Universal reference book for medicines
Product name: EXTRANEAL

Active substance: icodextrin

Type: Solution for peritoneal dialysis

Manufacturer: BAXTER HEALTHCARE Corp.
(Puerto Rico)
Description of the active substance:
This information is a reference and it is not enough that the drug has been prescribed by a doctor ..

PHARMACHOLOGIC EFFECT
A solution for peritoneal dialysis based on a polymer derived from starch acts as an osmotic agent.
7.5% solution is approximately iso-osmolar plasma, but allows ultrafiltration to be performed up to 12 hours with constant outpatient peritoneal dialysis. Reducing the number of calories is comparable with hyperosmolar solutions of dextrose. The volume of ultrafiltrate is comparable to that obtained with the use of 3.86% dextrose solution.
The concentration of glucose and the content of insulin in the blood do not change.

INDICATIONS
To replace the dextrose solution during one of the procedures of permanent ambulatory peritoneal dialysis or automated peritoneal dialysis in chronic renal failure complicated by a violation of the filtration function of the kidneys.

DOSING MODE
Intraperitoneally 1 time / day during the longest period between dialysis procedures.
The volume of the injected solution is determined by the patient's height-weight parameters and is usually 2 liters, in patients with a high index of 2.5 liters. In the case of a sensation of raspiraniya in the abdominal cavity volume of the solution is reduced to 1.5 liters. The procedure for removing the used solution and introducing a new one is performed within 10-20 min; the rate of excretion / administration should not create discomfort for the patient. The residence time of the solution in the abdominal cavity with constant outpatient peritoneal dialysis is 6-12 hours, with automated peritoneal dialysis - 14-16 hours.
SIDE EFFECT
Possible: abdominal pain, infection of the exit hole, peritonitis, catheter obstruction, electrolyte disorders, muscle cramps, increased or decreased blood pressure, decreased appetite, constipation, fatigue, visual impairment, swelling, dyspnea.
Side effects can be caused both by the solution itself and by the procedure performed.
CONTRAINDICATIONS
Intolerance to maltose, isomaltosis, recent surgery on the abdominal organs, diseases that can lead to abnormality of the abdominal wall or intestinal perforation, pregnancy, lactation, age under 18, hypersensitivity to icodextrin, and other polymers based on starch.

PREGNANCY AND LACTATION
Contraindicated during pregnancy and lactation.

APPLICATION FOR CHILDREN
Contraindicated for children and adolescents under 18 years.

SPECIAL INSTRUCTIONS
Use with caution in respiratory failure, hypokalemia, digestive disorders.

The use of the drug may require correction of the insulin dose in patients with diabetes mellitus.
Determination of the concentration of glucose in the blood should be carried out using a method specific for glucose to exclude the influence of maltose.
When carrying out peritoneal dialysis, a loss of protein, amino acids, water-soluble vitamins is possible, which requires their replenishment.

The turbidity of the withdrawn solution or the presence of filaments of fibrin in it, may indicate the development of infection.
During the procedure it is necessary to follow the rules of asepsis, as well as to monitor the hydration parameters of the patient, biochemical and hematological indices, plasma osmolality.
The solution (without removing the outer shell from the bag) before use should be heated to 37 ° C with the help of dry heat (best - on a special heating plate).

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