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Ferric Subsulfate


General


Pronunciation

(FER ik sub SULL fate)


Brand Names: U.S.

  • Astringyn
  • Monsels Ferric Subsulfate

Indications


Use: Labeled Indications

Hemostatic in minor surgical procedures


Contraindications


There are no contraindications in the manufacturer 's labeling.


Dosing and Administration


Dosing: Adult

Hemostasis: Topical: Apply evenly to wound


Dosing: Geriatric

Refer to adult dosing.


Dosing: Renal Impairment

No dosage adjustment provided in manufacturer 's labeling.


Dosing: Hepatic Impairment

No dosage adjustment provided in manufacturer 's labeling.


Administration

Topical: For external use only. Apply to wound using cotton applicator/swab. Avoid contact with eyes.


Dosage Forms/Strengths


Dosage Forms

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, External:

Astringyn: 259 mg/g (8 g) [contains benzalkonium chloride, glycerin, povidone (polyvinylpyrrolidone)]

Monsels Ferric Subsulfate: (8 mL, 60 mL)


Drug Interactions

There are no known significant interactions.


Monitoring Parameters

Hemostasis at site of application.


Adverse Reactions


Frequency not defined.

Dermatologic: Skin hyperpigmentation (application site)


Warnings/Precautions


Concerns related to adverse effects:

- Hyperpigmentation: May cause heavy pigmentation at application sites, which may result in histologic artifacts (upon rebiopsy) or in radiographic artifacts.

Other warnings/precautions:

- Appropriate use: For external use only. If inadvertent ocular administration occurs wash eye(s) immediately with large amounts of water or normal saline for approximately 15-20 minutes or until no evidence of solution remains.


Pregnancy Considerations

Ferric subsulfate is used as a hemostatic agent following cervical biopsies (Manca, 1997; Tam, 2005). May cause vaginal pain if leakage of solution occurs (Tam, 2005). A case report also describes use following a miscarriage; fertility was not impaired and a successful pregnancy occurred 7 months later (Disu, 2007).


Actions


Pharmacology

Causes agglutination of surface proteins resulting in hemostasis


Onset of Action

Hemostasis: ≤20 seconds


Patient and Family Education


Patient Education

- Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

- Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for healthcare professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience and judgment in diagnosing, treating and advising patients.

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