Bedside Snapshot

Use It For: Bleeding with low fibrinogen: major trauma, postpartum hemorrhage, massive transfusion, cardiac surgery, DIC; acute bleeding in congenital fibrinogen deficiency
Adult Dose: Trauma, fibrinogen ≤150 mg/dL or VEM deficit: concentrate 3–4 g IV or cryo 10 units (at least 1.5 g; not equal to 3–4 g)
PPH: same doses if <200 mg/dL with ongoing bleeding
Congenital, level unknown: 70 mg/kg IV
Pediatric Dose: Fibryga 70 mg/kg IV (<12 yr) or 50 mg/kg IV (≥12 yr); cryo 1–2 units per 10 kg (<50 kg). Replace for measured hypofibrinogenemia (commonly <150 mg/dL), not empirically
Onset / Duration: IV: immediate (level rises during the infusion) / variable: days if not consumed, much shorter with ongoing bleeding or DIC
Do Not Give / Hold If: Prior anaphylaxis to plasma-derived products or product components; fibrinogen at target with bleeding controlled; never use cryo-poor plasma for fibrinogen
Watch For: Thrombosis (limb swelling, chest pain, new neuro deficit); anaphylaxis (hives, wheeze, hypotension); with cryo, TRALI (hypoxemia within 6 hr), TACO (volume overload, can present later) and febrile reactions
Reversal / Rescue: No reversal agent: stop the infusion. Anaphylaxis: epinephrine IM. Thrombosis: image, anticoagulate once bleeding risk allows. Transfusion reaction: stop, notify the blood bank
Must Remember: Dose to a measured deficit: recheck Clauss fibrinogen or FIBTEM after every dose. Adding early empiric high-dose cryo to massive-transfusion care did not improve survival

Indications

ED / ICU / Transport

Traumatic hemorrhage with low fibrinogen: Clauss fibrinogen ≤150 mg/dL, or a viscoelastic fibrinogen deficit, during major bleeding. Fibryga is labeled for acquired deficiency. RiaSTAP is off-label.
Postpartum hemorrhage (PPH): bleeding that keeps going with fibrinogen <200 mg/dL. Fibryga is labeled for this. RiaSTAP is off-label.
Massive transfusion from any cause: GI, vascular or surgical bleeding. Use it when fibrinogen falls below target even with balanced resuscitation.
Bleeding after cardiac surgery: fibrinogen drops after cardiopulmonary bypass. Fibryga is labeled, and the FIBRES trial studied it.
Disseminated intravascular coagulation (DIC) with bleeding: abruption, amniotic fluid embolism, acute promyelocytic leukemia or sepsis. Treat the cause first. Fibryga is labeled. RiaSTAP is off-label.
Liver failure with active bleeding: the liver makes too little, and consumption uses up what is left. Fibryga is labeled. RiaSTAP is off-label.
Bleeding after fibrinolytic therapy: alteplase lowers fibrinogen more than tenecteplase does. A level drawn soon after the lytic can read falsely low. Give cryoprecipitate per the stroke or STEMI bleeding protocol.

Other Uses

Congenital afibrinogenemia or hypofibrinogenemia: acute bleeding episodes. RiaSTAP and Fibryga are both labeled for it. Neither product is indicated for dysfibrinogenemia.
Cryoprecipitate only: second choice for von Willebrand disease, hemophilia A or factor XIII deficiency when a specific factor concentrate is not on hand. For hemophilia A, use standard cryo only. Pathogen-reduced cryo is not for factor VIII replacement. Also used for uremic bleeding after other measures fail.

Dosing & Administration

Doses vary by protocol; follow local protocols and medical direction.

