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Contraindications and warnings for the use of drotrecogin alfa (activated) |
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| Contraindications |
Warnings |
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| Active internal bleeding |
Heparin >15 U/kg per hour |
| Recent (within 3 months) hemorrhagic stroke |
International Normalized Ratio > 3 |
| Recent (within 2 months) intracranial or intraspinal surgery or severe head trauma requiring hospitalization |
Platelet count < 30,000/mm3, even if platelet count is increased after transfusions (USA) (European Agency for the Evaluation of Medicinal Products: contraindication) |
| Trauma with increased risk for life-threatening bleeding (e.g. liver, spleen or complicated pelvic fractures) |
Recent gastrointestinal bleeding (within 6 weeks) |
| Patients with epidural catheters |
Recent administration of thrombolytic therapy (within 3 days) |
| Patients with intracranial neoplasm or mass lesion, or evidence of cerebral herniation |
Recent administration (< 7 days) of oral anticoagulant or glycoprotein IIb/IIIa inhibitors |
| Recent administration (< 7 days) of aspirin > 650 mg/day or other platelet inhibitors |
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| Recent ischemic stroke (< 3 months) |
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| Intracranial arteriovenous malformation |
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| Known bleeding diathesis |
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| Chronic severe hepatic disease (e.g. Child–Pugh C) |
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| Any other condition in which bleeding constitutes a significant hazard or would be particularly difficult to manage because of its location |
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Laterre and Wittebole Critical Care 2003 7:445 doi:10.1186/cc2342 |
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