Fibrin

(rINN)
Synonyms: Fibrina; Fibrine; Fibrinum.
Cyrillic synonym: Фибрин.

💊 Chemical information

Pharmacopoeias.

Many pharmacopoeias have monographs for fibrin preparations, including Eur..

Ph. Eur. 6.2

(Fibrin Sealant Kit; Fibrini Glutinum). It is composed of two components, a fibrinogen concentrate containing human fibrinogen (component 1), and a human thrombin preparation (component 2). The kit may also contain other ingredients, such as human factor XIII, a fibrinolysis inhibitor, or calcium ions. Stabilisers such as human albumin may be added. The human constituents are obtained from plasma for fractionation and the method of preparation includes a step or steps that have been shown to remove or inactivate known agents of infection. The constituents are passed through a bacteria-retentive filter and distributed aseptically into sterile containers. Containers of freezedried constituents are sealed under vacuum or filled with oxygen-free nitrogen or other suitable inert gas before sealing. No antimicrobial preservative is added. When thawed or reconstituted as stated on the label, the fibrinogen concentrate contains not less than 40 g/litre of clottable protein; the activity of the thrombin preparation varies over a wide range (about 4 to 1000 international units/mL). Protect from light.

💊 Profile

Fibrin glue is prepared by mixing solutions containing fibrinogen, thrombin, and calcium ions, with the addition of aprotinin to inhibit fibrinolysis. It may also include factor XIII and other clotting components. Fibrin glue is used as a haemostatic to control haemorrhage during surgical procedures or as a spray to bleeding surfaces. A dry artificial sponge of human fibrin, known as human fibrin foam, has been used similarly; it is prepared by clotting human thrombin with a foam of human fibrinogen solution. A collagen sponge coated with thrombin and fibrinogen is also available.

Adverse effects.

Fatal neurotoxicity has been reported1 after the use of a fibrin sealant during neurosurgical procedures. The toxicity may have been due to the presence of tranexamic acid as a stabiliser in the formulation, and such formulations should not be used in surgical operations where contact with the CSF or dura mater could occur.2 For rare reports of hypersensitivity reactions to aprotinin used locally as a component of fibrin sealant.
1. Committee on Safety of Medicines/Medicines Control Agency. Quixil human surgical sealant: reports of fatal reactions. Current Problems 1999; 25: 19. Also available at: http:// www.mhra.gov.uk/home/idcplg?IdcService=GET_ FILE&dDocName=CON2023713&RevisionSelectionMethod= LatestReleased (accessed 31/05/06
2. Committee on Safety of Medicines/Medicines Control Agency. Quixil human surgical sealant: update on fatal neurotoxic reactions. Current Problems 2000; 26: 10. Also available at: http:// www.mhra.gov.uk/home/idcplg?IdcService=GET_ FILE&dDocName=CON007460&RevisionSelectionMethod= LatestReleased (accessed 31/05/06)

Use.

Reviews.
1. Dunn CJ, Goa KL. Fibrin sealant: a review of its use in surgery and endoscopy. Drugs 1999; 58: 863–86.
2. Carless PA, et al. Fibrin sealant use for minimising peri-operative allogeneic blood transfusion. Available in The Cochrane Database of Systematic Reviews; Issu
1. Chichester: John Wiley; 2003 (accessed 03/06/05)
3. MacGillivray TE. Fibrin sealants and glues. J Card Surg 2003; 18: 480–5
4. Fattahi T, et al. Clinical applications of fibrin sealants. J Oral Maxillofac Surg 2004; 62: 218–24
5. Schexneider KI. Fibrin sealants in surgical or traumatic hemorrhage. Curr Opin Hematol 2004; 11: 323–6.

💊 Preparations

Ph. Eur.: Fibrin Sealant Kit. Proprietary PreparationsMulti-ingredient: Arg.: Beriplast P; Tissucol; Tissucol Duo Quick†; Austral.: Tisseel Duo; Austria: Beriplast; TachoSil; Tissucol; Tissucol Duo Quick; Belg.: Tissucol Duo; Braz.: Beriplast P; Tissucol†; Canad.: Tisseel; Chile: Beriplast P; Cz.: TachoSil; Tissucol; Denm.: TachoSil; Tisseel Duo Quick; Fin.: TachoSil; Tisseel Duo Quick; Fr.: Beriplast; TachoSil; Tissucol; Ger.: Beriplast; TachoSil; Tissucol Duo S; Tissucol-Kit; Gr.: Beriplast P; Hong Kong: Beriplast P; Tisseel; Hung.: Beriplast P; Tissucol-Kit; Indon.: Beriplast; Israel: Beriplast; Tisseel; Ital.: Beriplast; TachoSil; Tissucol; Mex.: Beriplast P; Tissucol†; Neth.: Beriplast P; TachoSil; Tissucol; Tissucol Duo; Norw.: TachoSil; Pol.: Beriplast; Port.: TachoSil; Tissucol Duo; Spain: Beriplast P Combi; TachoSil; Tissucol Duo; Swed.: TachoSil; Tisseel Duo Quick; Switz.: Beriplast P; TachoSil; Tissucol; Tissucol Duo S; Turk.: Beriplast P; UK: TachoSil; Tisseel; USA: Artiss.
Published December 01, 2018.