MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

Critical Care

Generic Name:

Dextran 40

Trade Name:

Rheomacrodex, low molecular weight Dextran, 10% Dextran 40, 10% LMD , 10% Gentran 40

Actions:

Unknown, but postulated to prevent or diminish platelet aggregation

 

Plasma expansion (colloid)

Indications:

- Prophylaxis of thrombosis

- Improvement of circulation in transplantation and graft procedures

- Plasma expansion

Administration Guidelines:

Usual Dose and Route

Prophylaxis of thrombosis: 2 to 3 G/hour (20-30mL/hr) IV; not to exceed 200g in 24 hours

Volume expansion: 500-1000mL IV bolus over 10-30 minutes; not to exceed 20mL/kg/day during first 24 hours.

Standard Concentration:

50 g/500 ml Dextrose 5 % in WATER (premixed)

50 g/500 ml 0.9 % Sodium Chloride (premixed)

Special Considerations:

- Dextran 40 has been associated with severe and fatal anaphylatic reactions. patients should be monitored closely during the first several minutes of administration.

- Patients should be adequately hydrated: low urine specific gravity or urine output may indicate poor renal excretion of dextran and warrant discontinuing the drug.

- Monitor serum osmolality. Discontinue if greater than 300 mOsm/mL

- Should not be used in patients with severe renal insufficiency

- Should be used with caution with any clinical state in which there is an increase risk of bleeding

Precautions and Side Effects:

- Mild urticaria

- Nausea and vomiting

- Wheezing, tightness in chest

- Hypotension

- Anaphylaxis

- Renal failure

-Concomitant administration of antiplatelet drugs greatly increases the risk of bleeding

 

Rev:1/08