Dextran 40 10% + Sodium Chloride 0.9%

Thromboembolic disorders, Hypovolaemic shock, Pulmonary embolism, Venous thrombosis

Intravenous Thromboembolic disorders Adult: As dextran 40: Initially, 500 ml of a 10% solution in sodium chloride 0.9% 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. Prophylaxis of postoperative thromboembolic disorders Adult: As dextran 40: 500 ml of a 10% solution in sodium chloride 0.9% 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. Hypovolaemic shock Adult: As dextran 40: Initially, 10 ml/kg given by rapid infusion as a 10% solution in sodium chloride 0.9% Doses may be given daily for up to 5 days.

Intravenous Thromboembolic disorders Child: As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children. Prophylaxis of postoperative thromboembolic disorders Child: As dextran 40: Up to 10 ml/kg in children.

Extreme caution

Hypersensitivity. Severe renal disease with oliguria or anuria. Marked cardiac decompensation. Pregnancy. Thrombocytopenia, Hypofibrinogenemia

Not a substitute for blood or blood components Administration may cause fluid overload; use with caution in patients at risk from overexpansion of blood volume (eg, very young, elderly patients, or those with heart failure) Large volumes of dextran (doses >1000 mL) may cause reduction in hemoglobin concentration and excessive dilution of plasma proteins due to hemodilution; transient prolongation of bleeding time or increase in bleeding tendency may occur with large volumes; use caution to prevent a decrease in hematocrit <30%. Severe and fatal anaphylactoid reactions reported; discontinue use immediately with signs of hypersensitivity and administer appropriate therapy. Use with caution in heart failure patients; monitor closely for fluid overload Use with caution in patients with active hemorrhage; may increase risk of more bleeding Renal failure reported with use; use with caution in patients with renal impairment; fluid status including urine output should be monitored closely; excessive dosing may precipitate renal failure in patients with advanced renal disease; use in severe oliguria or anuria is contraindicated Use with caution in patients with thrombocytopenia; doses >1000 mL may interfere with platelet function and transiently prolong bleeding time; observe for bleeding

C

Dextran: Enzyme inducers e.g. phenytoin or carbamazepine and enzyme inhibitors e.g. cimetidine. Sodium Chloride: May affect serum concentrations of lithium.

Congestive heart failure,Mild hypotension,Tightness of chest,Thrombocytopenia,Anaphylaxis,Injection site infection/phlebitis,Acute renal failure,Acidosis (if NaCl soln used),Pulmonary edema,Wheezing

Dextrans produce expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.