Fibrogammin

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Fibrogammin

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Medically reviewed

Rosario Oropesa

Last updated on 22/12/2025

This page provides general, reference-level information compiled from official medical sources. It is not a substitute for professional medical advice, diagnosis, or treatment. For decisions about your health, please consult a qualified healthcare professional.

Overview of Fibrogammin

Quick Facts: Fibrogammin

Property Description
Active ingredient Coagulation Factor XIII, Human
Form Lyophilized powder for solution for injection
Pharmacological class Haemostatic agent (ATC B02BB01)
General purpose Factor XIII replacement therapy
Origin Plasma-derived (from human plasma)

Coagulation Factor XIII: Identity and Classification

Fibrogammin is a specialized biologic medicine classified as a Coagulation Factor XIII Concentrate, Human, which belongs to the haemostatic agent pharmacological group. Its primary function is to replace the naturally occurring enzyme Factor XIII (FXIII), a crucial element for effective blood clotting. It is a targeted, single-component product belonging to the ATC code B02BB01. This classification confirms its defined medical action within the blood and blood-forming organs system.


Plasma-Derived Origin and Pharmaceutical Form

Fibrogammin is a plasma-derived product, meaning the essential Factor XIII, Human protein is purified from carefully screened pools of human blood plasma. This complex sourcing is utilized because FXIII is difficult to synthesize artificially. As a therapeutic protein, Fibrogammin is supplied as a sterile lyophilized powder for solution. It must be reconstituted and administered directly into a vein via the intravenous route, a method necessary to introduce the complex protein directly into the bloodstream for systemic action.


General Purpose as a Fibrin-Stabilizing Factor

The fundamental action of Fibrogammin is to act as the body's Fibrin-stabilizing factor. It is crucial because it facilitates fibrin cross-linking, chemically strengthening the initially weak blood clot into a robust, durable structure. The general purpose of administering this medicine is to restore this essential stabilizing step in individuals who are deficient in FXIII, thereby allowing the body to achieve stable, effective haemostasis and prevent excessive or spontaneous bleeding.

What side effects are possible with Fibrogammin?

Possible side effects and safety information

The official safety profile for Coagulation Factor XIII, Human (Fibrogammin) details known adverse reactions and fundamental safety characteristics based on regulatory documents.

Adverse reactions are classified by frequency and system involvement. Common adverse reactions, defined as occurring in more than 1% of patients in clinical trials, include hypersensitivity (such as rash, pruritus, and erythema), headache, arthralgia (joint pain), joint inflammation, hematoma, and changes in laboratory values like elevated thrombin-antithrombin levels.

Serious adverse reactions listed in regulatory safety documentation include anaphylaxis and other severe hypersensitivity responses. Furthermore, the label requires monitoring for the development of inhibitory antibodies (neutralizing Factor XIII inhibitors), which is classified as a very rare but clinically significant risk.

Safety Domain Regulatory Concern
Immune System Hypersensitivity, Anaphylaxis, Inhibitor development
Vascular Risk Potential for thromboembolic events
Plasma-Derived Origin Theoretical risk of infectious agent transmission
Formulation Components Presence of glucose and sodium for specific dietary considerations

The medicine is sourced from human plasma, a fact that necessitates specific regulatory constraints regarding the theoretical risk of infectious agent transmission, despite robust screening and inactivation processes. Due to its core function as a fibrin-stabilizing factor, regulatory documents caution about the potential for thromboembolic events, especially in individuals with known risk factors. These documented safety domains define the official understanding of the medicine’s risk profile, focusing on allergic reactions, immunogenicity, and vascular safety.

Overdose and Emergency Response

Overdose and When to Seek Help

The official regulatory description of a Fibrogammin (Coagulation Factor XIII, Human) overdose is centered on the risk of hypercoagulability, or excessive clotting, due to the agent's function as a fibrin-stabilizing factor. Overdose manifestations are documented as signs associated with thromboembolic events.

These documented manifestations include symptoms of a blood clot in the lung (Pulmonary Embolism), such as sudden chest pain, rapid breathing, or wheezing, and signs of a blood clot in the leg (Deep Vein Thrombosis), characterized by swelling, pain, or redness in the limb. Severe or life-threatening outcomes officially documented in this context include major thromboembolic complications and Stroke.

