Xigris is a new IV medication that we've been using quite frequently in the ICU recently for patients with sepsis. Since it was ordered along with IV antibiotics such as Primaxin, Zyvox, Cancidas, and others, we all assumed that it was a new antibiotic. It is pretty fragile stuff (you cannot shake it or transport it in the tube system), and VERY expensive ($1,700/day). We got curious and researched Xigris, and were very surprised to find out that it isn't an antibiotic at all - it's an antiinflammatory.

Severe sepsis or septic shock have a mortality rate of almost 100% when left untreated, and a 28-50% survival rate when treated with conventional methods. Patients treated with Xigris have a 69% survival rate.

Sepsis kills through its effects on the patient's microvasculature, mainly inflammation of the capillaries and clotting throughout the body. Xigris counteracts these effects themselves, rather than attempting to compensate for them like conventional therapy, which includes vasopressors and anticoagulants, does.

Xigris, brand name of dotrecogin alfa (activated)


Xigris is indicated for the reduction of mortality in adult patients with severe sepsis who have a high risk of death as indicated by an APACHE II score of 25 - 53
Dosage for adults
Xigris shoud be administered IV at an infusion rate of 24 mcg/kg/hr for a total duration of 96 hrs. The safety and efficacy of repeat doses of Xigris has not been evaluated.
Dosage for children
The safety and efficacy of Xigris has not been established in children (age newborn to 18)
How supplied
Xigris is supplied as a lysophilized powder in 5 mg and 20 mg single use vials, which must be reconstituted with sterile water and further diluted with sterile saline for IV administration
Additional Information
Xigris has many contraindications, most related to its main side effect, bleeding (see dotrecogin alfa (activated)for more information). Since Xigris is only used in patients with a high risk of dying, the risk/benefit ratio must be weighed for each individual patient.
Date of most recent Update
December 19, 2004
Further information is available in the writeup for the generic name(s) of this medication