Medicinal reference book geotar. Geotar medicinal reference book Description of pharmacological action

Dextran 40

International non-proprietary name

Dextran

Dosage form

Solution for infusion 6% and 10%

Compound

1 liter of the drug contains

active substance - dextran 40 molecular weight

from 35,000 to 45,000 60.0 g or 100.0 g

Excipients: sodium chloride, water for injection.

Oscripture

Liquid colorless or yellowish, transparent or slightly opalescent liquid, salty taste.

Pharmacotherapeutic group

Plasma substituting and perfusion solutions. Blood plasma preparations and plasma-substituting preparations. Dextran.

ATX code B05AA05

Pharmacological properties

Pharmacokinetics

Dextran is excreted from the body unchanged, mainly by the kidneys, 70% of the administered dose is excreted in 24 hours. 30% enters the reticuloendothelial system, the liver, where it is cleaved by the enzyme acid alpha-glucosidase to glucose. Does not participate in carbohydrate metabolism.

Pharmacodynamics

Dextran 40 is a plasma-substituting drug, belongs to low molecular weight dextrans. Promotes an increase in plasma volume by almost 2 times compared to the volume of the administered drug, since each gram of dextran with a molecular weight of 35,000-40,000 causes the movement of 20-25 ml of fluid from the tissues into the bloodstream. Due to the high oncotic pressure, it passes very slowly through the vascular wall and circulates in the vascular bed for a long time, normalizing hemodynamics due to fluid flow along the concentration gradient - from tissues to vessels. As a result, blood pressure quickly rises and is maintained at a high level for a long time, tissue edema decreases. Reduces and prevents aggregation of blood cells, restores blood flow in small capillaries, has a detoxifying effect. According to the osmotic mechanism, it stimulates diuresis (it is filtered in the glomeruli, creates a high oncotic pressure in the primary urine and prevents the reabsorption of water in the tubules), which contributes (and accelerates) the elimination of poisons, toxins, and degradative metabolic products. A pronounced volemic effect has a positive effect on hemodynamics and is simultaneously accompanied by the leaching of metabolic products from the tissues, which, together with an increase in diuresis, provides an accelerated detoxification of the body. When used at a dose of up to 15 ml / kg does not cause a noticeable change in bleeding time.

Indications for use

Prevention and treatment of traumatic, surgical, burn shock

Venous and arterial circulation disorders

To improve local circulation in vascular surgery

Prevention of postoperative and post-traumatic thromboembolism

For detoxification with peritonitis, pancreatitis

Dosage and administration

Adults

The drug is administered intravenously drip. The dose of the drug and the duration of treatment is set individually and depends on the indications for use and the patient's condition.

Immediately before using the medicinal product, with the exception of urgent cases, skin test. To do this, after treating the injection site with an antiseptic in the middle part of the inner surface of the forearm, 0.05 ml of the drug is injected intradermally with the formation of a "lemon peel". The presence of redness at the injection site, the formation of a papule or the appearance of symptoms of a general reaction of the body in the form of nausea, dizziness and other manifestations 10-15 minutes after the injection indicates the patient's hypersensitivity to the drug (risk group).

When using the drug, it is necessary to carry out bioassays: after the slow introduction of the first 5 drops of the drug, the transfusion is stopped for 3 minutes, then another 30 drops are administered and the infusion is stopped again for 3 minutes. In the absence of a reaction, the drug is continued. The first 10-20 minutes the drug is administered slowly, observing the patient's condition. The results of the bioassay must be recorded in the medical history.

In order to prevent and treat capillary blood flow disorders associated with traumatic, surgical and burn shock, 400-1000 ml per day (for 30-60 minutes) is used.

In case of violations of arterial and venous circulation, the drug is administered intravenously by drip 500 - 1000 ml (10 - 20 ml / kg) on the first day. The next day, and then every other day - 500 ml. The course of treatment is a maximum of two weeks.

Prevention of postoperative and post-traumatic thromboembolism: 500 - 1000 ml (10 - 20 ml / kg) is administered intravenously by drip. In order to minimize the risks of possible complications, the drug is used during surgery or immediately after injury. On the next day, treatment can be supplemented with an additional injection of 500 ml of dextran.

In vascular surgery: 500 ml (10 ml/kg) is injected intravenously during surgery, and another 500 ml of the drug is administered in the postoperative period. The next day, and then every other day - 500 ml. The course of treatment is a maximum of two weeks.

For the purpose of detoxification, it is administered intravenously in a single dose from 200 ml to 1000 ml for 60-90 minutes. In the following days, the drug is administered drip, in a daily dose of 500 ml. The drug, as a rule, causes an increase in diuresis (a decrease in diuresis indicates dehydration of the patient's body).

Side effects

Allergic / anaphylactic reactions (skin rash, itching, skin flushing, nausea, fever, fever, chills, Quincke's edema, anaphylactic shock)

If anaphylactic type reactions occur during infusion (redness and itching of the skin, Quincke's edema, etc.), it is necessary to immediately stop the administration of the drug and, without removing the needle from the vein, proceed with all the therapeutic measures provided for by the relevant instructions to eliminate the transfusion reaction ( antihistamines and cardiovascular agents, glucocorticosteroids, etc.).

With the introduction of the drug into peripheral veins, burning and soreness along the vein may occur.

Arterial hypertension

It can provoke bleeding, the development of acute renal failure.

With the rapid introduction of dextrans in large volumes, the so-called "dextran syndrome" can be provoked - damage to the lungs, kidneys, and hypocoagulation. In case of complaints of a feeling of tightness in the chest, difficulty breathing, back pain, as well as the onset of chills, cyanosis, circulatory and respiratory disorders, stop the transfusion and conduct appropriate symptomatic therapy.