Available Forms

RiaSTAP (fibrinogen concentrate, human): lyophilized single-dose vial. About 1 g (900–1,300 mg) reconstitutes in 50 mL sterile water. About 2 g (1,800–2,600 mg) takes 100 mL. Either way it lands at about 20 mg/mL. The potency printed on each vial is the real number. It is labeled only for congenital deficiency.
Fibryga (fibrinogen, human): one bottle per dose. About 1 g goes into 50 mL, or 2 g into 100 mL, using the supplied sterile water and Nextaro transfer device. That makes 20 mg/mL. It is labeled for acquired and congenital deficiency.
Cryoprecipitated antihemophilic factor (cryo): a frozen blood component. Each unit carries at least 150 mg fibrinogen and 80 units of factor VIII, plus factor XIII and von Willebrand factor, in about 5–20 mL of plasma. A pooled bag lists its unit count on the label.
Pathogen-reduced cryoprecipitated fibrinogen complex: about 740 mg fibrinogen per unit, made from 2 whole-blood plasma units. It stays usable for 5 days after thawing, or 4 hours if it was pooled without a sterile connecting device. It is not for factor VIII replacement in hemophilia A.

Fibrinogen concentrate vs cryoprecipitate
Feature	Fibrinogen Concentrate	Cryoprecipitate
Fibrinogen per dose	Known (potency on label): 3–4 g adult dose	Variable: at least 150 mg per unit; 10 units carry at least 1.5 g, about half a 3–4 g concentrate dose at minimum content
Volume	4 g = 200 mL	About 5–20 mL per unit plus saline used to pool
Preparation	Reconstitute at the bedside or in pharmacy; no thawing, no ABO matching	Blood bank thaws (up to 15 min); no compatibility testing; Rh not considered
Other factors	Fibrinogen only	Factor VIII, factor XIII, von Willebrand factor
Pathogen safety	Virus-inactivated plasma fraction	Donor-screened component (pathogen-reduced form available)

Adult Dosing

Indication	Dose & Route	Repeat / Max	Notes
Traumatic hemorrhage, fibrinogen ≤150 mg/dL or VEM deficit	Fibrinogen concentrate 3–4 g IV, or cryoprecipitate 10 units IV (for example two 5-unit pools)	Recheck fibrinogen or viscoelastic test after each dose; repeat to keep fibrinogen ≥150 mg/dL. No fixed max	European trauma guideline (6th ed., 2023): initial 3–4 g, which it equates with 15–20 single-donor cryo units. Ten units guarantee only at least 1.5 g by labeled minimum content (often more), so the two listed doses are not equivalent; dose cryo per the local MTP and recheck Clauss or VEM after each dose. The same guideline allows fibrinogen-based or plasma-based initial resuscitation, and local MTP packs may include cryo; give them per protocol. Adding early empiric high-dose cryo to standard care did not lower 28-day mortality (CRYOSTAT-2), so guide later doses by Clauss or VEM. Give tranexamic acid early; do not wait for results.
Postpartum hemorrhage, fibrinogen <200 mg/dL (or a viscoelastic deficit per local obstetric protocol) with ongoing bleeding	Cryoprecipitate 10 units IV, or fibrinogen concentrate 3–4 g IV	Per FIGO 2022, target at least 150–200 mg/dL; repeat by level. No fixed max	Fibrinogen ≤200 mg/dL early in PPH predicts severe bleeding. Randomized trials of early or pre-emptive concentrate in PPH (FIB-PPH, OBS2, FIDEL) showed no benefit when fibrinogen was not low; in OBS2, replacement was not needed with FIBTEM A5 above 12 mm or Clauss above 200 mg/dL, and a benefit below those levels was not excluded. Fibrinogen is normally higher in late pregnancy, so a value that looks normal for a nonpregnant adult is already low. Per FIGO 2022, give tranexamic acid as soon as PPH is diagnosed if within 3 hours of birth.
Bleeding after cardiac surgery (acquired deficiency)	Fibryga 4 g IV over about 10 min, or cryoprecipitate 10 units IV	Repeat 4 g if fibrinogen ≤200 mg/dL or FIBTEM A10 ≤10 mm. No fixed max (2–20 g given in the FIBRES trial)	Fibryga label dose for acquired deficiency in bleeding adults. FIBRES: 4 g raised fibrinogen about 90 mg/dL and 10 units of cryo about 70 mg/dL; concentrate was non-inferior for blood use. The label also reports 28-day mortality of 9.4% with Fibryga vs 7.4% with cryo; the trial was not designed to compare mortality.
Bleeding with DIC or liver failure	Same doses (3–4 g IV or cryo 10 units), guided by fibrinogen level	Repeat by level; ongoing consumption shortens the effect. No fixed max	Treat the underlying cause. Reserve components for bleeding patients or invasive procedures; do not treat a number alone. Trigger and target per local protocol.
Congenital fibrinogen deficiency, acute bleeding	RiaSTAP: (target − measured mg/dL) ÷ 1.7 = mg/kg IV. Fibryga: same formula ÷ 1.8. Level unknown: 70 mg/kg IV	RiaSTAP: keep 100 mg/dL until hemostasis. Fibryga: target 100 mg/dL (minor) or 150 mg/dL (major); redose below 80 or 130 mg/dL	Involve hematology. 70 mg/kg raises fibrinogen about 120–125 mg/dL. Thrombosis risk may be higher at targets of 150 mg/dL (Fibryga label).