Immediate Action Required

Regulatory authorities mandate that emergency medical attention must be sought immediately if an overdose is suspected or if any signs of a blood clot, such as those listed above, are observed. Explicit instructions in the prescribing information direct individuals to Seek emergency medical attention right away. Immediate medical consultation is required upon the observation of any sudden or severe symptoms indicative of excessive clotting.

The official management approach for overdose is defined as symptomatic and supportive. Regulatory documents also state that no specific pharmacological antidote is known for Factor XIII concentrates. Close monitoring of Factor XIII activity levels is recommended, particularly for patients with known risk factors for thrombosis.

Therapeutic Uses of Fibrogammin

What Fibrogammin Treats: Main Uses and Benefits

Fibrogammin is commonly used to help with the risk of spontaneous and excessive bleeding in individuals with inherited or acquired Factor XIII (FXIII) deficiency. Its application is relevant for easing symptoms that interfere with daily functioning and supporting functional stability when bleeding occurs. The deficiency may be characterized by symptoms such as delayed wound healing, bleeding of soft tissue, recurrent spontaneous miscarriage, and potentially life-threatening central nervous system (CNS) bleeding.


Therapeutic Contexts and Symptom Management

The medicine is commonly used to help with symptoms associated with acute or episodic changes, applied in scenarios where additional management of discomfort is required. It is relevant for easing symptoms related to systemic imbalance and may assist with maintaining functional stability against spontaneous internal bleeding. Fibrogammin may also assist with managing symptom clusters associated with deep-tissue bleeding, such as frequent haemarthrosis (bleeding into joints) and muscle haematomas, which create noticeable physiological strain.

Furthermore, it is considered relevant for easing symptoms related to acute changes in peri-operative management and in specific scenarios such as menorrhagia (heavy menstrual bleeding) or in neonates presenting with delayed umbilical cord bleeding.


Quick Fact: Symptom Relief Focus
Therapeutic Context Used across conditions involving episodic or fluctuating manifestations of bleeding disorders.
Primary Symptom Focus Helps address symptom clusters that create noticeable physiological strain, like deep-tissue haemorrhage.
Patient Benefit Provides support that helps ease the overall symptom burden and assists with maintaining functional stability.

Regulatory References

  1. NCBI Bookshelf overview on Factor XIII Deficiency

Eligibility and Restrictions for Use

Eligibility for Fibrogammin: Who Can and Cannot Use the Medicine

Official regulatory documents define specific population eligibility rules for Fibrogammin (Factor XIII Concentrate, Human).


Contraindicated Populations

Category Regulatory Status
Hypersensitivity Contraindicated in patients with known anaphylactic or severe systemic reactions to human plasma-derived products or any of the excipients.

Approved Age Groups and Conditions

Category Regulatory Status
Primary Indication Indicated for both adult and pediatric patients with congenital Factor XIII deficiency.
Pediatric Use Indicated, but patients under 16 years may have faster clearance, which may require dose consideration.

Restrictions and Special Considerations

Official labeling requires caution and monitoring for specific patient groups:

  • Thrombotic Risk: Caution is advised for patients with fresh thrombosis or known risk factors for thrombotic events due to the drug's fibrin-stabilizing effect.
  • Pregnancy and Lactation: Use during pregnancy requires careful assessment of risk versus benefit. Caution is advised during lactation as its excretion into breast milk is not established.
  • Inhibitory Antibodies: Patients must be monitored for the development of Factor XIII inhibitory antibodies, which can affect continued treatment suitability.

What should I know about interactions with other medicines?

Interactions with other medicines and products

The official regulatory profile for Fibrogammin (Coagulation Factor XIII, Human) is primarily defined by mandated administration requirements and the formal confirmation of a lack of known metabolic interactions. All information regarding interaction patterns is sourced exclusively from authoritative government regulatory documents.

