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Prolastin-C Liquid

alpha-1 proteinase inhibitor
Used for Alpha-1 Antitrypsin Deficiency
Used for Alpha-1 Antitrypsin Deficiency

Prolastin-C Liquid, commonly known as simply Prolastin, is an alpha-1 proteinase inhibitor. It's used as augmentation therapy to manage lung problems (emphysema) in adults with a genetic condition called alpha-1 antitrypsin (AAT) deficiency. This medication helps replace an enzyme that's missing in the body called AAT. Prolastin is given as an infusion into the veins (IV) once a week. Side effects aren't common, but can include headache and common cold symptoms.

Reviewed by:
reviewer
Robert Chad Hakim, PharmD, BCCCP
reviewer
Cydnee Ng, PharmD
Last reviewed on January 2, 2024
BasicsSide effectsPros & consPharmacist tipsFAQsWarningsDosageInteractionsContraindicationsAlternativesReferencesPricesMedicare
basics-icon

What is Prolastin?

What is Prolastin used for?

How Prolastin works

Alpha-1 antitrypsin (AAT), or alpha-1 proteinase inhibitor, is an enzyme (protein) that your body normally makes to help protect the lungs from damage. Without enough AAT, there's a higher risk for lung problems, like emphysema.

Prolastin is an enzyme replacement therapy. It restores the levels of AAT in adults with (AAT deficiency) to help protect the lungs.

Are you looking for information on Zemaira (alpha-1 proteinase inhibitor), Aralast NP (alpha-1 proteinase inhibitor), or Glassia (alpha-1 proteinase inhibitor) instead?

Drug Facts

Common BrandsProlastin-C Liquid
Drug ClassEnzyme replacement therapy
Controlled Substance ClassificationNot a controlled medication
Generic StatusNo lower-cost generic available
AvailabilityPrescription only
basics-icon

What are the side effects of Prolastin?

The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.

Common Side Effects

Side effects reported by people within the first 2 months of starting Prolastin-C:

Other Side Effects

  • Diarrhea
  • Fatigue
  • Chest pain
  • Back pain
  • Chills
  • Cough
  • Dizziness
  • Trouble breathing
  • Hot flush

Serious Side Effects

Contact your healthcare provider immediately if you experience any of the following.
  • Severe allergic reaction: anaphylaxis, hives, itching, swelling in the mouth or throat, chest tightness, trouble breathing, wheezing, feeling faint

Source: DailyMed

The following side effects have also been reported

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

More common

Bladder pain

bloody or cloudy urine

body aches or pain

chills

cough

difficult, burning, or painful urination

difficulty with breathing

ear congestion

fever

frequent urge to urinate

headache

loss of voice

lower back or side pain

runny or stuffy nose

sneezing

sore throat

unusual tiredness or weakness

Rare

Bloating or swelling of the face, arms, hands, lower legs, or feet

blurred vision

chest pain

cough producing mucus

diarrhea

difficult or labored breathing

dizziness

feeling faint, dizzy, or lightheadedness

flushing or redness of the skin, especially on the face and neck

general feeling of discomfort or illness

joint pain

loss of appetite

muscle aches and pains

nausea

nervousness

noisy breathing

pounding in the ears

rapid weight gain

shivering

slow or fast heartbeat

sweating

tightness in the chest

tingling of the hands or feet

trouble sleeping

unusual weight gain or loss

vomiting

Incidence not known

Confusion

difficulty with swallowing

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

fast, pounding, or irregular heartbeat or pulse

hives or skin rash

itching, puffiness or swelling of the eyelids or around the eyes, face, lips, or tongue

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

More common

Feeling of warmth

itching skin

muscle or bone pain

pain or tenderness around the eyes and cheekbones

redness of the face, neck, arms, and occasionally, upper chest

sudden sweating

Rare

Back pain

bloating

change in taste

changes in vision

fever

loss of taste

pain

redness of the skin

sleepiness or unusual drowsiness

swelling of the joints

unusual drowsiness, dullness, tiredness, weakness, or feeling of sluggishness

welts

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.

