thrombin, topical

Action and Spectrum

Actions and spectrum: 

thrombin topical is a hemostatic agent that converts fibrinogen to fibrin thereby stop bleeding. It is also used to promote hemostasis in patients with intravascular coagulation and liver disease.

Drug Interaction

Adverse Reaction

Frequency defined 

>10% 

Immune hypersensitivity reaction (15%) 

Nausea without vomiting (28%) 

Pain, procedural (29%) 

Nausea and vomiting (33%) 

Skin incision finding (63%) 

1-10% 

Thromboembolic disorder (6%) 

Frequency not defined 

Antibody formation 

General allergic reactions 

Black Box Warning

Black Box Warning: 

None  

Contraindication / Caution

Contraindication/Caution: 

Thrombin topical is contraindicated with known hypersensitivity to bovine-derived products, history of anaphylaxis, severe systemic reactions, severe arterial bleeding, or wounds with high bacteria concentrations. 

Pregnancy / Lactation

Pregnancy consideration: pregnancy category C 

Lactation: safety and efficacy not established 

Pregnancy category: 

• Category A: Satisfactory and well-controlled studies show no risk to the fetus in the first or later trimester. 

• Category B: There is no evidence of risk to the fetus found in animal reproduction studies and there are not enough studies on pregnant women. 

• Category C: Adverse effects on the fetus found with evidence in animal reproduction studies and no adequate evidence for an effect in humans, care must be taken for potential risks in pregnant women. 

• Category D: There is adequate data available with sufficient evidence of human fetal risk from various platforms, but despite potential risks may be used only in emergency cases for potential benefits. 

• Category X: Drugs listed in this category outweigh risks over benefits These category drugs should be prohibited for pregnant women. 

• Category N: There is no data available for the drug under this category. 

Pharmacology

Pharmacology: 

Pharmacodynamics: 

thrombin converts fibrinogen to fibrin which is a crucial step in formation of blood clots. When used topically thrombin promotes hemostasis by enhancing the conversion of the fibrinogen to fibrin at the site of application.  

Pharmacokinetics: 

Absorption 

Not significantly absorbed 

Distribution 

It does not have systemic distribution because it is not absorbed into the bloodstream. 

Metabolism 

No metabolism. 

Elimination and excretion 

N/A 

Adminstartion

Administration: 

thrombin topical applied topically directly to the skin or wound surface.  

Patient Information Leaflet

Patient information leaflet 

Generic Name: thrombin (topical) 

Pronounced: [ THROM-bin, TOP-i-kal] 

Why do we use thrombin (topical)? 

thrombin topical is used for topical hemostatic agent to control bleeding from small blood vessels during surgery. It also controls bleeding from needle punctures or surgical incisions in patients with bleeding disorders.