Gelatin


Generic Medicine Info
Indications and Dosage
Intravenous
Hypovolaemic shock
Adult: As 4% succinylated gelatin (modified fluid gelatin): Volume and infusion rate depends on the condition of the patient (e.g. amount of blood loss, blood pressure). Usual dose: Initially, 500-1,000 mL; higher doses may be given in severe cases. Administer the initial 20-30 mL slowly with careful observation for early detection of anaphylactic reactions. In emergency cases: 500 mL infused over 5-10 minutes may be given until signs of hypovolaemia are resolved. Doses are administered via infusion.

Topical/Cutaneous
Haemostatic
Adult: Adjunct to haemostasis in surgical procedures (except ophthalmic) when control of bleeding by pressure, ligature or other conventional procedures is ineffective or impractical: As absorbable gelatin sponge: Cut the sponge to the desired size and apply directly onto the bleeding site (either dry or saturated with sterile isotonic NaCl solution). Additional applications may be made if the 1st application does not control the bleeding. As absorbable gelatin powder: Apply the prepared paste onto the bleeding surface. Remove excess when the bleeding stops. Use the minimum amount needed to produce haemostasis; remove any excess once haemostasis is achieved.
Reconstitution
Topical: As absorbable gelatin powder: To prepare a putty-like paste, open the envelope and pour the contents (1 g) carefully into a sterile beaker. Add a total of approx 3-4 mL of sterile isotonic NaCl solution to the powder, then mix well.
Contraindications
IV: Hypersensitivity to galactose-α-1,3-galactose (alpha-Gal) or known allergy to red meat (mammal meat) and offal; hypervolaemia, hyperhydration. Topical: Hypersensitivity to porcine collagen. Primary treatment of coagulation disorders, closure of skin incisions, presence of infection, control of postpartum bleeding or menorrhagia. Application into intravascular compartments.
Special Precautions
IV: Patient with blood coagulation disorders, risk factors for circulatory overload (e.g. cardiac disease, CHF, hypertension, pulmonary oedema), oedema with salt or water retention, hypernatraemia, hyperkalaemia, history of allergic diseases (e.g. asthma); renal failure with oliguria or anuria. Topical: Application into contaminated areas of the body. Not intended as a substitute for surgical techniques and proper application of ligatures or conventional procedures for haemostasis. Safety and efficacy with topical thrombin have not been evaluated in studies; if concurrent use is necessary based on the doctor’s judgment, refer to thrombin detailed product information. Renal and hepatic impairment. Pregnancy and lactation.
Adverse Reactions
Significant: IV: Electrolyte imbalance, circulatory overload, dilution of blood coagulation factors.
Cardiac disorders: Tachycardia.
General disorders and administration site conditions: Chills, pyrexia (IV); asthenia, foreign body reactions, encapsulation of fluid, and haematoma at the application site (topical).
Infections and infestations: Wound infection (topical).
Respiratory, thoracic and mediastinal disorders: Rarely, dyspnoea, hypoxia, wheezing (IV).
Skin and subcutaneous tissue disorders: Rarely, sweating, urticarial reactions (IV); pruritus, rash (topical).
Vascular disorders: Rarely, hypertension or hypotension (IV).
Potentially Fatal: Rarely, anaphylactic/anaphylactoid reactions.
Monitoring Parameters
IV: Monitor serum electrolytes, fluid balance, blood pressure, Hb, haematocrit (which must not fall <25%), coagulation parameters, renal and hepatic functions, and haemodynamic status of the patient. Closely assess for hypersensitivity reactions.
Overdosage
IV: Symptoms: Hypervolaemia, electrolyte imbalance, circulatory overload (manifested by dyspnoea, headache, jugular vein congestion) with significant fall in haematocrit and plasma proteins. These symptoms may lead to impairment of heart and lung function (e.g. pulmonary oedema). Management: Symptomatic treatment with monitoring of electrolytes. Administer a rapid-acting diuretic in case of circulatory overload.
Drug Interactions
May increase the risk of paradoxical hypotensive reactions with ACE inhibitors (IV).
Lab Interference
IV: May increase the blood sedimentation rate, urine specific gravity, and non-specific protein assays (e.g. by biuret method).
Action
Description: Gelatin acts as a plasma volume substitute as a succinylated gelatin preparation. Succinylation of gelatin molecule results in a negatively charged molecule with consequent spatial expansion. Absorbable gelatin is used as a haemostatic in surgical procedures. Its mode of action is not fully understood, but it appears to arrest bleeding by forming an artificial clot and producing a mechanical matrix that facilitates clotting.
Duration: 3-4 hours (IV).
Pharmacokinetics:
Absorption: Topical: May be completely absorbed in the application site (when used in appropriate amounts).
Excretion: IV: Mainly via urine (75%); faeces (small amounts). Elimination half-life: Approx 4 hours.
Storage
Solution for infusion: Store below 25°C. Do not refrigerate or freeze. Sponge/powder: Store between 15-30°C.
MIMS Class
ATC Classification
B05AA06 - gelatin agents ; Belongs to the class of blood substitutes and plasma protein fractions. Used as blood substitutes.
B02BC01 - absorbable gelatin sponge ; Belongs to the class of local hemostatics. Used in the treatment of hemorrhage.
References
Anon. Gelatin (Absorbable). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 20/01/2021.

Anon. Gelatin (Succinylated). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 20/01/2021.

Buckingham R (ed). Gelatin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 20/01/2021.

Gelfoam Sterile Sponge (Pfizer, Inc.). MIMS Philippines. http://www.mims.com/philippines. Accessed 20/01/2021.

Gelofusine Ecobag (B. Braun Melsungen AG). MHRA. https://products.mhra.gov.uk. Accessed 20/01/2021.

Isoplex 4% Solution for Infusion (Beacon Pharmaceuticals Limited). MHRA. https://products.mhra.gov.uk. Accessed 20/01/2021.

Joint Formulary Committee. Gelatin. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 20/01/2021.

Surgifoam Sterile Sponge (Ethicon US, LLC). U.S. FDA. https://www.fda.gov. Accessed 20/01/2021.

Disclaimer: This information is independently developed by MIMS based on Gelatin from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2021 MIMS. All rights reserved. Powered by MIMS.com
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