Ferric Subsulfate Monsels Solution

Ferric Subsulfate Monsels Solution Brand Name- AstrinGyn

What is Ferric Subsulfate Monsels Solution

Ferric subsulfate, also known as Monsel’s solution, is a chemical solution commonly used in medical settings for its hemostatic (bleeding control) properties. It contains a combination of ferric sulfate and hydrochloric acid.

Monsel’s solution is typically applied topically to control bleeding in various clinical procedures, such as in the management of nosebleeds (epistaxis), wound care, and during certain gynecological procedures.

Ferric Subsulfate Monsels Solution is a topically applied solution containing roughly 20—26% iron.

The solution is produced by the oxidation of ferrous sulfate along with sulfuric and nitric acid.

It is used primarily as a topical hemostatic agent in minor surgical procedures (particularly dermatologic and gynecologic procedures).

The solution is moderately caustic and should be used with proper protection (e.g., gloves, eye mask if necessary) and in an area with adequate ventilation to avoid irritation to the skin, eyes, or respiratory tract.

Monsels solution has been in use medically for decades and was found in the early publications of the National Formulary of the United States.

Indications

• surgical bleeding

For use as a hemostatic for minor surgical bleeding occurring during minor dermatologic or gynecologic procedures

Mechanism of Action

• Application of ferric subsulfate solution (containing roughly 20—26% iron) coagulates tissue and blood proteins at the site of bleeding, which closes off the blood vessels.
• Local hemostasis of a full dermis punch biopsy occurs within 20 seconds of application

Side Effects

1. skin discoloration
2. skin irritation
3. tissue necrosis

Contraindications

• breast feeding
• ocular exposure
• ophthalmic administration
• organ biopsy
• parenteral administration
• pregnancy
• skin disease

Interactions

There are no drug interactions associated with Ferric Subsulfate Monsels Solution products.

• Ferrugination of fibrin, dermal collagen, and striated muscle fibers may result from the application of Monsel’s solution (20% ferric subsulfate) for hemostasis to wounds caused by excisions of skin.
• The collagen fibers in the dermis are coated with a slightly refractile, gray-brown substance which is strongly positive with Perl’s reaction for iron. Ferruginated collagen fibers are eliminated through the epidermis as the epidermis regenerates.
• Some of the ferruginated fibers become calcified. Siderophages are present in these and adjacent areas. Seepage of Monsel’s solution into deeper tissues at the site of biopsy may result in ferrugination of skeletal muscle, perichondrium, and even cartilage.
• In a study application of Monsel’s solution to biopsy sites caused experimentally in a rabbit and confirmed the capacity of the solution to produce ferrugination of collagen fibers and skeletal muscle. Ferrugination of collagen fibers becomes less pronounced as the wounds heal and as iron pigment is taken up by macrophages.
• Ferruginated fibers of skeletal muscle act as foreign bodies to elicit a granulomatous reaction. Comparison of biopsy sites to which Monsel’s solution had been applied with biopsy sites to which the solution had not been applied indicates that the substance does not seem to interfere with the rate of epidermal regeneration.
• However, when there is injury to skeletal muscle and other deep tissues by Monsel’s solution, an inflammatory reaction persists at these sites for weeks.

Mechanism of Action

Application of ferric subsulfate solution (containing roughly 20—26% iron) coagulates tissue and blood proteins at the site of bleeding, which closes off the blood vessels. Local hemostasis of a full dermis punch biopsy occurs within 20 seconds of application.⁵⁷⁶¹⁷

Pharmacokinetics

Ferric subsulfate solution is administered topically. Pharmacokinetic data are unknown.⁵⁷⁶¹⁷

Classifications

• Blood and Blood Forming Organs
  • Antihemorrhagics
    • Hemostatics
      •  Tissue Sealing Agents