Pediatric Dosing

Indication	Dose (per kg) & Route	Max Single / Max Total	Notes
Acquired deficiency with bleeding (trauma, surgery, massive transfusion)	Fibryga 70 mg/kg IV (<12 yr) or 50 mg/kg IV (≥12 yr)	Repeat the same dose if fibrinogen ≤200 mg/dL or FIBTEM A10 ≤10 mm. No fixed max	Pediatric trauma consensus (2023): replace fibrinogen for hypofibrinogenemia (most trauma centers treat <150 mg/dL); evidence is insufficient for empiric use. The ≤200 mg/dL redose trigger is from the Fibryga label; follow the local pediatric MTP.
Cryoprecipitate (children <50 kg)	1–2 units per 10 kg IV, or 2–3 mL/kg IV	Expected rise 60–100 mg/dL; repeat by level. No fixed max	AABB Circular pediatric dosing. ABO-compatible cryo may be preferred in neonates.
Congenital deficiency, acute bleeding	RiaSTAP ÷ 1.7; Fibryga ÷ 1.4 (<12 yr) or ÷ 1.8 (≥12 yr). Level unknown: 70 mg/kg IV	Same targets as adults; redose by level. No fixed max	Children have lower recovery, faster clearance and a shorter half-life, so they may need higher or more frequent doses. Hematology-directed.

Weight-based calculations: pediatric weight-based dosing.

Preparation & Administration

RiaSTAP: add 50 mL (1 g vial) or 100 mL (2 g vial) sterile water at room temperature; swirl, do not shake. Draw up through a 17-micron filter (not supplied). Give by slow IV injection no faster than 5 mL/min (about 100 mg/min); at that maximum, 3 g (150 mL) takes at least 30 minutes and 4 g (200 mL) at least 40 minutes. Use within 8 hours at 20–25 °C (68–77 °F); discard partial vials.
Fibryga: warm powder and diluent to room temperature, transfer with the Nextaro device, swirl until dissolved (5–10 min). Max rate 20 mL/min for acquired deficiency (4 g over about 10 min) and 5 mL/min for congenital deficiency. Use within 4 hours; do not refrigerate after reconstitution. Do not let blood enter the syringe (fibrin clots form).
Line: peripheral IV is acceptable. Give concentrates through a separate line or port, not mixed with other drugs; flush with 0.9% sodium chloride before and after Fibryga.
Cryoprecipitate: blood bank thaws at 30–37 °C; keep at room temperature, never refreeze. Transfuse as soon as possible: within 6 hours of thawing for an unentered single unit or a pool made before freezing or with an FDA-cleared sterile connecting device, and within 4 hours once the bag is entered (spiked with an administration set or pooled open). For a hung unit at handoff, confirm the thaw time and the spike or pool time and use the earlier expiry. Use a standard 150–260 micron blood filter.
Verify the product: Cryoprecipitate-reduced plasma (cryo-poor plasma) has lost its fibrinogen. It must never be used for fibrinogen replacement.

