Injection Ethamsylate - Adult Dosage

Standard Dose

• Each ampoule typically contains 250 mg/2 mL (125 mg/mL concentration).
• For IV use, it is given as a slow IV injection (not rapid bolus).

Perioperative Use (Prevention of Surgical Bleeding)

• Pre-operatively: 500 mg IM/IV given 1 hour before surgery.
• During surgery: 500 mg IV as needed.
• Post-operatively: 250-500 mg every 4-6 hours until bleeding risk subsides.

Menorrhagia (Heavy Menstrual Bleeding)

• 500 mg 3-4 times daily during menstruation (oral preferred; injection used in acute/severe cases).

Maximum Daily Dose

• Generally 1500-2000 mg/day in divided doses.

Mechanism of Action

1. Correcting abnormal platelet adhesion
2. Reducing capillary fragility and permeability
3. Inhibiting prostaglandin synthesis (reducing vasodilation at capillary level)

Key Indications

• Surgical hemorrhage (pre-, peri-, and post-operative)
• Menorrhagia
• Capillary bleeding disorders
• Trauma-associated bleeding
• Prevention of periventricular hemorrhage in premature neonates (neonatal dose: 12.5 mg/kg every 6 hours)

Contraindications

• Porphyria
• Known hypersensitivity to ethamsylate or sodium bisulfite (present as excipient)
• Uterine fibroids (relative contraindication for menorrhagia indication)

Side Effects

• Nausea, gastralgia
• Headache
• Transient drop in blood pressure (especially with rapid IV injection)
• Skin rash
• Allergic reactions (due to sodium bisulfite excipient)

Important Notes

• Not a substitute for surgical haemostasis - use as an adjunct.
• Does not affect normal coagulation or clotting cascade.
• Can be given alongside blood transfusions.
• Lab interference: Ethamsylate can falsely elevate serum creatinine measured by enzymatic assay (due to its hydroquinone structure), as noted in the Tietz Textbook of Laboratory Medicine.

Clinical note: Always follow local formulary or prescribing information, as exact dosing may vary by brand (e.g., Dicynone, Cyclonamine) and clinical indication.