Botroclot Contains Batroxobin, Not Gem Coagulase
Botroclot is a marketed preparation containing hemocoagulase derived from the snake Bothrops atrox, which is batroxobin—a thrombin-like enzyme with coagulant activity. 1
Active Ingredient Clarification
- Batroxobin is the active enzyme in Botroclot, isolated from Bothrops atrox (also known as Bothrops atrox moojeni) snake venom 2, 1
- The term "gem coagulase" does not appear in medical literature as a recognized coagulation enzyme
- Batroxobin is classified as a snake venom-derived thrombin-like serine protease with distinct hemostatic properties 3
Mechanism of Action
Batroxobin functions differently from thrombin:
- Cleaves fibrinopeptide A from fibrinogen to convert it into fibrin, forming clots 3, 4
- Unlike thrombin, batroxobin does not cleave fibrinopeptide B (though some sources indicate it cleaves both A and B peptides, contrasting with ancrod which only cleaves A) 2
- Maintains coagulant activity even in the presence of heparin, making it useful in anticoagulated patients 3
- Does not activate factor XIII, resulting in fibrin clots that are more susceptible to fibrinolysis 2
Clinical Applications of Botroclot
The formulation is used for:
- Dental surgeries and minor surgical wounds as its primary indication 1
- Emerging evidence suggests potential benefit in diabetic wound healing, where topical application improved wound closure, decreased inflammatory markers, and increased collagen deposition in animal models 1
- Related batroxobin preparations have been studied in deep vein thrombosis, stroke, and other thrombotic conditions 2, 5
Important Distinction from Standard Anticoagulants
- Batroxobin is not endorsed by major guidelines (American College of Chest Physicians, American Heart Association) as a standard antithrombotic agent 6
- Guideline-endorsed thrombolytics include tPA (alteplase), reteplase, tenecteplase, streptokinase, and urokinase with established safety profiles 6, 7
- Batroxobin's mechanism as a defibrinogenating enzyme differs fundamentally from standard anticoagulants like heparin, which work through antithrombin potentiation 8