Formulary
Marstacimab: Indications, Dosing, Side Effects and Interactions
Marstacimab is a recombinant human monoclonal antibody that binds to tissue factor pathway inhibitor, thereby preventing inhibition of the extrinsic...
MedNext Academy | 3 min read
Marstacimab: Indications, Dosing, Side Effects and Interactions
Marstacimab is a recombinant human monoclonal antibody that binds to tissue factor pathway inhibitor, thereby preventing inhibition of the extrinsic...
Drug action
Marstacimab is a recombinant human monoclonal antibody that binds to tissue factor pathway inhibitor, thereby preventing inhibition of the extrinsic coagulation pathway and promoting haemostasis.
Indications and dose
**Haemophilia A (initiated by a specialist),Haemophilia B (initiated by a specialist)**
- **Adult** (By Subcutaneous Injection): (body-weight 50 kg and above) Loading dose 300 mg for 1 dose, then 150 mg once weekly, increased if necessary up to 300 mg once weekly, increased dose used if control of bleeding events is inadequate.
**Haemophilia A (initiated by a specialist), Haemophilia B (initiated by a specialist) for marstacimab**
- **Child 12-17 years (body-weight 35-49 kg)** (By subcutaneous injection): Loading dose 300 mg for 1 dose, then 150 mg once weekly.
- **Child 12-17 years (body-weight 50 kg and above)** (By subcutaneous injection): Loading dose 300 mg for 1 dose, then 150 mg once weekly, increased if necessary up to 300 mg once weekly, increased dose used if control of bleeding events is inadequate.
Cautions
Increased risk of thromboembolic events; major surgery (interrupt treatment-consult product literature) Cautions, further information Increased risk of thromboembolic events Consider benefits versus risks of treatment in patients that may be at increased risk of thromboembolic events, such as those with a history of coronary artery disease, venous or arterial thrombosis, or ischaemic disease, and in those with acute severe illness with increased tissue factor expression (such as serious infection, sepsis, trauma, crush injuries, or cancer). Monitor patients for early signs of thrombosis and offer thromboprophylaxis; interrupt treatment if thromboembolism occurs. M
Side effects
Common or very common Headache; hypertension; skin reactions
Interactions
**Other interactions (2):**
- No clinical drug interaction studies with marstacimab have been conducted.
- As a monoclonal antibody (mAb), marstacimab is expected to be cleared through catabolic pathways.
Pregnancy
Use only if potential benefit outweighs risk (no information available). M
Breast feeding
Specialist sources indicate use with caution, especially if breast-feeding a neonate or preterm infant (no information available). Large molecular weight suggests limited excretion into milk and drug molecule likely to be partially destroyed in the infant's gastro-intestinal tract; waiting for at least 2 weeks postpartum to resume treatment may minimise transfer to infant.
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Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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