Dosing Notes:

Order concentrate in grams of fibrinogen. Order cryoprecipitate in units. A 5-unit pool counts as 5 units.
Infusion time matters when someone is bleeding. At the label maximum of 5 mL/min, 4 g of RiaSTAP (200 mL) takes about 40 minutes. Fibryga 4 g at 20 mL/min (acquired deficiency) takes about 10 minutes.
In a 70 kg adult, 10 units of cryo raise fibrinogen about 50–75 mg/dL by the AABB Circular (1 unit per 7–10 kg). FIBRES measured about 70 mg/dL. The FIGO estimate runs as high as about 100 mg/dL. In FIBRES, 4 g of concentrate raised it about 90 mg/dL. With ongoing bleeding, expect less.
The label formulas run on the measured level and body weight. Recheck the level after each dose.
Renal and hepatic considerations: see Special Populations.

Contraindications & Precautions

Contraindications

RiaSTAP: known anaphylactic or severe systemic reaction to human plasma-derived products
Fibryga: severe immediate hypersensitivity, including anaphylaxis, to Fibryga or its components (sodium citrate, glycine, L-arginine)
Cryoprecipitate: no lab or viscoelastic evidence of the specific defect it treats; vWD, hemophilia A or factor XIII deficiency when specific factor concentrates are available
Pathogen-reduced cryo: prior hypersensitivity to amotosalen or other psoralens; neonates under certain short-wavelength phototherapy devices
Dysfibrinogenemia: not an indication for either concentrate

Precautions

Thrombotic risk: MI, PE, DVT, stroke and arterial thrombosis have all been reported. Weigh benefit against risk in patients with prior thrombosis, in thrombosis-predominant DIC, or once the bleeding is controlled.
Hypersensitivity: Watch from the first minutes of the infusion for hives, chest tightness, wheeze and hypotension.
Infectious agents: Both come from human plasma. Screening and viral inactivation lower the risk. They do not remove it.
Volume: 4 g of concentrate is 200 mL. In heart failure, renal failure and small children, watch for circulatory overload.
ABO: Large volumes of ABO-incompatible cryo can turn the direct antiglobulin test (DAT) positive.

Hold / Reassess If

Fibrinogen is at or above target (≥150 mg/dL trauma; above 200 mg/dL in PPH or after cardiac surgery) or FIBTEM A10 >10 mm, and bleeding is controlled
Hives, wheeze, hypotension or hypoxemia during the infusion: stop and assess for anaphylaxis or a transfusion reaction
New limb swelling, chest pain or focal neurologic deficit: stop and evaluate for thrombosis

Adverse Effects & Toxicity

Common

Fever and headache (RiaSTAP, >1%)
Nausea, vomiting, fever and thrombocytosis (Fibryga in congenital deficiency, >5%)
Chills, dyspnea and rash (postmarketing)
Mild urticaria or wheeze with plasma-containing products such as cryo (1–3%). Antihistamines usually work.
After cardiac surgery, atrial fibrillation, anemia, delirium and acute kidney injury show up at similar rates with concentrate and with cryo. 28-day mortality was 9.4% with concentrate and 7.4% with cryo. The trial was not designed to compare mortality.

Serious / Life-Threatening

Effect	Recognition	Management
Thromboembolism	Limb swelling, pleuritic or chest pain, hemoptysis, dyspnea, new neurologic deficit; 8.6% with concentrate vs 12.4% with cryo after cardiac surgery	Stop further doses; image; anticoagulate when bleeding risk allows
Anaphylaxis	Hives, chest tightness, wheeze, hypotension during infusion	Stop the infusion; epinephrine IM, airway support, fluids
TRALI (cryo)	Hypoxemia and noncardiogenic pulmonary edema within 6 hours of transfusion	Stop; respiratory support (often ventilation); notify the blood bank
TACO	New or worsening respiratory distress with signs of volume overload; higher risk with heart, lung or renal disease, the very young and older adults	Stop or slow; treat pulmonary edema promptly; notify the blood bank
Febrile or hemolytic reaction (cryo)	Temperature rise ≥1 °C (1.8 °F), chills, back pain, hypotension	Stop; notify the blood bank; send the bag, administration set and a post-reaction blood sample

Overdose & Toxicity Management

Overcorrection: Too much fibrinogen raises thrombotic risk and adds no hemostatic benefit. There is no antidote.
Immediate management: stop further doses, check fibrinogen, and treat any thrombosis on standard lines once bleeding is controlled.

