Prolastin, Aralast, Zemaira
Classifications: enzyme inhibitor;
Therapeutic: enzyme inhibitor

Pregnancy Category: C


Prolastin: 25 mg/mL; Aralast: 16 mg/mL; Zemaira: 50 mg/mL


Alpha1-proteinase inhibitor (alpha1-PI; alpha1-antitrypsin) is extracted from plasma and used in patients with panacinar emphysema who have alpha1-antitrypsin deficiency. Alpha1-antitrypsin deficiency is a chronic, hereditary, and usually fatal autosomal recessive disorder that results in a slowly progressive, panacinar emphysema.

Therapeutic Effect

Prevents the progressive breakdown of elastin tissues in the alveoli, thus slowing panacinar emphysema progression.


Indicated for chronic replacement therapy in patients with alpha1-antitrypsin deficiency and demonstrable panacinar emphysema.


Individuals with selective IgA deficiencies; pregnancy (category C); lactation.

Cautious Use

Patients with significant heart disease or other conditions that may be aggravated with slight increases in plasma volume. Safety and efficacy in children are not established.

Route & Dosage

Panacinar Emphysema
Adult: IV 60 mg/kg once/wk



PREPARE: IV Infusion: ??Warm unopened diluent and concentrate to room temperature.??Use the supplied, double needle transfer device to reconstitute with sterile water for injection (supplied by manufacturer) to yield a concentration of 20 mg/mL. 

ADMINISTER: IV Infusion: ?? Give within 3 h after reconstitution.??Give alone, without mixing with other agents.??Administer at rate of 0.08 mL/kg/min or more slowly as determined by response and comfort of the patient.?? Note: The recommended dosage takes about 30 min to administer to a 70 kg person.  

  • Store unreconstituted drug at 2°–8° C (35°–46° F). Do not refrigerate after reconstitution. Discard unused solution.

Adverse Effects (≥1%)

Hematologic: Leukocytosis. CNS: Dizziness, fever (may be delayed). Respiratory: Upper and lower respiratory tract infections. Other: Hepatitis B if not immunized.


Distribution: Crosses placenta; distributed into breast milk. Metabolism: Undergoes catabolism in the intravascular space; approximately 33% is catabolized per day. Half-Life: 4.5–5.2 d.

Nursing Implications

Assessment & Drug Effects

  • Administer with caution in patients at risk for circulatory overload. Monitor cardiac status.
  • Monitor respiratory status (rate, dyspnea, lung sounds) throughout therapy.
  • Lab tests: Monitor serum alpha1-PI level (minimum serum concentration level should be 80 mg/mL); periodic pulmonary functions and ABGs.

Patient & Family Education

  • Avoid smoking and notify physician of any changes in respiratory pattern.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

© 2006-2022 Last Updated On: 11/22/2022 (0)
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