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albumin IV (Rx)Brand and Other Names:Albuminar, Alba, more...Albuked, Albutein, Buminate, Flexbumin, Kedbumin, Plasbumin

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 50mg/mL (5%)
  • 250mg/mL (25%)
more...

Usual Dosing Guidelines

Initial: 25 g (5% or 25% solution) IV infusion; may repeat q15-30min if response inadequate

Not to exceed 250 g/48 hr

See IV info for infusion rate

Choice of 5% vs 25% depends on whether patient requires primarily volume (5%) or primarily protein/oncotic pressure (25%)

25% Solution

Acute nephrosis

Acute liver failure

ARDS

Burns

Cardiopulmonary bypass

Hypoproteinemia

Renal dialysis

Hypovolemic shock

Hemolytic disease of newborn

Hepatic surgery/transplantation

5% Solution

Hypovolemic shock

Burns

Hypoproteinemia

Cardiopulmonary bypass

Acute liver disease

Dosage Forms & Strengths

injectable solution

  • 50mg/mL (5%)
  • 250mg/mL (25%)
more...

Usual Dosing Guidelines

Neonates (<28 days old)/infants: 10-20 mL/kg IV of 5% solution 

500-1000 mg/kg IV infusion

Not to exceed 250 g/48 hr or 6 g/kg/day

See IV Info for infusion rate

Choice of 5% vs 25% depends on whether patient requires primarily volume (5%) or primarily protein/oncotic pressure (25%)

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Interactions

Interaction Checker

albumin IV and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Anaphylaxis

            CHF precipitation

            Edema

            Hypertension/hypotension

            Hypervolemia

            Tachycardia

            Decr myocardial contractility

            Bronchospasm

            Pulmonary edema

            Salt and water retention

            Chills

            Fever

            Headache

            Nausea/vomiting

            Pruritus

            Rash

            Urticaria

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            Warnings

            Contraindications

            Hypersensitivity to commercially available albumin products

            Severe anemia, cardiac failure

            25% solution in preemies (risk of IVH)

            Cautions

            Chronic renal insufficiency, chronic anemia, low cardiac reserve, normal plasma albumin

            Ineffective in chronic nephrosis or hypoproteinemia due to chronic cirrhosis, malabsorption, enteropathies, pancreatic insufficiency or undernutrition

            Do NOT use sterile water as diluent

            Avoid using 25% concentration in preterm infants due to high risk of intraventricular hemorrhage

            Use caution in patients on sodium restriction

            All commercial formulations contain 130-160 mEq/L of sodium

            Monitor patients for signs of hypervolemia, such as, pulmonary edema

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            Pregnancy & Lactation

            Pregnancy category: C

            Lactation: Endogenous albumin found in breast milk; compatible

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

            more...
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            Pharmacology

            Mechanism of Action

            Replacement of plasma protein; increases intravascular oncotic pressure, mobilizes fluids from interstitial into intravascular space

            Distribution

            Plasma compartment: 30-40%

            Extravascular compartments: 67%

            Half-life, distribution: 16 hr; inversely proportional to plasma albumin concentrations

            Metabolism

            Minimally in the liver; main site is unknown

            Elimination

            Elimination half-life: 15-20 days

            Excretion: Intestinal mucosa, not via kidney

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            Administration

            IV Incompatibilities

            Additive: Verapamil

            Y-site: Fat emulsions, midazolam, vancomycin, verapamil

            IV Compatibilities

            Solution: Dextrose solutions, saline solutions, dextrose-saline, Ringer LR, Na-lactate 1/6M

            Y-site: Diltiazem, lorazepam

            IV Preparation

            Reconstitution: If 5% human albumin is unavailable, dilute 25% human albumin with NS or D5W

            Do NOT use sterile water as diluent - risk of potentially fatal hemolysis & ARF

            IV Administration

            For IV administration only

            Use within 4 hr after opening vial; discard unused portion

            Do not dilute 5% solution

            Albumin 25% may be given undiluted or diluted in NS

            May give in combination or through same administration set as saline or carbohydrates

            Do not use with ethanol or protein hydrolysates; precipitation may form

            Hypoproteinemia: Infuse over 30-120 min; not to exceed 5-10 mL/min for 5% solution, 2 mL/min for 20% solution, and 2-3 mL/min for 25% solution

            Hypovolemic shock

            • Initial bolus infusion as rapidly as desired
            • As plasma volume approaches normal, infuse 5% solution up to 2-4 mL/min and 25% solution up to 1 mL/min to avoid circulatory overload

            Storage

            Store at <30°C (86°F); do not freeze

            Do not use solution if turbid or contains a deposit; use within 4 hr of opening vial; discard unused portion

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            Images

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            Formulary

            FormularyPatient Discounts

            To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.

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            • View the formulary and any restrictions for each plan.
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            • Compare formulary status to other drugs in the same class.
            • Access your plan list on any device – mobile or desktop.

            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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