Fibrinogen Concentrate

How it works

It replaces fibrinogen, the substrate that thrombin converts to fibrin to form the stabilising mesh of a blood clot, thereby restoring effective clot formation when fibrinogen is deficient.

Prescribing in practice

• Thromboembolic events can occur, particularly with high or repeated dosing, so use the lowest effective dose and weigh the risk in patients with thrombotic predisposition.
• Dosing should be guided by measured fibrinogen levels and the clinical bleeding state rather than given empirically.
• As a plasma-derived product it carries a theoretical transmissible infection risk and allergic or hypersensitivity reactions may occur during infusion.

Monitoring

Guide replacement with fibrinogen assays and clinical response, and observe for thrombotic and hypersensitivity reactions during and after administration.

Counselling the patient

• This is a clotting factor given by infusion to help blood clot normally.
• Report any chest pain, leg swelling, breathlessness or signs of a reaction during treatment.
• It is prepared from human plasma and screened to minimise infection risk.

Evidence & guidelines

Fibrinogen concentrate is established for congenital fibrinogen deficiency and is used in acquired hypofibrinogenaemia, including major haemorrhage protocols, with thrombosis a recognised risk.