The plasma-derived fibrinogen product Riastap, from CSL Behring, was approved by FDA on January 16 for the treatment of bleeding in patients with congenital fibrinogen deficiency. An estimated 1 or 2 individuals per 1 million have the deficiency, according to the National Hemophilia Foundation. For those patients, CSL Behring said, Riastap is the only FDA-licensed treatment for episodes of acute bleeding, which can be life threatening. The labeling for the new product states that the dosage, duration of treatment, and frequency of administration of fibrinogen concentrate depends on the clinical condition of the patient, laboratory test values, and the extent of the bleeding. Treatment should target a plasma fibrinogen concentration of 100 mg/dL until hemostasis is achieved. Allergic reactions and generalized reactions, such as chills, fever, nausea, and vomiting, were the adverse reactions most commonly reported during clinical studies of the product and postmarketing surveillance in other countries. CSL Behring will distribute Riastap as single-use vials containing 900–1300 mg of lyophilized fibrinogen concentrate powder for reconstitution with 50 mL of sterile water for injection. Packages of Riastap do not contain the diluent. Doses should be administered at room temperature by slow i.v. injection at a rate not exceeding 5 mL/min.
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