pros-and-cons

Pros and cons of Prolastin

thumbs-up

Pros

Helps replace missing AAT in your body

Can be given at home

Taken only once per week

Available as a ready-to-use liquid

thumbs-down

Cons

Not clear if it can slow the worsening of emphysema due to AAT deficiency

Needs to be given as an infusion into the vein

Must be administered by a trained healthcare provider

pharmacist-tips

Pharmacist tips for Prolastin

pharmacist

  • Mark your calendar with your appointments to see your provider and when your Prolastin once-weekly infusions are due. This will help you and your provider keep track of your treatment and make sure you don't miss any doses.

    • Allergic reactions or infusion-related reactions can happen during or after your Prolastin infusion. Get medical help right away if you have any signs of an allergic reaction or anaphylaxis, including trouble breathing or rash, so you can get treated as soon as possible.

      Getting Prolastin infusions at home (if instructed by your provider):

      • Depending on your insurance coverage and discussions with your provider, you might be able to get your Prolastin infusions at home. Your care team can arrange for a trained nurse to make a home visit to help administer the medication.

        • You'll get the Prolastin vials delivered directly to your home before your appointments with the nurse for your infusions.

          • Store Prolastin vials in the refrigerator and in the original container to protect them from light. You can also store them at room temperature for up to 1 month. But once the medication is at room temperature, don't put it back in the refrigerator and don't use it if it's been at room temperature for longer than 1 month.

            • When the nurse arrives for the appointment for your Prolastin infusion, they'll help prepare your dose. The nurse might need to transfer the liquid from multiple vials into an empty, sterile bag that's then used for the infusion.

              • Once your dose is prepared, it must be given within 3 hours. The medication doesn't contain any preservatives, so bacteria might start to grow in the solution if it hasn't been used for some time. Your nurse will need to prepare a new dose for your infusion.

                • After each Prolastin infusion, the home nurse will help you keep track of your infusions. The nurse will probably use a treatment log to write down the lot number of the vial(s) used, the time and date of your infusions, and any side effects or reactions that you have.

                  faqs

                  Frequently asked questions about Prolastin

                  What should I expect from my first Prolastin infusion?
                  You'll probably get your first few Prolastin infusions at a clinic or infusion center so you can be closely monitored for side effects and allergic reactions to the medication. Plan for some time at the beginning of your appointment to check in and fill out some paperwork. Your care team might check your vitals and ask some questions to see how you're generally doing. The actual Prolastin infusion only takes about 15 minutes, as long as you're tolerating the infusion okay. It's also safe to drive yourself to and from the appointment because the medication doesn't typically cause sleepiness or dizziness. Call the place where you'll get Prolastin infusions if you have specific questions about what to expect.
                  Can I get Prolastin infusions at home?
                  It's possible to get your Prolastin infusions at home, depending on your insurance coverage and if your provider feels it's safe for you to do so. Your care team might arrange for a trained healthcare provider to make a home visit to administer Prolastin. In this case, you'll get the medication delivered directly to your home before your appointments with the home nurse. Discuss with your providers to see whether getting Prolastin infusions at home is right for you.
                  Can Prolastin be stopped when I am sick?
                  If you're feeling sick during the Prolastin infusion, let a healthcare provider know right away. The provider might slow down your infusion or stop the infusion until you feel better. They also might recommend other medications to help relieve your symptoms, for example acetaminophen (Tylenol) for fever. If you feel generally sick and aren't well enough to get your infusion, call your provider to see what to do and whether to reschedule your appointment.
                  What's the difference between Zemaira and Prolastin?
                  Both Prolastin-C Liquid (or sometimes simply known as Prolastin) and Zemaira are brand-name medications that contain the same active ingredient, alpha 1-proteinase inhibitor. These two brands are very similar to each other. Studies show that brands of alpha 1-proteinase inhibitors are safe and work just as well as each other. Prolastin-C Liquid and Zemaira are given as once-weekly infusions through the vein with the help of a trained healthcare provider. The main difference between them is that Prolastin-C Liquid is available as a liquid that's ready for infusion, whereas Zemaira comes as a powder that needs to be mixed before administration. Discuss with your provider about which brand is right for you.
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                  warings-icon

                  What are the risks and warnings for Prolastin?

