How Do Hemostatics Work?

Hemostatics are drugs that are administered intravenously during emergencies to reduce hemorrhage (bleeding from a ruptured blood vessel) and prevent death from hemorrhage within a hospital setting or any prehospital situations. There are several hemostatic agents such as prothrombin complex concentrate, recombinant clotting factors, and other agents each with a different mechanism to induce hemostasis (stop bleeding from a blood vessel). They include:

• Concentrating coagulation factors
• Adhesion to the tissues where traumatic hemorrhage occurred
• Delivering procoagulant factors to the hemorrhage site

Our body naturally produces clotting factors to stop blood loss during any injury such as accident or combat injury. However, patients with congenital diseases such as Von Willebrand disease (VWD) and hemophilia lack clotting factors. They are classified as:

• Hemophilia a: clotting factor VIII deficiency
• Hemophilia b: clotting factor IX deficiency
• Hemophilia c: clotting factor XI deficiency
• VWD: low levels or defective Von Willebrand factor proteins that does not work to form clots

Some patients may develop coagulation disorders because of the following factors:

• Vitamin K deficiency
• Hemodilution
• Acquired platelet dysfunction
• Coagulation factor consumption in extracorporeal circuits (blood is taken out from the patient’s body for any procedure and is carried by an apparatus)
• Activation of fibrinolytic, fibrinogenolytic, and inflammatory pathways
• Hypothermia

Hemostatics are given intravenously to treat uncontrollable massive bleeding in the absence of clotting factors or in the presence of coagulation disorders. They are also used to treat:

• Hemorrhage following trauma
• Intracranial hemorrhage
• Postpartum hemorrhage
• Bleeding during or following major surgeries

Side effects associated with hemostatics include:

• Headache
• Difficulty breathing
• Nausea and vomiting
• Chest pain
• Weakness and numbness in arms and legs
• Trouble breathing
• Slurred speech
• Blurred vision
• Injection site complications
• Anaphylaxis (life-threatening allergic reactions)

The information contained herein is not intended to cover all possible side effects, precautions, warnings, drug interactions, allergic reactions, or adverse effects. Check with your doctor or pharmacist to make sure these drugs do not cause any harm when you take them along with other medicines. Never stop taking your medication and never change your dose or frequency without consulting your doctor.

Generic and brand names of hemostatic drugs include:

• Anti-inhibitor coagulant complex (Feiba NF, Feiba VH Immuno)
• Antihemophilic factor recombinant (Advate, Adynovate, Afstyla, Eloctate, Esperoct, Helixate FS, Jivi, Kogenate FS, Kovaltry, NovoEight, Nuwiq, Obizur, Recombinate, turoctocog alfa, Xyntha, Factor VIII [Recombinant])
• Antihemophilic factor/von Willebrand factor complex (Alphanate, Humate P, Wilate)
• Factor IX (AlphaNine SD, Mononine)
• Factor IX complex (Bebulin, Bebulin VH, Profilnine SD)
• Factor IX, recombinant (Alprolix, BeneFIX, Ixinity, nonacog beta pegol, Rebinyn, Rixubis)
• Factor IX, recombinant/albumin fusion protein (Idelvion)
• Factor VIIa recombinant-jncw
• Factor VIIa, recombinant (NovoSeven RT, Sevenfact)
• Factor VIII, human plasma derived (Antihemophilic Factor [Human], Hemofil M, Koate DVI, Monoclate-P)
• Factor X, human (Coagadex)
• Factor XIII A-subunit, recombinant (catridecacog, Tretten)
• Factor XIII concentrate, human (Corifact)
• Fibrin sealant (Artiss, Evicel, TachoSil, Tisseel VH)
• Fibrinogen/thrombin (Raplixa)
• Prothrombin complex concentrate, human (Kcentra)
• Thrombin (Recothrom, Thrombin JMI, Thrombogen)
• Vitamin K1 (phytonadione) (AquaMephyton, Mephyton, Vitamin K)