dextran (Rx)

Brand and Other Names:Gentran, LMD, more...Rheomacrodex
  • Print

Dosing & Uses

AdultPediatricGeriatric

Dosage Forms & Strengths

injectable solution

  • 6% (Dextran 70)
  • 10% (Dextran 40)
more...

Shock

No more than 20 mL/kg IV during first 24 hours; THEN 10 mL/kg/day 

Same mL dosage for both 10% & 6%

10% Solution

  • No more than 5 days
  • First 500 mL infused rapidly, then slow infusion

Surgery (DVT/PE Prophylaxis)

10% Solution: 500-1000 mL (~10 mL/kg) on day of surgery; THEN 500 mL/day for 2-3 days; THEN 500 mL q2-3Days PRN up to 2 weeks

6% Solution: Not approved but used

Priming Fluid in Pump Oxygenators, Uterine Cavity Distention

Add 10-20 mL/kg (or 1-2 g/kg); not to exceed 20 mL/kg (2g/kg); dose varies with volume of pump oxygenator 

Renal Impairment

Extreme caution

Hepatic Impairment

Extreme caution

Progenitor Cell Mobilization (Orphan)

Treatment to mobilze progenitor cells prior to stem cell transplantation

Orphan indication sponsor

  • TikoMed AB; P.O. Box 81 (Karlsfaltsvagen 349); SE-263 03, Viken, Sweden

Pancreatic Islet Transplantation (Orphan)

LMW dextran sulfate (Ibsolvmir): Prevention of graft rejection during pancreatic islet transplantation

Orphan indication sponsor

  • TikoMed AB; P.O. Box 81 (Karlsfaltsvagen 349); SE-263 03, Viken, Sweden

Dosage Forms & Strengths

injectable solution

  • 6%
  • 10%
more...

10% Solution

Initial dose: 10 mL/kg IV infused rapidly, no more than 20 mL/kg/24 hours, THEN no more than 10 mL/kg/day, no more than 5 days 

Shock

No more than 20 mL/kg IV during first 24 hours; THEN 10 mL/kg/day 

Same mL dosage for both 10% & 6%

10% solution: No more than 5 days; First 500 mL infused rapidly, then slow infusion

Surgery (DVT/PE prophylaxis)

10% Solution: 500-1000 mL (~10 mL/kg) on day of surgery; THEN 500 mL/day for 2-3 days; THEN 500 mL q2-3Days PRN up to 2 weeks

6% Solution: Not approved but used

Priming fluid in pump oxygenators, uterine cavity distention

Add 10-20 mL/kg (or 1-2 g/kg); not to exceed 20 mL/kg (2g/kg); dose varies with volume of pump oxygenator

Next:

Adverse Effects

Frequency Not Defined

Congestive heart failure

Mild hypotension

Tightness of chest

Thrombocytopenia

Anaphylaxis

Injection site infection/phlebitis

Acute renal failure

Acidosis (if NaCl soln used)

Pulmonary edema

Wheezing

Previous
Next:

Warnings

Contraindications

Hypersensitivity to dextran or corn products

Pulmonary edema, severe bleeding disorders, severe CHF, severe oliguria/anuria due to renal disease, significant hemostatic defects, cardiac decompensation

10%: Marked thrombocytopenia or hypofibrinogenemia

Cautions

Decreased urinary output 2nd to shock, bowel surgery, dehydration, active hemorrhage, hypernatremia, pathological abdominal conditions, thrombocytopenia

Monitor urinary output

Contains no preservatives, discard unused portions

Previous
Next:

Pregnancy & Lactation

Pregnancy Category: C

Lactation: not known if distributed into breast milk, avoid

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...
Previous
Next:

Pharmacology

Mechanism of Action

Branched polysaccharide volume expander through highly colloidal starch structure; lowers platelet & RBC adhesiveness

Pharmacokinetics

Elimination half-life: 40 min

Duration: 3-4hr (plasma expanding effects)

Distribution half-life: 12 min

Vd: 6.5 L

Metabolism: Minimally in tissues; liver, kidney, spleen

Excretion: urine 75%

Dialyzable: HD: No

Previous
Next:

Administration

IV Incompatibilities

Do not dilute or admix with other drugs

IV Administration

Infuse first 500 mL over 15-30 min, then slow infusion

Storage

Protect from freezing

Previous
Next:

Images

Previous
Next:

Formulary

FormularyPatient Discounts

Adding plans allows you to compare formulary status to other drugs in the same class.

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

Adding plans allows you to:

  • View the formulary and any restrictions for each plan.
  • Manage and view all your plans together – even plans in different states.
  • 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.
Additional Offers
Email to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Email Forms to Patient

From:

To:

The recipient will receive more details and instructions to access this offer.

By clicking send, you acknowledge that you have permission to email the recipient with this information.

Previous