NAME OF DRUG
dextran 40

CLASSIFICATION

Plasma volume expander

ALTERNATE NAMES

RHEOMACRODEX, MACRODEX, GENTRAN

INDICATIONS

•  to improve local circulation in various conditions, especially peripheral vascular occlusion or reconstruction
• plasma volume expansion during hypovolemic shock due to surgery or trauma
• prophylaxis of post-operative and post-traumatic thromboembolism

RECONSTITUTION AND STABILITY

• stable at room temperature

COMPATIBILITY

• compatible with NS, D5W
• compatible with amikacin, aminophylline, cefamandole, cloxacillin, epinephrine, erythromycin, gentamicin, heparin, hydrocortisone, piperacillin, ranitidine, sodium bicarbonate, tobramycin, vancomycin, verapamil, vitamin B with C

• incompatible with ampicllin, promethazine

ROUTES OF ADMINISTRATION

• IV infusion

VH & HSC ADMINISTRATION POLICY

DOSAGE

• dextran 40 - 500-1000 mL (10-20 mL/kg) in first 24 hours; thereafter 500 mL every 1-2 days for up to 2 weeks

• dextran 40 - 500-1000 mL (10-20 mL/kg) on day of surgery, then 500 mL daily x 2-3 days, then 500 mL every 2-3 days for up to 2 weeks

• dextran 40 - initially 500-1000 mL (10-20 mL/kg) infused as rapidly as needed; may follow with 500 mL (10 mL/kg) during the same 24 hour period; thereafter 500 mL (10 mL/kg) may be repeated daily for up to 5 days

dosage adjustment may be necessary in patients with renal insufficiency

• acute renal failure, hemorrhage due to thrombocytopenia or interferences with coagulation proteins
• hypersensitivity reactions including generalized urticaria, tightness of chest, wheezing, hypotension, nausea and vomiting

•  urine output should be monitored
• monitor for signs of circulatory overload
• contraindicated with marked thrombocytopenia or a bleeding diathesis
• use caution when administered to patients with heart failure or those patients at risk of overloading the circulation

Revised June 2008