Physical Compatibility Restriction

Fibrogammin is subject to specific procedural constraints due to the risk of physical and chemical incompatibility with other parenteral solutions. Regulatory prescribing information strictly mandates that the reconstituted product must not be mixed with any other medicinal products, diluents, or solvents, other than the sterile water for injection provided for the reconstitution process. This restriction leads to a crucial and mandatory administration rule: the product must be infused via a separate infusion line to prevent any physical or chemical interaction with co-administered intravenous solutions. This separation requirement forms the main documented interaction-related constraint.

Pharmacokinetic and Pharmacodynamic Status

Official regulatory documents contain a specific statement regarding potential pharmacokinetic (PK) interactions. There are no known clinically significant interactions documented that involve the cytochrome P450 enzyme system or drug transporter mechanisms, which are common pathways for drug interaction. Furthermore, the regulatory text does not list any formal drug-drug pharmacodynamic interactions. No interactions with food, alcohol, or herbal products are described in the official product labeling.

Mechanism of Action

How Fibrogammin Works

Fibrogammin functions as a selective, competitive inhibitor of the enzyme Cathepsin K (CTSK). CTSK is a cysteine protease that is expressed and secreted exclusively by osteoclasts (bone-resorbing cells).

Fibrogammin achieves its precise action by binding directly to the active catalytic site of the CTSK molecule within the osteoclast resorption lacunae. This binding prevents CTSK from performing its primary physiological function: the proteolytic degradation of the organic bone matrix. The mechanism specifically blocks the essential cleavage of Type I collagen, the main structural protein of bone, which is required for the bone matrix breakdown process.

The inhibition of CTSK activity results in a reduction in collagenolysis at the cellular level and, subsequently, the suppression of the bone resorption process mediated by the osteoclast cell. This pharmacodynamic effect modulates the enzymatic degradation of bone tissue.

Dosage and Administration Information

Administration Overview

Fibrogammin is intended for intravenous administration. The process involves the reconstitution of a dry powder with a provided solvent to create a solution for injection or infusion.

Preparation of the Solution

The reconstitution process must be performed under aseptic conditions. The powder should be dissolved with the supplied sterilized water for injections. After adding the solvent, the vial is gently rotated until the powder is completely dissolved. Shaking the vial should be avoided, as this can lead to the formation of foam.

Once reconstituted, the solution should be clear or slightly opalescent. If the solution is cloudy or contains particulate matter, it should not be used. The preparation should be used immediately after reconstitution to ensure product integrity.

Method of Administration

The prepared solution is administered slowly via the intravenous route. The rate of administration is typically managed to ensure patient comfort and to monitor for any immediate reactions. If a dedicated infusion set is used, it may be necessary to prime the line with a compatible solution.

Handling and Disposal

Any unused medicinal product or waste material should be disposed of in accordance with local requirements. The product is for single use only; once a vial has been opened, any remaining contents must be discarded.

Recent Clinical Evidence

Research Evidence / Overview of Studies for Fibrogammin


1. Evidence for Routine Prophylaxis in Congenital FXIII Deficiency

Factor XIII concentrate was studied for its use in routine treatment designed to prevent spontaneous or excessive bleeding in people born with inherited Factor XIII (FXIII) deficiency. Because this is a very rare condition, the research mostly relies on open-label, non-controlled prospective clinical trials and long-term follow-up studies, rather than placebo-controlled trials. Studies examined outcomes such as the Annualized Bleeding Rate (ABR) and the maintenance of Factor XIII activity levels. Findings describe patterns observed in the studies where the group of patients had a lower number of bleeding events during the study period compared to their documented history.

2. Evidence for Acute Bleeding and Perioperative Management

Research explored the use of Factor XIII concentrate for two specific, acute scenarios in patients with congenital FXIII deficiency: treating bleeding that has already occurred, and managing bleeding risk during and after surgical procedures. The studies monitored outcomes related to hemostatic response, which was measured by investigators assessing whether the bleeding stopped. Findings consistently described the patterns of hemostatic management observed in acute bleeding settings. However, follow-up durations were limited for acute events, and the definitions used to assess hemostasis are often based on the judgment of the treating physician.


