a hospital or surgery who believe they may have overdosed and experience shallow breathing, an extremely slow or fast heartbeat, seizures, unconsciousness, flushed skin or loss of co-ordination may require immediate attention. In these circumstances, patients or their caregivers should contact the local poison control center on 1800-222-1222 or the emergency services on 911.

Interactions

All drugs have the potential to interact with other medicines or chemicals within the human body, and these interactions can cause changes in the effects of one or more medications. In some instances, interactions can lead to a medication becoming ineffective in treating the condition it was prescribed for. In other instances, interactions can cause serious or even fatal side effects. Because of these risks, patients are advised to keep a detailed list of all medicines they are currently taking. This includes over the counter remedies, herbal supplements, complimentary medicines and vitamins as well as prescribed drugs.

Below is a list of medications known to interact negatively with Fibrinogen. Patients who are currently undergoing treatment with one or more of these drugs should inform their doctor prior to using Fibrinogen for the first time:

  • Carfilzomib
  • Kryptolis

Warnings

To ensure that this medicine is safe for them, patients are advised to inform their doctor or healthcare provider if they have a history of blood clots or strokes.

Fibrinogen is manufactured from human plasma, which is part of the blood. As such, it could contain infectious agents or viruses. While donated plasma is treated and tested to reduce this risk, there is still a minute possibility that Fibrinogen could transmit an infectious disease. Patients are advised to discuss these risks with their doctor.

Before taking Fibrinogen, patients should ensure that their doctor or healthcare provider performs sufficient tests to guarantee that they do not have an pre-existing conditions which would otherwise prevent them from safely using this medication.

Patients who self-administer Fibrinogen should not do so unless they understand how to correctly inject and dispose of needles, IV tubing and any other items used in the process. Fibrinogen must not be mixed with other medicines or given with other medicines through the same IV line.

Storage

Fibrinogen should be stored in a refrigerator between 2C and 8C. It should be protected from light, and should not be frozen. Each vial of this medicine is designed for single use only, and should be disposed of after use, even if some medicine remains at the bottom of the vial after the rest of it has been injected.

Unwanted, unused or expired Fibrinogen should be disposed of in accordance with state law. It should not be flushed down a toilet or drain. Most pharmacies offer takeback schemes, and these are widely regarded as the easiest way to dispose of unwanted medication.

Summary

Fibrinogen is a beneficial medicine, however, it may pose a risk to patients who neglect to communicate properly with their healthcare providers. As a treatment designed to combat blood disorders, it contributes to the clotting of the blood during injury or inflammation, but it can also cause co-ordination problems such as dizziness or blurred vision. Because of this, it is important for the patient to be honest and up-front about any pre-existing medical conditions which could exacerbate these effects. Some medications can also interact negatively with Fibrinogen, and it is therefore in the best interests of the patient to impart all necessary information to their doctor prior to using Fibrinogen.

When taken correctly, this medication can provide relief for serious symptoms which, if left untreated, could result in major blood loss or even death. This provides the patient with a much greater quality of life. To achieve this, doctor and patient must work together in order to find the most appropriate dose and best possible frequency of use.