Dextran

Indications
 Intravenous
Hypovolaemic shock
Adult: As dextran 40: Initially, 10 ml/kg given by rapid infusion as a 10% solution in sodium chloride 0.9% or glucose 5%. Doses may be given daily for up to 5 days. As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused at a rate of 20-40 mL/min. Maintenance: 10 ml/kg/day for3 days (Dextran 70).
Max Dosage:
Intravenous
Thromboembolic disorders
Adult: As dextran 40: Initially, 500 ml of a 10% solution in sodium chloride 0.9% or 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.
Child: As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children.
Intravenous
Prophylaxis of postoperative thromboembolic disorders
Adult: As dextran 40: 500 ml of a 10% solution in sodium chloride 0.9% or 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.
Child: As dextran 40: Up to 10 ml/kg in children.
Intravenous
Prophylaxis of pulmonary embolism or venous thrombosis in moderate- to high-risk patients undergoing surgery
Adult: As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr during or immediately after surgery, followed by 500 mL on the next day and on subsequent alternate days for up to 2 wk after surgery in high-risk patients.
Intrauterine
As an aid in hysteroscopy
Adult: As dextran 70: 50-100 mL of a 32% solution instilled into the uterus as a rinsing and dilatation fluid.
Contraindications
 Hypersensitivity. Severe renal disease with oliguria or anuria. Marked cardiac decompensation. Pregnancy.
Warnings / Precautions
 Lactation.
Adverse Reactions
 GI disturbances; headache, dizziness; allergic reactions; raised liver enzyme values; alopecia; bone marrow suppression.
Drug Interactions
 Enzyme inducers e.g. phenytoin or carbamazepine and enzyme inhibitors e.g. cimetidine.
See Below for More dextran Drug Interactions
Mechanism of Actions
 Dextrans produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.
Metabolism: Dextrans with molecular weight>50,000 are slowly metabolised to glucose.
Excretion: Urine: 50% (as unchanged dextran 70 within 24 hr); 70% (as unchanged dextran 40 within 24 hr). Dextrans with molecular weight<50,000 are excreted unchanged by the kidney; small amounts are eliminated in the faeces.
Storage Conditions
 Intrauterine: Store at 25°C. Intravenous: Store at 25°C.
ATC Classification
 B05AA05 - dextran ; Belongs to the class of blood substitutes and plasma protein fractions. Used as blood substitutes.
Storage
 Intrauterine: Store at 25°C. Intravenous: Store at 25°C.
Available As
  • Dextran 0.1% w/v
  • Dextran 10% w/v

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