Ethamsylate is a synthetic hemostatic (anti-hemorrhagic) agent used primarily to control capillary bleeding. It is not a vasoconstrictor, coagulant, or antifibrinolytic. Its primary action is to correct abnormal platelet adhesion and increase capillary wall resistance, thereby reducing bleeding time and blood loss from small vessels. It is widely used in India for menorrhagia and peri-operative prophylaxis.
Adult: For menorrhagia: 500mg three times daily, starting 5 days before expected onset of menses and continuing through the menstrual period. For surgical prophylaxis: 500mg three times daily, starting 2-3 days before surgery and continuing for several days post-operatively.
Note: Administer orally with or without food. Tablet should be swallowed whole with a glass of water. For best results in menorrhagia, a cyclic regimen is crucial.
Ethamsylate's precise mechanism is not fully elucidated but is distinct from other hemostatic agents. It is believed to act by: 1) Correcting abnormal platelet adhesion by increasing platelet aggregation at the site of capillary injury, possibly by increasing platelet adenosine diphosphate (ADP) activity. 2) Increasing capillary wall resistance and reducing capillary permeability by promoting the polymerization of mucopolysaccharides in the capillary wall. 3) It may also have a mild anti-hyaluronidase activity, which helps stabilize the capillary basement membrane.
Pregnancy: Category B2 (Australian) / Not formally classified by US FDA. Animal studies have not shown teratogenicity. Use during pregnancy only if clearly needed, typically for bleeding episodes. Should be avoided in the first trimester unless benefit outweighs risk.
Driving: May cause dizziness or headache. Patients should be cautioned about driving or operating machinery until they know how the drug affects them.
| Anticoagulants (Warfarin, Acenocoumarol) | Theoretically may reduce anticoagulant effect, but clinical significance is minimal. Monitor INR. | Moderate |
| Antiplatelet drugs (Aspirin, Clopidogrel) | Potential antagonism of Ethamsylate's effect on platelet adhesion. Use combination with caution. | Moderate |
| Desmopressin | Additive hemostatic effect. May be used together clinically. | Mild |