Dextran 40
Generic Name
dextran-40-10-09-injection
Manufacturer
Various Generic Manufacturers
Country
Global
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Price Details
Current market pricing information
| Variant | Unit Price | Strip Price |
|---|---|---|
| dextran 40 10 09 injection | N/A | N/A |
Description
Overview of the medicine
Dextran 40 is a low molecular weight polysaccharide solution used as a plasma volume expander to restore blood volume in various conditions of hypovolemia and to improve microcirculation. It also has antithrombotic properties.
Uses & Indications
Dosage
Adults
Dosage is highly individualized. Typically, an initial dose of 500-1000 mL (10% solution) infused rapidly, followed by maintenance doses not exceeding 20 mL/kg/24h for several days. Total daily dose should not exceed 1.5 g/kg.
Elderly
Use with caution in elderly patients due to potential for impaired renal function and increased risk of fluid overload or cardiac complications. Dose adjustment may be required.
Renal_impairment
Contraindicated in severe renal failure (oliguria or anuria). Use with extreme caution in moderate renal impairment, and dosage should be significantly reduced. Monitor renal function closely.
How to Take
Dextran 40 is administered by intravenous infusion. The rate of infusion should be carefully controlled, especially during the initial phase, to avoid rapid plasma expansion and potential cardiac strain. It should be administered through a separate intravenous line or a Y-connector with compatible solutions.
Mechanism of Action
Dextran 40 increases plasma oncotic pressure, drawing fluid from the interstitial space into the intravascular compartment, thereby expanding plasma volume. It also reduces blood viscosity by decreasing erythrocyte aggregation and inhibits platelet aggregation, improving microcirculation.
Pharmacokinetics
Onset
Immediate for volume expansion and rheological effects.
Excretion
Primarily renal excretion of smaller dextran molecules. Larger molecules are retained longer in the circulation and may be slowly metabolized.
Half life
Approximately 6-8 hours for molecules not excreted immediately. Smaller molecules are rapidly excreted.
Absorption
Administered intravenously, hence 100% bioavailable.
Metabolism
Partially metabolized by dextranases in the body, which break down larger dextran molecules into smaller ones. The extent of metabolism is limited.
Side Effects
Contraindications
- Known hypersensitivity to dextran or any component of the formulation.
- Severe bleeding disorders (e.g., thrombocytopenia, hypofibrinogenemia) or known sensitivity to dextran.
- Severe congestive heart failure or pulmonary edema.
- Severe renal failure with oliguria or anuria.
- Severe dehydration (unless corrected prior to Dextran 40 administration).
- Patients with pre-existing conditions that predispose to fluid overload.
Drug Interactions
Other Plasma Expanders
Caution should be exercised if used with other plasma volume expanders to avoid excessive volume expansion or electrolyte disturbances.
Anticoagulants/Antiplatelet Agents
Concomitant use may increase the risk of bleeding due to dextran's effects on platelet function and blood viscosity. Close monitoring of coagulation parameters is recommended.
Storage
Store at controlled room temperature (20-25°C). Protect from freezing. Do not use if solution is cloudy or contains particulate matter.
Overdose
Overdose can lead to hypervolemia (fluid overload), pulmonary edema, congestive heart failure, acute renal failure (due to osmotic nephrosis), and coagulopathy. Management involves discontinuing the infusion, supportive care, and managing symptoms (e.g., diuretics for fluid overload, dialysis for severe renal failure).
Pregnancy & Lactation
Pregnancy Category C. Use Dextran 40 during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether dextran is excreted in human milk; caution should be exercised when administered to a nursing woman.
Side Effects
Contraindications
- Known hypersensitivity to dextran or any component of the formulation.
- Severe bleeding disorders (e.g., thrombocytopenia, hypofibrinogenemia) or known sensitivity to dextran.
- Severe congestive heart failure or pulmonary edema.
- Severe renal failure with oliguria or anuria.
- Severe dehydration (unless corrected prior to Dextran 40 administration).
- Patients with pre-existing conditions that predispose to fluid overload.
Drug Interactions
Other Plasma Expanders
Caution should be exercised if used with other plasma volume expanders to avoid excessive volume expansion or electrolyte disturbances.
Anticoagulants/Antiplatelet Agents
Concomitant use may increase the risk of bleeding due to dextran's effects on platelet function and blood viscosity. Close monitoring of coagulation parameters is recommended.
Storage
Store at controlled room temperature (20-25°C). Protect from freezing. Do not use if solution is cloudy or contains particulate matter.
Overdose
Overdose can lead to hypervolemia (fluid overload), pulmonary edema, congestive heart failure, acute renal failure (due to osmotic nephrosis), and coagulopathy. Management involves discontinuing the infusion, supportive care, and managing symptoms (e.g., diuretics for fluid overload, dialysis for severe renal failure).
Pregnancy & Lactation
Pregnancy Category C. Use Dextran 40 during pregnancy only if the potential benefit justifies the potential risk to the fetus. It is not known whether dextran is excreted in human milk; caution should be exercised when administered to a nursing woman.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years, depending on manufacturer and storage conditions.
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Approved
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Dextran 40 is a well-established medicine with extensive clinical use. While specific new trials might focus on niche applications or comparisons, its core efficacy and safety profile are well-documented through decades of clinical practice and research.
Lab Monitoring
- Renal function tests (serum creatinine, BUN) before and during treatment.
- Electrolytes and fluid balance.
- Coagulation parameters (PT, aPTT, bleeding time) to monitor for bleeding risk.
- Hemoglobin and hematocrit.
- Urine output.
Doctor Notes
- Premedication with antihistamines may be considered to reduce the incidence of anaphylactoid reactions, especially in high-risk patients.
- Carefully monitor fluid balance, renal function, and coagulation parameters during and after infusion.
- Avoid use in patients with known severe renal failure or uncorrected dehydration.
Patient Guidelines
- Dextran 40 is administered in a hospital or clinic setting by healthcare professionals.
- Patients should report any symptoms of allergic reactions (rash, itching, difficulty breathing) or signs of fluid overload (swelling, shortness of breath) immediately.
- Fluid intake and output will be closely monitored by medical staff.
Missed Dose Advice
Dextran 40 is typically used in acute, controlled clinical settings. Doses are administered by healthcare professionals based on immediate patient needs. Therefore, 'missed dose' advice as with regular medication is not applicable.
Driving Precautions
Patients receiving Dextran 40 are generally hospitalized or critically ill and should not drive or operate machinery.
Lifestyle Advice
- No specific lifestyle changes are generally required as Dextran 40 is typically used for acute medical conditions.
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Global Brand Names
International brand names for this medicine. Click a brand to search for detailed information.