Hemocoagulase is a hemostatic agent derived from the venom of the Bothrops atrox snake. It is a complex of two main enzymes: thrombin-like enzyme (TLE) and Factor X activator. It acts locally to promote clot formation at the site of bleeding without causing systemic hypercoagulability, making it a valuable agent for controlling capillary and venous bleeding in surgical and traumatic settings. In India, it is widely used across surgical specialties.
Adult: Dose is highly dependent on the extent of bleeding and surgical site. Typical dose: 1-2 IU (International Units) by local injection (submucosal, subserosal) or topical application (soaked in sterile gauze). May be repeated if necessary. Always follow specific brand prescribing information.
Note: For INJECTION: Reconstitute with provided solvent (usually 1-2 ml of sterile water/NS). Inject slowly into the tissue surrounding the bleeding site or into the submucosa/subserosa. Do NOT inject intravenously or intra-arterially. For TOPICAL USE: Apply solution directly to the bleeding surface or soak a sterile gauze piece and apply under pressure for several minutes.
Hemocoagulase exerts its hemostatic action through two synergistic pathways: 1) Thrombin-like Enzyme (TLE): Directly converts fibrinogen to fibrin monomers, forming a stable clot. Unlike thrombin, TLE is not inhibited by antithrombin III. 2) Factor X Activator: Activates Factor X to Factor Xa, which in turn, along with Factor V, converts prothrombin to thrombin, amplifying the clotting cascade. This dual action leads to rapid, localized fibrin clot formation without depleting systemic clotting factors or causing significant systemic thrombosis.
Pregnancy: Category C: Animal reproduction studies have not been conducted. Use only if clearly needed and potential benefit justifies potential risk to the fetus. Local application minimizes systemic exposure.
Driving: No effect on ability to drive or use machines.
| Anticoagulants (Warfarin, DOACs) | Hemocoagulase's local hemostatic effect may be reduced in systemically anticoagulated patients. No direct pharmacokinetic interaction. | Moderate |
| Antiplatelets (Aspirin, Clopidogrel) | May reduce efficacy of hemocoagulase for controlling bleeding. No direct interaction. | Moderate |
| Thrombolytics (Streptokinase, Alteplase) | Concurrent use is contradictory. Thrombolytics may lyse the clot formed by hemocoagulase. | Major |