Ancrod

Ancrod Uses, Dosage, Side Effects, Food Interaction and all others data.

Ancrod, marketed as Viprinex, is a defibrinogenating agent derived from Malayan pit viper venom. The defribrinogenation of blood results in an anticoagulant effect. Currently, Viprinex®/ancrod is not approved or marketed in any country, but is being investigated as a stroke treatment in worldwide clinical trials. In January 2005, the U.S. FDA granted a 'fast-track status' for investigation of ancrod use in patients suffering from acute ischemic stroke, a life threatening condition caused by the blockage of blood vessels supplying blood and oxygen to portions of the brain, for which phase III trials are currently being conducted.

The decreased viscosity is directly attributable to lowered fibrinogen levels and leads to important improvements in blood flow and perfusion of the microcirculation. Ancrod decreases the blood viscosity in affected arteries, leads to less intense pain, improves physical limb mobility, facilitates physical and ergo therapy, and decreases the likelihood of local thrombotic events.

Ancrod
Uses
Dosage
Side Effect
Precautions
Interactions
Uses during Pregnancy
Uses during Breastfeeding
Accute Overdose
Food Interaction
Half Life
Volume of Distribution
Clearance
Interaction With other Medicine
Contradiction
Storage

Trade Name	Ancrod
Generic	Ancrod
Ancrod Other Names	Ancrod
Type
Protein binding	95% bound to erythrocytes
Groups	Approved, Investigational
Therapeutic Class
Manufacturer
Available Country
Last Updated:	September 19, 2023 at 7:00 am

Uses

Ancrod is an anticoagulant purified from the venom of the Malayan pit viper that functions by inactivating circulating plasma fibrinogen. Not currently approved for use or marketed in any country.

Ancrod is indicated for the treatment of deep vein thrombosis (DVT), central retinal branch vein thrombosis, pripaism, pulmonary hypertension of embolic origin, embolism after insertion of prosthetic cardiac valves, rethrombosis after thrombolytic therapy, rethrombosis after vascular surgery, and prevention of DVT after repair of a fractured neck of a femur.

How Ancrod works

Ancrod's anticoagulant effects are through the rapid removal of fibrinogen from the blood within hours following ancrod administration. Ancrod specifically cleaves only the alpha chain of fibrinogen, producing the characteristic fibrinopeptides A, AP and AY, not the B-fibrinopeptide. The resulting fibrin polymers are imperfectly formed and much smaller in size (1 to 2 µm long) than the fibrin polymers produced by the action of thrombin. These ancrod-induced microthrombi are friable, unstable, urea-soluble and have significantly degraded a-chains. They do not cross-link to form thrombi. They are markedly susceptible to digestion by plasmin and are rapidly removed from circulation by either reticuloendothelial phagocytosis or normal fibrinolysis, or both. Blood viscosity is reduced by 30-40%. Ancrod does not activate plagminogen and does not degrade preformed, fully cross-linked thrombin fibrin. Consequently, unlike fibrinolytic agents, ancrod can be used postoperatively. Ancrod does not activate Factor XIII, produce platelet aggregation, or release ADP, ATP, potassium, or serotonin from platelets.

Toxicity

Currently, a new dosing strategy is being investigated in two international phase III trials as part of the 'Ancrod Stroke Program (ASP).' Each of these studies will enroll 650 patients and assess whether a brief, relatively rapid ancrod infusion with no maintenance dosing will be both effective and safe.

Ancrod is contraindicated in patients with known bleeding disorders, unexplained excessive bleeding in the past, platelet counts <100,000 except for Heparin-induced thrombocytopenia, planned surgery, active GIT ulcerations, malignant disease, renal stones, uncontrolled arterial hypertension, active pulmonary tuberculosis, impaired fibrinolysis, severe liver disease, shock, or impending shock. Ancrod should not be given shortly before delivery or via the intramuscular route.

Ancrod has been listed as pregnancy category X by the FDA. Ancrod should not be used in pregnancy as it may interfere with implantation. It is not teratogenic in animal studies but there were some fetal deaths from placental hemorrhage.

Side effects may include hypersensitivity reactions and pain at the injection site.

Food Interaction

Avoid herbs and supplements with anticoagulant/antiplatelet activity. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.