Children

Half the adult dose.

Neonatology: 10 mg per kg body weight
(0,1 ml=12,5 mg) injected intramuscularly within 2
hours of birth then every 6 hours for 4 days.
4.3. Contra-indications
Acute porphyria.
Bronchial asthma, proven hypersensitivity to sul-
phites.
Hypersensitivity to the active substance or to any of
the excipients.
4.4. Special warnings and special precautions
for use
As parenteral administration of Dicynone 250 for
injection may induce a drop in blood pressure, it
is advised to carefully monitor patients suffering
from blood pressure instability or hypotension (see
Adverse reactions).
4.5. Interactions with other medicinal products
and other forms of interaction
Thiamine (vitamin B1) is inactivated by the sulphite
contained in Dicynone 250 for injection.
If a perfusion with Dextran is necessary, Dicynone
250 must be injected first.
4.6. Pregnancy and lactation
Pregnancy category C: For etamsylate, no clinical
data on exposed pregnancies are available.
Animal studies do not indicate direct or indirect
harmful effects with respect to pregnancy, embryo-
nal/foetal development, parturition or postnatal
development (see 5.3.). As a precaution, Dicynone
should not be administered during the first trimes-
ter of pregnancy, whereas during the second and
third trimester, it should be administered only if the
expected therapeutic benefit is judged as superior to
the potential risk for the foetus.
In the absence of data regarding passage into
maternal milk, lactation during treatment is not
1. Name of the medicinal product
DICYNONE 250 Injection solution
2. Qualitative and quantitative composition
1 ampoule for injection contains:
Etamsylate 250 mg.
For excipients, see section 6.1.
3. Pharmaceutical form
Solution for injection.
4. Clinical particulars
4.1. Therapeutic indications
In surgery:
Prevention and treatment of pre-, per-, or postsurgi-
cal capillary haemorrhages in all delicate operations
and in those affecting highly vascularised tissues:
E.N.T., gynaecology, obstetrics, urology, odontosto-
matology, ophthalmology, plastic and reconstructive
surgery.
In paediatrics:
Prevention of periventricular haemorrhages in pre-
mature babies.
4.2. Posology and method of administration
Adults
Presurgical: 1-2 ampoules i.v. or i.m. (250-500 mg) 1
hour before surgery.
Persurgical: 1-2 ampoules i.v. Repeat the dosage if
necessary.
Postsurgical: 1-2 ampoules (250-500 mg) every 4-6
hours as long as the risk of bleeding persists.
Emergency cases, according to the severity of the
case: 1-2 ampoules i.v. or i.m. every 4-6 hours as
long as the bleeding risk persists.
Local treatment: soak a swab with the contents of
one ampoule and apply to haemorrhagic area, or in
the tooth socket after dental extraction. The applica-
tion may be repeated if necessary; it may be associ-
ated with oral or parenteral administration.
DICYNONE 250 Injection solution
OM Pharma
DICYNONE 250 Injection solution - p.2/3
5.2. Pharmacokinetic properties
After i.v. administration of 500 mg etamsylate, the
maximum plasma level, i.e. 50 g/ml, is reached
after 10 minutes; plasma half-life is about 1,9h.
About 85% of the administered dose are excret-
ed in the first 24h-urine. The molecule is excreted
unchanged.
Etamsylate crosses the placental barrier. Maternal
and cord blood contains similar concentrations of
etamsylate. It is not known if etamsylate is excreted
in the maternal milk.
Kinetics in particular situations
It is not known if the pharmacokinetic properties of
etamsylate are modified in patients suffering from
renal and/or hepatic function disorders.
5.3. Preclinical safety data
Acute and chronic toxicity studies, foetotoxicity
and mutagenicity studies on etamsylate have not
revealed any toxic effect.
6. Pharmaceutical particulars
6.1. List of excipients
1 ampoule contains:
- Sodium bisulfite
- Water for injection
- Antioxidant (E 223)
- Sodium hydrogen carbonate
- Nitrogen
6.2. Incompatibilities
Thiamine (vitamin B1) is inactivated by the sulphite
contained in Dicynone 250 for injection.
If a perfusion with Dextran is necessary, Dicynone
250 must be injected first.
6.3. Shelf-life
Dicynone 250 ampoules should not be administered
after the expiration date indicated on the package
(EXP).
6.4. Special precautions for storage
Protect the ampoules from light. Discard Dicynone
250 ampoules if the solution is coloured. To be
stored protected from heat (below 30C).
Store in the original package.
advisable or, if lactation is to continue, the treatment
must be stopped.
4.7. Effects on ability to drive and use machines
Dicynone 250 for injection has no effect on the abil-
ity to drive and use machines.
4.8. Undesirable effects
In certain cases, parenteral administration can pro-
duce a drop in blood pressure. Pressure returns to
normal values within the next hours.
Rare: gastralgia, nausea, headache, skin rash.
In most cases these symptoms disappear spontane-
ously.
Dicynone 250 ampoules for injection contains
sodium bisulphite as antioxidant that may cause
allergic reactions, nausea and diarrhoea in sus-
ceptible patients. The allergic reactions may lead
to anaphylactic shock and cause life-threatening
asthma attacks. The incidence in the population is
not known but is probably low. However, hyper-
sensitivity towards sulphite is observed more fre-
quently in asthmatics than in non-asthmatics (see
Contraindications and Precautions). In case
of hypersensitivity reactions, the administration
of Dicynone 250 ampoules must be immediately
stopped.
4.9. Overdose
No case of overdose has been reported. In case of
overdosage, a symptomatic treatment should be ini-
tiated.
5. Pharmacological properties
5.1. Pharmacodynamic properties
ATC code: B02BX01 (Other systemic hemostatics)
Etamsylate is a synthetic antihaemorrhagic and
angioprotective drug acting on the first step of hae-
mostasis (endothelium-platelet interaction). By
improving platelet adhesiveness and restoring cap-
illary resistance, it is able to reduce bleeding time
and blood losses.
Etamsylate has no vasoconstrictor action, it does
not influence fibrinolysis nor modify the plasma
coagulation factors.
DICYNONE 250 Injection solution - p.3/3
6.5. Nature and content of container
2-ml neutral glass ampoules.
6.6. Instructions for use and handling
No special instructions.
7. Marketing authorization holder
OM PHARMA, 22, rue du Bois-du-Lan, 1217 Meyrin
2/Geneva, Switzerland