Last update Nov. 14, 2022

Aprotinin

Likely Compatibility

Fairly safe. Mild or unlikely adverse effects. Compatible under certain circumstances. Follow-up recommended. Read Commentary.

It is a polypeptide (58 amino acids) that inhibits the activity of various proteolytic enzymes (serine protease, chymotrypsin, kallikrein, plasmin, and trypsin) and slows fibrinolysis. It is used to reduce bleeding during complex surgeries such as heart and liver surgery. intravenous administration.

At the date of the last update, we found no published data on its excretion in breast milk.

Its high molecular weight make it highly unlikely that significant quantities will pass into breast milk.

Due to its protein nature, it deteriorates in the gastrointestinal tract, not being absorbed. This low oral bioavailability minimizes the passage into plasma of the infant from ingested breast milk.

It has been withdrawn from the market in many countries due to the risk of serious complications (Dietrich 2009, Kristeller 2008), although it continues to have other indications, even in children. (Schertz 2022, Royston 2015) 

Alternatives

Suggestions made at e-lactancia are done by APILAM team of health professionals, and are based on updated scientific publications. It is not intended to replace the relationship you have with your doctor but to compound it. The pharmaceutical industry contraindicates breastfeeding, mistakenly and without scientific reasons, in most of the drug data sheets.

Jose Maria Paricio, Founder & President of APILAM/e-Lactancia

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Other names

Aprotinin is also known as


Aprotinin in other languages or writings:

Group

Aprotinin belongs to this group or family:

Tradenames

Main tradenames from several countries containing Aprotinin in its composition:

Pharmacokinetics

Variable Value Unit
Oral Bioavail. 0 %
Molecular weight 6.511 daltons
VD 0.38 l/Kg
T½ 10 hours

References

  1. Schertz K, Karam O, Demetres M, Mayadunna S, Faraoni D, Nellis ME. Prophylactic Use of Antifibrinolytics During Pediatric Cardiac Surgery With Cardiopulmonary Bypass on Postoperative Bleeding and Transfusion: A Systematic Review and Meta-Analysis. Pediatr Crit Care Med. 2022 Nov 1;23(11):e517-e529. Consulted on Nov. 14, 2022 Abstract
  2. Royston D. The current place of aprotinin in the management of bleeding. Anaesthesia. 2015 Jan;70 Suppl 1:46-9, e17. Abstract
  3. Dietrich W. Aprotinin: 1 year on. Curr Opin Anaesthesiol. 2009 Feb;22(1):121-7. Abstract
  4. Kristeller JL, Roslund BP, Stahl RF. Benefits and risks of aprotinin use during cardiac surgery. Pharmacotherapy. 2008 Jan;28(1):112-24. Review. Abstract
  5. Levy JH, Bailey JM, Salmenperä M. Pharmacokinetics of aprotinin in preoperative cardiac surgical patients. Anesthesiology. 1994 May;80(5):1013-8. Abstract

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