Hemase

Gemaza has a thrombolytic and fibrinolytic effect.

Indications Hemase

It is used to eliminate various ophthalmological diseases:

• hemophthalmos or hyphema;
• hemorrhages of a subretinal, preretinal or intraretinal nature;
• diagnosed fibrinoid syndrome of various origins;
• occlusion in the area of the central artery or thrombosis affecting the central vein in the area of the retina, as well as its branches;
• prevention of adhesions after antiglaucoma surgical procedures.

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Release form

It is produced in the form of powder (5000 IU), from which an intravenous solution is prepared, in glass ampoules with a capacity of 1-2 ml. One plate contains 3, 5 or 10 such ampoules.

It is produced in the form of a medicinal liquid (volume 10 million IU), which is contained in 0.5 l bottles (there are 6 such bottles inside the pack).

Pharmacodynamics

The medicine is an enzymatic one, and its action is due to the activity of the main element – prourokinase (it is an enzyme – serine endopeptidase). According to its chemical structure, it is a single-chain molecule with a molecular weight of 54,000 Daltons, which also contains 2 polypeptide chains linked by a disulfide bridge and having a molar weight of 20,000 and 34,000 Daltons.

The mechanism of therapeutic action consists of specific stimulation of processes of transformation of profibrinolysin into a separate fibrinolytic element of blood – substance plasmin. This component can destroy fibrin clots.

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Pharmacokinetics

Peak values in the eye tissues are observed after 2 hours, and traces of the drug are observed in the blood after 12 hours after application.

The half-life of the drug is about 6 hours. Systemic effects do not develop because the drug is used in small doses.

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Dosing and administration

Standard method of dissolving powder and using medicinal solution.

It is necessary to dissolve the contents of 1 ampoule of the drug in a 0.9% solution of sodium chloride (0.5 ml). The portion size after dissolving the powder will be 5000 IU. The drug must be administered parabulbar (injection into the lower eyelid) or subconjunctival (into the area under the conjunctiva). During such a course, a maximum of 10 therapeutic injections are allowed.

Performing irrigation during treatment of hyphema or massive fibrinous effusion in the anterior chamber of the eye.

It is necessary to take a solution in a 0.2 ml portion, in which the powder will be diluted (dose 1000 ME) or 0.1 ml of a medicinal solution with powder in a volume of 500 ME, after which its amount should be brought to 0.5 ml using a 0.9% sodium chloride solution.

Use of intravitreal injection methods.

It is necessary to take 0.1 ml of the ready solution, which is obtained using standard dissolution (500 ME), and then dilute it with 0.9% sodium chloride solution (0.1-0.2 ml). It is necessary to use it for hemophthalmos of various genesis, and also for fibrinoid syndrome - a single intravitreal injection.

To prevent the development of adhesions after antiglaucoma surgical operations.

It is necessary to dissolve the medicine in proportions that are used for subconjunctival administration. Then it is necessary to administer the drug into the filtration pad at the initial stage of the postoperative period in the amount of 1-3 injections - a more precise scheme is determined by the surgeon.

It is important to note that it is prohibited to mix Gemaza with other medications (except dexamethasone) in the same syringe.

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Use Hemase during pregnancy

It is prohibited to use Gemaza during pregnancy.

Contraindications

Main contraindications:

• a tendency to bleeding, including such disorders as hemophilia, hemorrhagic diathesis, thrombocytopenia, etc.;
• bleeding in the gastrointestinal tract that occurred less than 28 days before using the drug, operations in the spinal cord and intracranial area that occurred at least 56 days before using the drug, extensive operations or injuries that occurred at least 28 days before using the drug, which increase the likelihood of bleeding;
• performing CPR or other resuscitation procedures that last more than 10 minutes;
• liver pathologies, against the background of which severe forms of hemostasis disorders are observed;
• chronic renal failure, in which the serum creatinine level is greater than 0.02 g/l, and urea is greater than 0.5 g/l;
• puncture in the area of any large vessel (including the subclavian vein);
• problems with retinal function that are hemorrhagic in nature due to diabetes (such as retinopathy);
• a recent stroke of hemorrhagic origin (or its presence in the patient’s medical history);
• hypertensive crisis;
• increased values of systolic blood pressure (more than 180 mmHg) or diastolic blood pressure (more than 110 mmHg);
• cardiogenic shock, stage 4 according to the Killip classification;
• active tuberculosis;
• septic endocarditis;
• there is a suspicion of aortic dissection;
• the presence of intolerance to sodium chloride, prourokinase, and dextran 40.

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Side effects Hemase

The use of the medication may cause the appearance of allergic side effects:

• swelling;
• skin hyperemia at the injection site or on the face;
• tenonitis, which is of an allergic nature, the symptoms of which are conjunctival hyperemia, chemosis, and, in addition, deterioration of the motor mobility of the eyeball.

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Overdose

With a single injection of the drug in a dose of more than 5000 IU, the likelihood of developing allergic symptoms increases, which are listed among the side effects.

In case of intoxication or during surgical operations while using the drug, in order to reduce the likelihood of hemorrhages, general use of the substance etamsylate should be performed in the form of intramuscular injections in a dose of 0.25-0.5 g.

Interactions with other drugs

The medication cannot be combined with injections of the substance collalysin.

Caution is required when combining drugs with other thrombolytics.

The simultaneous use of the drug with dexamethasone and emoxipin is permitted.

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Storage conditions

Gemaza in ampoules or vials (they should be placed vertically) is kept in a dark place inaccessible to small children with a temperature within the range of 2-8°C.

Shelf life

Gemaza can be used for 2 years from the date of manufacture of the drug.

Application for children

Since there is too little data regarding the use of the drug in pediatrics, it is not recommended to prescribe it to children.

Analogues

The drug's analogues include such drugs as Fibrinolysin, Actilyse, Thrombovazim, and Metalyse.

Reviews

Gemaza is often used to eliminate ophthalmological hemorrhages. Most patients in their reviews indicate that the injections are effective and efficient, helping to cope with the disorders.