Indications & Dose: PREVENTION OF PRE-OPERATIVE BLOOD LOSS IV Adult Initially 1.4mg over 10min as test dose before surgery then loading dose of 2 million KIU over 20-30min given in supine position after induction of anesthesia but before sternotomy followed by continuous inf of 5 million KIU/h until end of the operation. An additional dose of 2 million KIU is added to the prime volume of the extracorporeal circuit. In patients with septic endocarditis, a dose of 3 million KIU is added to the prime volume of circuit & continuous inf may be continued into the early postoperative period. The total amount of aprotinin used is usually no more than 7 million KIU. A regimen comprising of 50% of the dose for loading, maintenance & to prime the circuit is used in low-risk patientsPatients at high risk for blood loss during CABG surgery

ADR: Serious: Bronchospasm, cardiac arrhythmias, anaphylaxis, hypersensitivity reactions, hypotension, renal dysfunction, reversible renal failure, local thrombophlebitis, GI disturbances, Others: skin rashes, fatalities

DDI: Serious Heparin increases activated clotting time, ACEIs increases risk of renal failure, Neuromuscular blockers leads to apnoea, Tretinoin leads to fatal thrombotic complications