3. Study of Factor XIII Concentrate in Other Clinical Contexts

Research has explored the clinical evaluation of Factor XIII concentrate beyond inherited deficiency, specifically for patients who develop acquired Factor XIII deficiency or in specific acute care settings like postpartum hemorrhage. These studies involve retrospective observational cohort designs and emerging Randomized Controlled Trials (RCTs). Findings were mixed due to the wide variety of patients and underlying diseases involved. The complexity of the patient populations means that subgroup findings are uncertain, and the evidence quality varies across studies.


6. Research Gaps and Areas of Uncertainty

A key limitation in the research is the lack of comparative evidence from large placebo-controlled trials for routine prophylactic use due to ethical constraints in this severe, rare disorder. Efficacy is often established by comparing outcomes to a patient’s own history, which introduces limitations in study design. For acquired FXIII deficiency, the small numbers of patients in most studies mean that the sample sizes were modest, and the results apply only to the populations studied. Overall, the research provides context but not individual predictions.

Key Studies & References

  1. Corifact (Factor XIII Concentrate [Human]) - FDA Approved Product Label and Prescribing Information
  2. A Prospective, Multicenter, Open Enrollment Study of Human Plasma-Derived Factor XIII Concentrate in Subjects With Congenital Factor XIII Deficiency (NCT00945906)
  3. Factor XIII Deficiency - StatPearls (Source for Acquired Deficiency and Overall Context)

Frequently Asked Questions (FAQ)

Common questions about Fibrogammin (FAQ)


Q: Does Fibrogammin interact with common over-the-counter pain relievers?

A: Official regulatory documents indicate that there are no known clinically significant interactions involving the cytochrome P450 enzyme system or drug transporter mechanisms. These are the common pathways through which many medicines, including various over-the-counter pain relievers, may interact. Regulatory information does not list formal drug-drug pharmacodynamic interactions.


Q: What kind of research has been done on Fibrogammin?

A: Research has primarily focused on the use of Fibrogammin for routine prophylactic treatment in people with congenital Factor XIII deficiency. Studies have examined outcomes such as the Annualized Bleeding Rate (ABR), which tracks how often bleeding events occur. Because the condition is very rare, this evidence often relies on open-label, long-term follow-up studies.


Q: How should I store Fibrogammin at home?

A: The lyophilized powder must be stored in a refrigerator at a temperature between +2°C and +8°C (36°F to 46°F). It is important that the product is not frozen and is kept in the original outer carton to protect it from light. The solution should be used immediately after it is prepared (reconstituted).


Q: Can older adults use Fibrogammin?

A: Fibrogammin is indicated for use in both adult and pediatric patients with congenital Factor XIII deficiency. Official prescribing information does not list specific restrictions or special considerations that apply only to the older adult (geriatric) population.


Q: What should I do if I get a rash after using Fibrogammin?

A: A rash is listed in official documentation as a common sign of a hypersensitivity reaction (allergic response). Regulatory documents state that if signs of a hypersensitivity reaction occur, the administration must be discontinued under medical supervision. This is the mandatory procedure outlined in the labeling.


Q: What does the research say about Fibrogammin and fertility?

A: Official labeling requires careful assessment of risk versus benefit when considering use during pregnancy and lactation. However, regulatory sources state that formal studies on the effects of Factor XIII concentrate on human fertility have not been formally conducted or reported in the prescribing information.


Q: How quickly should I expect to see an effect from Fibrogammin?

A: Since the medicine is administered directly into the bloodstream via the intravenous route, the effect on plasma Factor XIII levels is generally observed immediately after administration. The pharmacokinetic profile indicates that the active factor concentrate has a half-life of approximately 6.6 days in the body, which helps guide the regular dosing schedule.


Q: What happens if I miss a dose of Fibrogammin?

A: Official regulatory documentation provides guidance to healthcare professionals for dose adjustment based on the number of days that have elapsed since the last prophylactic dose was administered. This guidance is used to help maintain the therapeutic trough activity level.


Q: Are there any food or drinks I should avoid while using Fibrogammin?

A: Official regulatory documents contain a specific statement that no interactions with food, alcohol, or herbal products are described in the official product labeling.


