MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

 

Generic Name:

Hemin

Trade Name:

Panhematin

Action:

Inhibits the hepatic and / or marrow synthesis of ALA synthase, the enzyme that regulates the porphyrin / heme pathway.

Indications:

Treatment of recurrent attacks of acute intermittenT porphyria (AIP)

Administration:

Run over 10- 15 minutes with 0.45 micron or smaller filter.  Administer through a large vein or central line

Dose

1 to 4 mg/kg/day may be repeated no earlier than every 12 hours in more severe case. However not to exceed 6mg/kg in any 24 hour period.

Standard Concentration:

7mg/ml after adding 43 milliliters of Sterile Water For Injection to the vial of 313mg. 

Special Considerations:

IV Pharmacist:

    ·  Mix upon request from floor Pharmacist only

    ·  Immediately after adding diluent, the product should be shaken well for 2 to 3 minutes to aid dissolution.

     · Immediately hand medication plus 0.22 micron filter (round & yellow) to the floor pharmacist for delivery after reconstituted

Decentral Pharmacist:

    ·  Make sure patient is qualify for Hemin, which has indication for Acute Intermittent Porphyria, and patient has to use 400grams glucose/day for 1 to 2 days prior Hemin.

     · Upon approval, communicate with the nurse for dosing time.

     ·  Notify IV pharmacist to mix medication when needed for dose

     ·  Scan in Mysis for indication of delivery

     · Immediately deliver the medication to the floor with the filter

     · Assist nurse to make sure medication is being delivered to the patient before leaving the floor.

Nurse:

     · Should be administered immediately after preparation

     · Must use the in line filter that provided by pharmacist

     · An infusion pump is recommended to ensure accuracy of dosing and administration time.

     · At the end of infusion, flush the line with 50ml of Normal Saline

Precautions and Side Effects:

     · Thrombocytopenia

     · Phlebitis

     · Products made from human blood may contain infectious agents.

Resources

 Panhematin ̉  Package Insert, Lexicomp

 

 

RevJan-08