Aprotinin

Aprotinin
Clinical data
Other names	Trasylol, bovine pancreatic trypsin inhibitor
AHFS/Drugs.com	Monograph
Pregnancy; category	X;
Dependence; liability	None
Routes of; administration	Intravenous
ATC code	B02AB01 (WHO) ;
Legal status
Legal status	UK: POM (Prescription only); In general: ℞ (Prescription only);
Pharmacokinetic data
Bioavailability	100% (intravenous)
Identifiers
	IUPAC name Aprotinin;
CAS Number	9087-70-1 9004-04-0;
IUPHAR/BPS	6570;
DrugBank	DB06692 ;
ChemSpider	none;
UNII	04XPW8C0FL;
KEGG	D02971 ;
ChEMBL	ChEMBL1201619 ;
ECHA InfoCard	100.029.983
Chemical and physical data
Formula	C284H432N84O79S7
Molar mass	6511.51 g·mol−1
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The drug aprotinin (Trasylol, previously Bayer and now Nordic Group pharmaceuticals), is a small protein bovine pancreatic trypsin inhibitor (BPTI), or basic trypsin inhibitor of bovine pancreas, which is an antifibrinolytic molecule that inhibits trypsin and related proteolytic enzymes. Under the trade name Trasylol, aprotinin was used as a medication administered by injection to reduce bleeding during complex surgery, such as heart and liver surgery. Its main effect is the slowing down of fibrinolysis, the process that leads to the breakdown of blood clots. The aim in its use was to decrease the need for blood transfusions during surgery, as well as end-organ damage due to hypotension (low blood pressure) as a result of marked blood loss. The drug was temporarily withdrawn worldwide in 2007 after studies suggested that its use increased the risk of complications or death;^[1] this was confirmed by follow-up studies. Trasylol sales were suspended in May 2008, except for very restricted research use. In February 2012 the European Medicines Agency (EMA) scientific committee reverted its previous standpoint regarding aprotinin, and has recommended that the suspension be lifted.^[2] Nordic became distributor of aprotinin in 2012.^[3]

^ "Bayer Temporarily Suspends Global Trasylol Marketing" (PDF) (Press release). Trasylol.com. 2007-11-05. Archived from the original (PDF) on 2011-07-17. Retrieved 2007-12-03.
^ "European Medicines Agency recommends lifting suspension of aprotinin". European Medicines Agency. 2012-02-17. Archived from the original on 2014-02-18. Retrieved 2012-02-22.
^ "The Nordic Group acquires rights to Trasylol® from Bayer HealthCare". The Nordic Group B.V. Archived from the original on 1 February 2014. Retrieved 28 January 2014.

[1] "Bayer Temporarily Suspends Global Trasylol Marketing" (PDF) (Press release). Trasylol.com. 2007-11-05. Archived from the original (PDF) on 2011-07-17. Retrieved 2007-12-03.

[EMA2012-2] "European Medicines Agency recommends lifting suspension of aprotinin". European Medicines Agency. 2012-02-17. Archived from the original on 2014-02-18. Retrieved 2012-02-22.

[3] "The Nordic Group acquires rights to Trasylol® from Bayer HealthCare". The Nordic Group B.V. Archived from the original on 1 February 2014. Retrieved 28 January 2014.

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