Monitoring

Parameter	When / How Often	Target / Act If
Laboratory: Clauss fibrinogen	Baseline, after each dose, and with each massive-transfusion lab set	Trauma ≤150 mg/dL or PPH <200 mg/dL with bleeding: give a further dose
Laboratory: viscoelastic test (FIBTEM, TEG functional fibrinogen)	With each viscoelastic test in the bleeding protocol	FIBTEM A10 ≤10 mm (label repeat trigger): redose; thresholds are device-specific
Laboratory: ionized calcium	Every massive-transfusion lab set	Keep 1.1–1.3 mmol/L; if low give calcium chloride
Laboratory: PT/INR, aPTT, platelets, hemoglobin	Per massive-transfusion protocol	PT or aPTT above 1.5 × normal with bleeding: plasma per protocol. Platelets <50 × 10⁹/L with bleeding (<100 × 10⁹/L in head injury): platelets per protocol
Clinical: bleeding and hemodynamics	Continuous during resuscitation	Ongoing bleeding despite fibrinogen at target: check platelets, calcium, temperature and surgical source
Clinical: infusion reaction	Vital signs before, during and after; start slowly and watch closely early	Hives, wheeze, hypotension, fever or hypoxemia: stop and treat
Clinical: thrombosis	Daily after bleeding stops	Limb swelling, chest pain, neurologic change: image; start VTE prophylaxis per protocol once bleeding is controlled

Interactions & Compatibility

Clinically Significant Interactions

Drug / Class	Effect	What To Do
tranexamic acid	Complementary: prevents breakdown of the new fibrin clot	Give early in trauma and PPH; do not wait for fibrinogen or viscoelastic results
Prothrombin complex concentrate (PCC)	Additive thrombin generation and delayed thrombotic risk	In trauma, correct fibrinogen first; consider PCC only if VEM shows delayed coagulation initiation (for example a prolonged EXTEM CT) once fibrinogen is normal, per protocol
Anticoagulants (warfarin, DOACs, heparin)	Fibrinogen does not reverse them	Use the specific reversal agent (vitamin K and PCC, protamine, DOAC reversal)
Fibrinolytics	Per the product labels, alteplase 100 mg lowers circulating fibrinogen about 16–36% and tenecteplase 30–50 mg (STEMI doses) about 4–15%; both stay active in a drawn sample and keep breaking down fibrinogen in the tube, so a level drawn during therapy can read falsely low	Bleeding after a fibrinolytic: check fibrinogen, read it with the clinical picture, and replace per the stroke or STEMI bleeding protocol
Calcium-containing fluids (lactated Ringer's)	Clot citrated blood components in the line	Never run with cryoprecipitate in the same tubing

IV Compatibility

RiaSTAP: do not mix with other drugs or IV solutions; give through a separate injection site.
Fibryga: not in the same tubing or container as other drugs; flush with 0.9% sodium chloride before and after.
Cryoprecipitate: only 0.9% sodium chloride may share the line; no drugs added to the bag.
Verify with an institutional compatibility resource.