                  Prolastin can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.

                  risk-warning

                  Severe allergic reactions

                  • Risk factors: Immunoglobulin A (IgA) deficiency

                    Prolastin might contain a tiny amount of immunoglobulin A (IgA), which is a type of protein that's naturally found in the body. People who have IgA deficiency can have antibodies against IgA. Having antibodies against IgA raises the risk of having an allergic reaction, including anaphylaxis, to Prolastin.

                    Let your provider know right away or contact emergency medical help if you have any signs of a severe allergic reaction, such as hives, itching, swelling in the mouth or throat, chest tightness, trouble breathing, wheezing, or feeling faint or lightheaded. Your provider might prescribe an epinephrine pen (EpiPen) for you to use in case of a severe allergic reaction.

                    risk-warning

                    Risk of infection

                    Because Prolastin is made from human blood products, there's a risk that it might contain viruses and other germs that can make you sick. But your risk of infection is low since the donors of these blood products are carefully screened. Also, there are high manufacturing standards put into place to make sure the germs are killed or removed.

                    To prevent serious infections in the rare case that your doses of Prolastin are affected, let your provider know right away if you start to feel sick or have symptoms, such as feeling confused and anxious or having trouble maintaining your balance.

                    dosage

                    Prolastin dosage forms

                    Typical dosing for Prolastin

                    The typical dose is 60 mg/kg of body weight, given as an infusion into the vein (intravenous or IV) once a week.

                    interactions

                    Interactions between Prolastin and other drugs

                    Prolastin may interact with certain medications or supplements. Always let your doctor and pharmacist know about any other medications or supplements (including prescribed and over-the-counter medications, vitamins, and dietary or herbal supplements) that you are currently taking. The list below does not include all possible drug interactions with Prolastin. Please note that only the generic name of each medication is listed below.

                    Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

                    contraindications-icon

                    Prolastin contraindications

                    Contraindications are specific health conditions or situations in which a person should not take a medication due to safety concerns. If you have any of the following conditions or if any of the following apply to you, let your healthcare provider know because Prolastin will not be safe for you to take.
                    alternatives

                    What are alternatives to Prolastin?

                    There are a number of medications that your doctor can prescribe in place of Prolastin. Compare a few possible alternatives below.
                    Prolastin
                    Used for:
                    View Prices
                    Zemaira
                    Used for:
                    View Prices
                    Glassia
                    Used for:
                    View Prices

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                    References

                    Best studies we found

                    American Lung Association. (2023). Treating and managing alpha-1 antitrypsin deficiency.

                    Grifols USA, LLC. (2022). Prolastin-C liquid (alpha1-proteinase inhibitor- human injection, solution [package insert]. DailyMed.

                    Grifols USA, LLC. (2023). Frequently asked questions about PROLASTIN-C LIQUID.

                    View All References (6)

                    Li, Z., et al. (2022). Comparative biochemical efficacy analysis of an alpha1-proteinase inhibitor (Glassia) in patients with alpha-1 antitrypsin deficiency. Pulmonary Pharmacology & Therapeutics.

                    MediMedia USA, Inc. (2010). Alpha1-proteinase inhibitor (human). Pharmacy & Therapeutics.

                    MedlinePlus. (2022). Selective deficiency of IgA.

                    National Heart, Lung, and Blood Institute. (2023). COPD: Alpha-1 antitrypsin deficiency. National Institutes of Health.

                    National Human Genome Research Institute. (2024). Antibody. National Institutes of Health.

                    Patel, A., et al. (2023). Biochemistry, immunoglobulin A. StatPearls.

                    GoodRx Health has strict sourcing policies and relies on primary sources such as medical organizations, governmental agencies, academic institutions, and peer-reviewed scientific journals. Learn more about how we ensure our content is accurate, thorough, and unbiased by reading our editorial guidelines.
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