albumin IV (Rx)

Brand and Other Names:Albuminar, Alba, more...Albuked, Albutein, Flexbumin, Kedbumin, Plasbumin, Albuminex
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Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 50mg/mL (5%)
  • 250mg/mL (25%)

Acute Liver Failure

Indicated for maintenance of cardiovascular function following paracentesis due to cirrhotic ascites

6-8 g IV for every 100 mL of ascitic fluid removed

Adult Respiratory Distress Syndrome

Indicated for adult respiratory distress syndrome (ARDS) in conjunction with diuretics to correct fluid volume overload associated with ARDS

25 g IV over 30 minutes; repeat q8hr PRN

Burns

Indicated after 24 hr post burn if severe albumin depletion in order to favor edema reabsorption

Amount of albumin required to achieve adequate plasma volume and protein content should be determined by direct observation of vital signs or measurement of either plasma oncotic pressure or protein content

Cardiopulmonary Bypass

Indicated for procedures as part of the priming fluids for bypass machine

Required dose can be estimated from the difference between the desired and actual total serum protein concentration multiplied by the estimated plasma volume (~40 mL/kg) times 2 (to account for extravascular deficit, which absorbs about half of the administered dose)

Hypoalbuminemia

Indicated for restoration and maintenance of circulating blood volume deficiency caused by illness or active bleeding; when albumin deficiency results from excessive protein loss, the effect of albumin administration will be temporary unless the underlying disorder is reversed

Hemodialysis

Indicated for patients undergoing long-term hemodialysis or for those who are fluid-overloaded and cannot tolerate substantial volumes of sodium for therapy of shock or hypotension

25 g IV

Hypovolemia

Indicated for restoration and maintenance of circulating blood volume where volume deficiency is demonstrated and colloid use is appropriate

Initial 25 g IV; adjust according to volume requirements

Ovarian Hyperstimulation Syndrome

Indicated as a plasma expander in fluid management of severe forms of ovarian hyperstimulation syndrome (OHSS)

50-100 g IV infused over 4 hr; repeat q4-12hr PRN

Dosage Forms & Strengths

injectable solution

  • 50mg/mL (5%)
  • 250mg/mL (25%)

Hemolytic Disease of the Newborn

25% albumin: 1 g/kg/dose IV administered before or during plasma exchange  

Use 25% concentration with extreme caution in neonates, owing to risk of intraventricular hemorrhage from rapid expansion of intravascular volume

Hypovolemia

5% albumin: 0.5-1 g/kg/dose IV infused over 1 hr; may infuse more rapidly for hypovolemic shock

Ascites with Hypoalbuminemia

25% albumin: 1 g/kg/dose IV infused over 2-3 hr; may repeat q8hr until serum albumin above 2.5 g/dL

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Interactions

Interaction Checker

and albumin IV

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            Adverse Effects

            Frequency Not Defined

            Flushing

            Urticaria

            Fever

            Chills

            Nausea

            Vomiting

            Tachycardia

            Hypotension

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            Warnings

            Contraindications

            Hypersensitivity to commercially available albumin products; suspected hypersensitivity to perflutren, blood, blood products or albumin

            Severe anemia, heart failure

            Cautions

            Hypersensitivity reactions reported; monitor patient during infusion in facility that can respond to anaphylaxis

            Caution in conditions where hypervolemia and its consequences or hemodilution could represent a special risk (eg, heart failure, arterial hypertension, esophageal varices, pulmonary edema, hemorrhagic diathesis, severe anemia, renal and postrenal anuria)

            Do not dilute with sterile water for injection as this may cause hemolysis; use D5W or 0.9% NaCl for dilution

            When replacing large volumes of albumin, control of coagulation and hematocrit is essential; ensure adequate substitution of other blood constituents (eg, coagulation factors, electrolytes, platelets, erythrocytes)

            Colloid osmotic effect is ~4 times that of human blood; therefore, when concentrated albumin is administered, ensure adequate hydration of the patient; carefully monitor to guard against circulatory overload by assessing arterial blood pressure and pulse rate, central venous pressure, pulmonary artery occlusion pressure, urine output, electrolyte levels, and hematocrit/hemoglobin

            Albumin is a blood product; extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD)

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            Pregnancy & Lactation

            Pregancy

            No human or animal data are available to indicate the presence or absence of drug-associated risk

            Lactation

            Unknown if excreted in human milk

            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.

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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 and acute renal failure

            IV Administration

            For IV administration only

            5% solution: Use for hypovolemia or patients who are intravascularly depleted

            25% solution: Use in patients who have fluid or sodium restrictions, or to mobilize fluids

            Use within 4 hr after opening vial; discard unused portion

            Do not dilute 5% solution

            Albumin 25% may be given undiluted or diluted in in 0.9% NaCl

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

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

            Storage

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

            Store vial in outer carton to protect from light

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

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            Formulary

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            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.
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            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
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            Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.