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Generic Name: hetastarch (HET a starch)
Brand Name: Hespan, Hextend

What is hetastarch?

Hetastarch (hydroxyethyl starch) is made from natural sources of starch. Hetastarch increases the volume of blood plasma that can be lost from bleeding or severe injury. Plasma is needed to circulate red blood cells that deliver oxygen throughout the body.

Hetastarch is used to treat or prevent hypovolemia (decreased blood plasma volume, also called "shock") that may occur as a result of serious injury, surgery, severe blood loss, burns, or other trauma.

Hetastarch may also be used for purposes not listed in this medication guide.

Important Information

You should not receive this medication if you have a bleeding or blood clotting disorder, congestive heart failure, kidney disease, or urination problems not caused by hypovolemia (decreased blood plasma volume).

Hetastarch can harm your kidneys. Call your doctor at once if you have any of these symptoms of kidney damage: swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no urinating.

Before taking this medicine

You should not receive this medication if you are allergic to hetastarch, or if you have:

  • a bleeding or blood clotting disorder;

  • kidney disease;

  • congestive heart failure; or

  • urination problems not caused by hypovolemia (decreased blood plasma volume).

If possible before you receive hetastarch, tell your doctor if you have:

  • liver disease;

  • a history of heart disease; or

  • if you are allergic to corn.

FDA pregnancy category C. It is not known whether hetastarch will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether hetastarch passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

In an emergency situation it may not be possible to tell your caregivers about your health conditions, or if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medicine.

How is hetastarch given?

Hetastarch is injected into a vein through an IV. A healthcare provider will give you this injection.

Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will be watched closely while you are receiving hetastarch. Your blood will also need to be tested daily during treatment.

What happens if I miss a dose?

Because you will receive hetastarch in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since hetastarch is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving hetastarch?

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Hetastarch side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have:

  • wheezing or gasping for breath, rapid breathing, sweating, and anxiety;

  • a light-headed feeling, like you might pass out;

  • weak pulse, slow breathing;

  • chest pain, fever, chills, cough; or

  • easy bruising, unusual bleeding, or any bleeding that will not stop.

Rare but serious side effects may include:

  • severe headache, vision or speech problems, mental changes;

  • drooping eyelids, loss of feeling in your face, tremors, trouble swallowing; or

  • severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Hetastarch can harm your kidneys. Call your doctor at once if you have any of these symptoms of kidney damage: swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no urinating.

Common side effects may include:

  • mild itching or skin rash;

  • mild headache;

  • muscle pain; or

  • swollen glands, mild flu symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Hetastarch dosing information

Usual Adult Dose for Hypovolemia:

Dosage for Acute Use in Plasma Volume Expansion: 500 to 1000 mL by intravenous infusion
Maintenance dose: Total dosage and rate of infusion depends on the amount of blood or plasma lost and the resultant hemoconcentration
Maximum dose: Doses of more than 1500 mL per day (approximately 20 mL per kg of body weight) are usually not required although higher doses have been used in postoperative and trauma patients.

Dosage in Leukapheresis: 250 to 700 mL to which citrate anticoagulant has been added and administered to the input line of the centrifugation apparatus at a ratio of 1:8 to 1:13 to venous whole blood.

-Hetastarch and citrate should be thoroughly mixed to assure effective anticoagulation.
-Hetastarch admixtures of 500 to 560 mL with citrate concentrations up to 2.5% are compatible for 24 hours at room temperature.

What other drugs will affect hetastarch?

Other drugs may interact with hetastarch, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your doctor or pharmacist can provide more information about hetastarch.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 2.02.

Date modified: February 01, 2018
Last reviewed: July 29, 2013