Hydroxyethyl Starch Dosage

Applies to the following strengths: 6%-NaCl 0.9%

Usual Adult Dose for Hypovolemia

Up to 50 mL/kg IV daily

Duration of Therapy: Can be administered repetitively over several days.

Comments:

The daily dose and rate of infusion depends on the patient's blood loss, on the maintenance or restoration of hemodynamic and on the hemodilution.

Use: For the treatment and prophylaxis of hypovolemia (this drug is not a substitute for red blood cells or coagulation factors in plasma)

Usual Pediatric Dose for Hypovolemia

Less than 2 years:
16 plus or minus 9 mL/kg IV daily (up to 50 mL/kg per day)

2 to 12 years:
36 plus or minus 11 mL/kg IV daily (up to 50 mL/kg per day)

Greater than 12 years:
Up to 50 mL/kg IV daily (up to 50 mL/kg per day)

Duration of Therapy: Can be administered repetitively over several days.

Comments: Dosage in children should be adapted to the individual patient colloid needs, considering the disease state, hemodynamic, and hydration status.

Use: For the treatment and prophylaxis of hypovolemia (this drug is not a substitute for red blood cells or coagulation factors in plasma)

Renal Dose Adjustments

Dose adjustment(s) may be required; however, no specific guidelines have been suggested. Caution recommended.
Avoid use in patients with preexisting renal dysfunction.
Discontinue therapy at the first sign of renal injury.
Monitor renal function in hospitalized patients for at least 90 days.

Liver Dose Adjustments

Mild to moderate hepatic impairment: Data not available
Severe hepatic impairment: Contraindicated

Precautions

US BOXED WARNINGS:
Mortality/Renal Replacement Therapy:

In critically ill adult patients, including patients with sepsis, use of hydroxyethyl starch (HES) products increases the risk of mortality and renal replacement therapy.
Do not use HES products in critically ill adult patients, including patients with sepsis.

CONTRAINDICATIONS:

Hypersensitivity to the active component or any of the ingredients
In critically ill adult patients, including patients with sepsis, due to increased risk of mortality and renal replacement therapy (RRT)
Severe liver disease
In volume overload
Preexisting coagulation or bleeding disorders
Renal failure with oliguria or anuria not related to hypovolemia
Dialysis
Severe hypernatremia
Severe hyperchloremia
Intracranial bleeding

Consult WARNINGS section for additional precautions.

Dialysis

Contraindicated

Other Comments

Administration advice:

This drug is administered by IV infusion only.
The daily dose and rate of infusion depend on the patient's blood loss, on the maintenance or restoration of hemodynamics and on the hemodilution (dilution effect).
This drug can be administered repetitively over several days.
The initial 10 to 20 mL should be infused slowly, keeping the patient under observation due to possible anaphylactoid reactions.

Storage requirements:

Store at 15C to 25C (59F to 77F). Do not freeze.

Reconstitution/preparation techniques:

Do not remove the container from its overwrap until immediately before use.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.
Do not administer unless the solution is clear, free from particles and the container is undamaged.
This drug should be used immediately after insertion of the administration set.
Do not vent.
If administered by pressure infusion, air should be withdrawn or expelled from the bag through the medication/administration port prior to infusion.
Discontinue the infusion if an adverse reaction occurs.
It is recommended that administration sets be changed at least once every 24 hours.
For single use only. Discard unused portion.
The manufacturer product information should be consulted.