Dextran

Table of contents

  • Brand Names
  • Drug Combinations
  • Chemistry
  • Pharmacologic Category
  • Mechanism of Action
  • Therapeutic Use
  • Pregnancy and Lactation Implications
  • Contraindications
  • Warnings and Precautions
  • Adverse Reactions
  • Drug Interactions
  • Genes that may be involved
  • Dosage
  • Pharmacokinetics and Pharmacodynamics
  • Special Considerations

Brand Names

Europe

Denmark: Macrodex, Promiten, Rescueflow, Rheomacrodex; Estonia: Dextran; Finland: Rescueflow; France: Rescueflow; Germany: Deltadex, Rescueflow; Greece: Deltadex, Gentran, Neodextril, Rheomacrodex; Hungary: Promiten, Rheomacodex; Italy: Eudextran, Plander; Latvia: Dextran; Lithuania: Dextran; Luxembourg: Gentran, Promiten, Rheomacrodex; Malta: Dextran, Netherlands: Dextran; Poland: Desktran; Portugal: Dextrano; Romania: Dextran; Spain: Rheomacrodex; Sweden: Macrodex, Perfadex, Plasmodex, Promiten, Rescueflow, Rheomacrodex.

North America

Canada: Dextran.

Latin America

Mexico: Rheomacrodex.

Asia

Japan: MDS.

Drug combinations

Dextran and Hydroxypropyl Methylcellulose

Dextran, Glycerin, and Hydroxypropyl Methylcellulose

Chemistry

Dextran 40: Mw: 35000-40000 (average). Dextran 40 is derived by controlled hydrolysis and fractionation of polysaccharides elaborated by the fermentative action of certain strains of Leuconostoc mesenteroides (NRRL, B.512 F; NCTC, 10817) on a sucrose substrate. It is a glucose polymer in which the linkages between glucose units are almost entirely of α-1:6 type. CAS-9004-54-0 (1965).

Pharmacologic Category

Hemorrheologic Agents. Replacement Preparations. Plasma Volume Expander. (ATC-Code: B05AA05).

Mechanism of action

Produces plasma volume expansion by virtue of its highly colloidal starch structure, similar to albumin.

Therapeutic use

Blood volume expander used in treatment of shock or impending shock when blood or blood products are not available. Priming fluid in cardiopulmonary bypass and for prophylaxis of venous thrombosis and pulmonary embolism in surgical procedures associated with a high risk of thromboembolic complications.

Pregnancy and lactiation implications

Use with caution during pregnancy or lactation.

Unlabeled use

Contraindications

Hypersensitivity to dextran or any component of the formulation. Marked hemostatic defects (thrombocytopenia, hypofibrinogenemia) of all types including those caused by drugs. Marked cardiac decompensation. Renal disease with severe oliguria or anuria.

Warnings and precautions

May cause a depression of hematocrit (can cause hemodilution). Risk of fluid overload during administration (caution in hypovolemia). Hypersensitivity reactions may occur, although dextran 40 rarely causes a reaction (dextran 1 is indicated for prophylaxis of serious anaphylactic reactions to dextran infusions). Renal failure is possible. Caution in active hemorrhage.

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