Dextran 40 10% + Dextrose 5%

Indications

Dextran 40 10% + Dextrose 5% is used for: Thromboembolic disorders, Hypovolaemic shock, Pulmonary embolism, Venous thrombosis

Adult Dose

Intravenous Thromboembolic disorders Adult: As dextran 40: Initially, 500 ml of a 10% solution in glucose 5% infused over 4-6 hr, followed by 500 ml infused over 4-6 hr on the next and subsequent alternate days for not more than 10 days. Prophylaxis of postoperative thromboembolic disorders Adult: As dextran 40: 500 ml of a 10% solution in glucose 5% infused over 4-6 hr during or at the end of the surgery. Dose may be repeated the following day and treatment may be continued on alternate days for up to 10 days in high-risk patient. Hypovolaemic shock Adult: As dextran 40: Initially, 10 ml/kg given by rapid infusion as a 10% solution in glucose 5%. Doses may be given daily for up to 5 days. Hepatic Impairment Extreme caution

Child Dose

Intravenous Thromboembolic disorders Child: As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children. Prophylaxis of postoperative thromboembolic disorders Child: As dextran 40: Up to 10 ml/kg in children.

Renal Dose

Extreme caution

Administration

Contra Indications

Hypersensitivity. Severe renal disease with oliguria or anuria. Marked cardiac decompensation. Pregnancy.

Precautions

Lactation: not known if distributed into breast milk, avoid

Pregnancy-Lactation

Interactions

Dextran: Enzyme inducers e.g. phenytoin or carbamazepine and enzyme inhibitors e.g. cimetidine.

Adverse Effects

Side effects of Dextran 40 10% + Dextrose 5% : 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

Mechanism of Action

Dextrans produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.