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Int J Clin Pharmacol Res. 2002;22(3-4):81-3.

Fatal cases of gabexate mesilate-induced anaphylaxis.

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  • 1Department of Internal Medicine I, Nihon University School of Medicine, Tokyo, Japan. m-2000@mbk.sphere.ne.jp


Gabexate mesilate, ethyl-4-(6-guanidinohexanoyloxy) benzoate monomethanesulfonate (C16H23N3 O4CH4O3S: M.W. 417.48), is a synthetic protease inhibitor and was introduced for clinical use in 1978. It rarely induces anaphylaxis, and patients with gabexate mesilate-induced shock had been reported to survive with appropriate treatments including respiratory support. However, there were increasing reports on fatal cases in recent years: 6 cases have been reported to develop fatal anaphylaxis following dripping infusions of gabexate mesilate. All the fatal cases rapidly developed anaphylaxis (within 5 minutes), whereas 7 out of 11 in recovered cases developed it 5 or more minutes after the injection. Venous access should be kept for at least 30 minutes to prepare for and to treat this fatal reaction in patients receiving gabexate mesilate repeatedly.

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