ADMINISTRATION OF DROTRECOGIN ALFA (activated)

Drotrecogin alfa (activated) (Activated Protein C, Xigris™) is a novel drug with anti-inflammatory, anticoagulant and pro-fibrinolytic properties. It has been shown to reduce mortality in septic patients, particularly in patients with multi-organ failure (defined by NICE as 2 or more major organs) when added to best standard care.

It is a very expensive drug and the Prescribing Criteria Checklist must be signed by the ICU Consultant to ensure the patient is eligible to receive drotrecogin alfa (activated) before the drug is made up and administered.

5 mg vial = £152 Treatment for an 80 kg patient will cost >£6000.

Dosage

• All patients should receive drotrecogin alfa (activated) at a dose of 24 microgram/kg/hour (use actual body weight) for up to 96 hours (4 days) by intravenous infusion.

• If the infusion is interrupted for any reason, Xigris should be restarted at the 24 microgram/kg/hour infusion rate and continued to complete the full recommended 96 hours of dosing administration.

• No dosage adjustment is required in acute renal or hepatic failure.

Prescription

Should state: Drotrecogin alfa (activated) 24 microgram/kg/hour for 96 hours xx kg

Preparation and Administration

• Drotrecogin alfa (activated) vials must be kept in the fridge

• Once reconstituted drotrecogin alfa (activated) is stable for up to 14 hours at room temperature so infusions must not run for longer than this

• Giving sets should be labelled with the time and date when the infusion was first started and changed every 48 hours

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