Special Populations

Pediatrics: children under 12 years recover less (1.4 vs 1.8 mg/dL per mg/kg). They also clear it faster and have a shorter half-life, so they may need higher doses. See the Pediatric Dosing table.
Neonates: ABO-compatible cryo may be the preferred choice. Avoid pathogen-reduced cryo in neonates under short-wavelength phototherapy. The risk there is erythema from amotosalen.
Pregnancy: There are no human or animal reproduction studies for either concentrate. Fibrinogen normally rises in late pregnancy. A low level in PPH predicts severe bleeding. Do not hold indicated replacement in life-threatening obstetric hemorrhage.
Lactation: No data show whether it passes into human milk or what it does to the breastfed infant. Weigh the benefits of breastfeeding against the mother's need.
Older Adults: No specific adjustment is established. Nearly half of Fibryga's cardiac surgery patients were over 65. RiaSTAP was not studied in this group.
Renal Impairment: No specific adjustment is established. With large doses, watch volume status.
Hepatic Impairment: No specific adjustment is established. In liver failure, low synthesis means fibrinogen that gets used up is not replaced. Monitor levels closely.
Obesity / Dosing Weight: Label formulas use body weight. No obesity-specific guidance exists. Adult acquired-deficiency dosing is a fixed 3–4 g, adjusted to the measured level.
Congenital Deficiency: Thrombosis can happen on its own, with or without replacement. Dose under hematology direction.

Field & Transport Considerations

Scope: Most of the use happens in hospital and on interfacility transport. Critical care and flight teams (RN, paramedic, CCT) keep running cryo or concentrate that the sending hospital started. Rules vary by state and agency protocol.
Storage & Stability: RiaSTAP: refrigerate at 2–8 °C (36–46 °F), do not freeze, protect from light. Fibryga: 2–25 °C (36–77 °F), do not freeze, protect from light. After reconstitution use RiaSTAP within 8 hours and Fibryga within 4 hours.
Thawed Cryo: Room temperature, and never refreeze. An unentered unit (single, or pooled before freezing or with a sterile connecting device) expires 6 hours after thawing. Once the bag is entered, spiked with an administration set or pooled open, it expires 4 hours after that. Hanging a unit at handoff? Get the thaw time and the spike or pool time, take the earlier expiry, and check it against transport time before you leave.
Infusions in Transport: blood filter, a dedicated line with 0.9% sodium chloride only, and blood-product documentation (unit numbers, start and stop times) per transfusion policy.
Handoff Essentials: product and total dose (grams or units) with times, last fibrinogen or FIBTEM result and time, TXA dose and time, total blood products, last ionized calcium, and any reaction.

Clinical Pearls

Concentrate Is Not Low-Volume: Each gram is reconstituted in 50 mL, so 4 g is 200 mL. Ten units of cryo (about 5–20 mL each, plus pooling saline) adds up to a comparable volume. Choose the product for speed and predictable content. Volume is not the reason.

Fibrinogen Falls First: In major hemorrhage, fibrinogen is usually the first clotting factor to reach a critical level. In a French cohort of women whose PPH needed a second-line uterotonic, a fibrinogen of 200 mg/dL or less at enrollment had a 100% positive predictive value for severe PPH.

Clauss vs FIBTEM:

Clauss fibrinogen: a central-lab plasma level in mg/dL. It is the number most triggers and labels use.
FIBTEM (ROTEM): whole-blood clot firmness in mm (A5, A10). Cytochalasin D blocks platelets, so the result shows the fibrin share of the clot.
Viscoelastic results reach the bedside faster. Thresholds differ between devices, so use your protocol's numbers.

Cryo vs Cryo-Poor Plasma: Cryoprecipitate-reduced plasma is the supernatant left after cryo is made. It has lost its fibrinogen, factor VIII, factor XIII and von Willebrand factor. Read the bag label before you hang it for hypofibrinogenemia.

Exam Discriminator (CCRN, FP-C): Bleeding with a fibrinogen of 80 mg/dL? Give cryoprecipitate or fibrinogen concentrate, not more FFP. Plasma carries little fibrinogen, and the amount varies. It dilutes what is left. Cryo brings fibrinogen, factor VIII, factor XIII and von Willebrand factor with it.

Targeted, Not Reflexive: Three empiric cryo pools added to standard massive-transfusion care did not improve survival in CRYOSTAT-2. Don't reach for it on reflex. Use the fixed MTP packs that include cryo, per protocol. After the first labs, replace fibrinogen against a measured Clauss or viscoelastic deficit, then recheck.