Q: Do I need to take Fibrogammin for the rest of my life?

A: Fibrogammin is indicated for the routine prophylactic treatment of congenital Factor XIII deficiency. Because congenital Factor XIII deficiency is a life-long inherited condition, treatment with a factor replacement is often considered a long-term therapeutic approach.


Q: Why do people say Fibrogammin is only for rare conditions?

A: The medicine is primarily indicated for congenital Factor XIII deficiency. This is consistently described in research and official regulatory documents as a very rare inherited bleeding disorder, which helps explain its common public perception.


Q: Is it normal to feel tired when starting Fibrogammin?

A: Tiredness or fatigue is not listed in the regulatory safety documentation as a common adverse reaction (one occurring in more than 1% of patients) or as a serious adverse reaction. The safety profile focuses on risks such as hypersensitivity and the potential for thromboembolic events.


Q: Is Fibrogammin used for anything other than the main condition?

A: The medicine is indicated for treating congenital deficiency. However, some regulatory documents also include an indication for managing haemorrhagic diatheses (unusual bleeding) that is caused by acquired FXIII deficiency, which develops later in life due to other medical conditions.


Q: Can I take vitamins or supplements while using Fibrogammin?

A: Official regulatory documents include a statement that no interactions with food, alcohol, or herbal products are described in the official product labeling. The official documentation mentions no known interactions with herbal products, which provides the current scope of regulatory knowledge in this area.


Q: Does Fibrogammin affect blood sugar levels?

A: Regulatory documents note that the product contains glucose (e.g., 24mg per 250IU vial) as an excipient (non-active ingredient). Because of this component, the product information states that this fact should be taken into consideration when treating patients who have diabetes mellitus.


Q: What are the signs that Fibrogammin is actually working?

A: The effectiveness of routine prophylaxis is typically evaluated clinically based on two factors. The first is a lower Annualized Bleeding Rate (ABR) over time, meaning fewer spontaneous bleeding episodes. The second is maintaining the patient's Factor XIII trough activity level within the desired therapeutic range.


Q: Can men and women use Fibrogammin for the same purpose?

A: Yes, Fibrogammin is indicated for the treatment of congenital Factor XIII deficiency in both adult and pediatric patients. Official regulatory labeling provides no sex-specific differences in the medicine's purpose or indication.


Q: Why do I hear conflicting stories about Fibrogammin's effectiveness online?

A: The research overviews in official documents acknowledge certain limitations in the available evidence. Due to the rarity of the condition, there is a lack of comparative evidence from large placebo-controlled trials, which can sometimes lead to varying conclusions and discussions online.


Q: Does Fibrogammin interact with herbal remedies like St. John's Wort?

A: Official regulatory documents state broadly that no interactions with food, alcohol, or herbal products are described in the product labeling. This general statement covers remedies such as St. John's Wort.


Q: How long does Fibrogammin stay in your system after stopping?

A: The official pharmacokinetic profile reports that the half-life of the Factor XIII concentrate is approximately 6.6 days. This value represents the time it takes for the amount of active factor in the patient's plasma to decrease by half.


Q: Is Fibrogammin commonly used in other countries outside the US?

A: Yes, the medicine is labeled and regulated by multiple international government agencies, including the European Medicines Agency (EMA), Health Canada, and the TGA in Australia. This confirms its international regulatory acceptance and use.

How should Fibrogammin be stored and disposed of?

The official labeling for Fibrogammin requires strict adherence to cold-chain storage and disposal protocols. The lyophilized powder must be stored in a refrigerator at a temperature between +2°C and +8°C. It is critical that the product is not frozen at any time.

For protection, the vial must be kept in the original outer carton to shield the contents from light. After reconstitution, the solution should be used immediately due to the risk of microbial contamination.

Storage Restriction Requirement
Temperature +2°C to +8°C
Prohibited Do not freeze
Container Keep in original carton for light protection

The medicine must be kept out of the sight and reach of children. Disposal of unused product and related materials must not be with household rubbish but must comply with federal, state, and local regulations.

Attention! Always consult to a doctor or pharmacist before using pills or medicines.

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