Warnings and Hazards

Warnings about products, services, information or anything else considered to increase risks and hazards for people with PSD will be published on this page.

Octaplas presents a transfusion risk for patients with Protein S Deficiency

Octaplas is the only FDA-licensed pooled, solvent/detergent (S/D) treated plasma for transfusion. The FDA has recently approved revised product handling for Octaplas, which increases the time span between product thawing and patient administration.

Octaplas is indicated for the replacement of multiple coagulation factors in patients with acquired deficiencies due to liver disease, undergoing cardiac surgery or liver transplant; and for plasma exchange in patients with thrombotic thrombocytopenic purpura (TTP). More than 13.5 million bags of Octaplas have been transfused to more than 4.5 million patients worldwide.

However excessive bleeding due to hyperfibrinolysis can occur due to low levels of alpha2-antiplasmin, and thrombosis can occur due to low levels of Protein S. Therefore Octaplas is contraindicated in patients with Protein S Deficiency.

Recommendation to limit intake of Cranberry Juice

The BMJ (British Medical Journal) has published an article which suggests that there is a possible interaction between warfarin and cranberry juice. The author recommends that until further research is conducted anyone taking warfarin (or Coumadin) should limit their intake of cranberry juice.

Giving Blood Can Put You At Risk

The UK National Blood Service have advised that people with Protein S Deficiency and a history of clotting or taking anti-coagulants should not donate blood. If you call the UK National Blood Service on 0300 123 23 23 it is best to ask for the assistance of a specialist advisor.

Update 23/Aug/2001: In 2001 it was said that even if you are not on medication the process of transfusion itself is a risk factor to the donor - your blood pressure will drop and this could cause thrombosis

Update 16/Mar/2016: In 2016 the advice was relaxed to allow donations from those with Protein S Deficiency and no clotting history and not taking anti-coagulants.

Incorrect Web Site Information

This page incorrectly stated "Deficient protein S can result in excessive bleeding tendencies" when in fact "bleeding" should read "clotting". An email was sent to Ed Bennett at University of Maryland Medical Center (21 Aug 2000) who passed it on to Katherine Holland at Dr Koop.

Update 7/Nov/2000: Suzanne Meyers at Dr Koop advises that their Medical Advisory Board has reviewed the content and agreed to the correction. The information was provided to them by adam.com and they will follow the matter up with them and ensure other syndicated sites (such as Meridian Health System, Lancaster Health Alliance, Netscape and ABC Network News) will also be updated.

Caution About Packaging

The colours used for the different doses of warfarin are widely established. If you are using warfarin from a Norton Healthcare blister pack be sure to take the correct dose - until recently they had 1mg brown tablets packed in blue packaging, 3mg blue tablets packed in green packaging, and 5mg pink tablets in orange packaging.

Update 14/Aug/2000: Norton Healthcare confirmed that the confusing colour scheme was already being replaced as a result of other enquiries they received.

Warfarin Colour Coding

Last updated: Wednesday, 16th March 2016, © 2000-2017

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