Pharmacology

Mechanism of Action

Thrombin cuts fibrinogen (factor I) into fibrin monomers. Those monomers link up into the clot mesh.
Factor XIIIa cross-links the fibrin. That makes the clot firmer and harder for fibrinolysis to break down.
Replacing fibrinogen firms the clot (a higher FIBTEM amplitude). It also helps the platelet plug hold in dilutional or consumptive coagulopathy.

Pharmacokinetics

Route	Onset	Peak	Duration
IV	Immediate (level rises during the infusion)	End of infusion	Variable: days if not consumed; much shorter with ongoing bleeding or DIC

Half-life: about 79 hours (3.3 days) for RiaSTAP in congenital deficiency; about 70 hours in patients under 16 years.
Recovery: 1.7 mg/dL (RiaSTAP) or 1.8 mg/dL (Fibryga) rise per mg/kg in adults; 1.4 mg/dL per mg/kg in children under 12 years (Fibryga).
Distribution: volume of distribution about 53 mL/kg (roughly the plasma volume).
Elimination: It is used up by clot formation and broken down by plasmin. Clearance is about 0.6 mL/hr/kg.
Normal plasma level: 200–450 mg/dL.

Names & Classification

Generic Name: Fibrinogen concentrate (human); cryoprecipitated antihemophilic factor (cryoprecipitate) is a blood component
Brand Names: RiaSTAP (CSL Behring); Fibryga (Octapharma)
Pharmacologic Class: Human plasma-derived coagulation factor I (fibrinogen) concentrate
Therapeutic Class: Hemostatic agent; blood product
Controlled Substance: Not controlled
ISMP High-Alert: No
Look-Alike / Sound-Alike: Cryoprecipitate vs cryoprecipitate-reduced (cryo-poor) plasma, which contains almost no fibrinogen
Error-Prone Abbreviations to Avoid: "U" for units of cryoprecipitate; write "units"

References

CSL Behring GmbH. (2025). RiaSTAP (fibrinogen concentrate, human) lyophilized powder for solution for intravenous injection: prescribing information. DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=903dc8d0-39da-462c-9dac-004e0c7a26cc
Octapharma USA Inc. (2025). Fibryga (fibrinogen, human) lyophilized powder for reconstitution, for intravenous use: prescribing information. DailyMed, U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=e3422d2a-2cb6-6f49-0be7-cb960b3d5bd5
AABB, American Red Cross, America's Blood Centers, & Armed Services Blood Program. (2024). Circular of information for the use of human blood and blood components (June 2024). AABB. https://www.aabb.org/docs/default-source/default-document-library/resources/circular-of-information-watermark.pdf
Rossaint, R., Afshari, A., Bouillon, B., Cerny, V., et al. (2023). The European guideline on management of major bleeding and coagulopathy following trauma: Sixth edition. Critical Care, 27, 80. https://doi.org/10.1186/s13054-023-04327-7
Escobar, M. F., Nassar, A. H., Theron, G., Barnea, E. R., et al. (2022). FIGO recommendations on the management of postpartum hemorrhage 2022. International Journal of Gynecology & Obstetrics, 157(Suppl 1), 3–50. https://doi.org/10.1002/ijgo.14116
Davenport, R., Curry, N., Fox, E. E., Thomas, H., et al. (2023). Early and empirical high-dose cryoprecipitate for hemorrhage after traumatic injury: The CRYOSTAT-2 randomized clinical trial. JAMA, 330(19), 1882–1891. https://doi.org/10.1001/jama.2023.21019
Russell, R. T., Esparaz, J. R., Beckwith, M. A., Abraham, P. J., et al. (2023). Pediatric traumatic hemorrhagic shock consensus conference recommendations. Journal of Trauma and Acute Care Surgery, 94(1S Suppl 1), S2–S10. https://doi.org/10.1097/TA.0000000000003805
Charbit, B., Mandelbrot, L., Samain, E., Baron, G., et al. (2007). The decrease of fibrinogen is an early predictor of the severity of postpartum hemorrhage (landmark study). Journal of Thrombosis and Haemostasis, 5(2), 266–273. https://doi.org/10.1111/j.1538-7836.2007.02297.x

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Fibrinogen (RiaSTAP, Cryoprecipitate)