Contraindications

Hypersensitivity to the components of the drug

Decompensated heart failure, pulmonary edema

Fructose-1,6-diphosphatase deficiency

Hyperkalemia

Traumatic brain injury with increased intracranial pressure

Hemorrhagic stroke

Hemorrhagic diathesis

Ongoing internal bleeding

Hypocoagulation

Thrombocytopenia

Severe renal dysfunction, accompanied by oligo- and anuria

Severe allergic conditions of unknown etiology

Hypervolemia, hyperhydration and other situations in which the introduction of massive doses of fluids is contraindicated

Children and adolescents under 18 years of age (due to the lack of clinical data on safety and efficacy)

Pregnancy and lactation (due to the lack of clinical data on safety and efficacy)

In patients with reduced filtration capacity of the kidneys, it is necessary to limit the introduction of sodium chloride.

Drug Interactions

Together with the drug, it is advisable to administer crystalloid solutions (0.9% sodium chloride solution, 5% dextrose solution). This is especially important in the treatment of dehydrated patients and after major surgery. Can be used in conjunction with other traditional transfusion agents. It is necessary to first check the compatibility of dextran with drugs that are planned to be introduced into the infusion solution. With simultaneous use with anticoagulants, it is necessary to reduce their dose. Co-administration with low molecular weight heparins is not recommended.

special instructions

In the course of treatment, it is necessary to control the ionic composition of blood serum, fluid balance and kidney function. In patients with diabetes mellitus with severe hyperglycemia and hyperosmolarity, Dextran 40 should be used with caution.

The presence of dextran in the blood affects the results of the laboratory determination of the concentration of bilirubin and protein. In this regard, it is recommended to take blood samples to determine the content of bilirubin and protein in the blood before the administration of the drug.

Dextrans are able to envelop the surface of erythrocytes, preventing the determination of the blood group, therefore, washed erythrocytes must be used for analysis.

As a rule, dextran causes an increase in diuresis (if there is a decrease in diuresis with the release of viscous syrupy urine, this may indicate dehydration). In this case, intravenous crystalloid solutions must be administered to replenish and maintain water and electrolyte balance. In the event of oliguria, saline solutions and furosemide must be administered.

Before use, make sure that the packaging is intact and the solution is clear.

Features of the influence of the drug on the ability to drive a vehicle and potentially dangerous mechanisms

Given the side effects of the drug, care should be taken when driving vehicles or other potentially dangerous mechanisms.

Overdose

Symptoms: when used in doses exceeding the recommended therapeutic (more than 15 ml / kg), it can provoke bleeding, the development of acute renal failure, hyperkalemia, arterial hypertension, oliguria, anuria may occur.

Treatment: symptomatic therapy.

Release form and packaging

200 ml and 400 ml of the drug are poured into polypropylene bottles with a loop-holder, sealed with polypropylene caps with a rubber lining and equipped with a cap with a tear-off ring for opening, welded onto the bottle.

30 or 40 bottles, together with the appropriate number of instructions for medical use in the state and Russian languages, are placed in a group package from a cardboard box.

Storage conditions

Store in a place protected from light, at a temperature not exceeding 25º C.

Keep out of the reach of children!

Shelf life

Do not use after the expiration date.

Terms of dispensing from pharmacies

On prescription

Manufacturer

LLP "Kelun-Kazpharm" (Kelun-Kazpharm), Almaty region, Karasai district, Eltai village, s. Kokozek.

Name and country of the marketing authorization holder

Name and country of the packaging organization

Kelun-Kazpharm LLP (Kelun-Kazpharm), Kazakhstan

Address of the organization accepting claims from consumers on the quality of products in the territory of the Republic of Kazakhstan:

Instructions for medical use

medicinal product

Dextran 40

Tradename

Dextran 40

International non-proprietary name

Dextran

Dosage form

Solution for infusion 6% and 10%

Compound

1 liter of the drug contains

active substance - dextran 40 molecular weight

from 35,000 to 45,000 60.0 g or 100.0 g

Excipients: sodium chloride, water for injection.

Description

Liquid colorless or yellowish, transparent or slightly opalescent liquid, salty taste.

Pharmacotherapeutic group

Plasma substituting and perfusion solutions. Blood plasma preparations and plasma-substituting preparations. Dextran.

ATX code B05AA05

Pharmacological properties

Pharmacokinetics

Pharmacodynamics

Indications for use

Prevention and treatment of traumatic, surgical, burn shock

Venous and arterial circulation disorders

To improve local circulation in vascular surgery

Prevention of postoperative and post-traumatic thromboembolism

For detoxification with peritonitis, pancreatitis

Dosage and administration

Adults

The drug is administered intravenously drip. The dose of the drug and the duration of treatment is set individually and depends on the indications for use and the patient's condition.

In order to prevent and treat capillary blood flow disorders associated with traumatic, surgical and burn shock, 400-1000 ml per day (for 30-60 minutes) is used.

Side effects

Allergic / anaphylactic reactions (skin rash, itching, skin flushing, nausea, fever, fever, chills, Quincke's edema, anaphylactic shock)

With the introduction of the drug into peripheral veins, burning and soreness along the vein may occur.

Arterial hypertension

It can provoke bleeding, the development of acute renal failure.

Contraindications

Hypersensitivity to the components of the drug

Decompensated heart failure, pulmonary edema

Fructose-1,6-diphosphatase deficiency

Hyperkalemia

Traumatic brain injury with increased intracranial pressure

Hemorrhagic stroke

Hemorrhagic diathesis

Ongoing internal bleeding

Hypocoagulation

Thrombocytopenia

Severe renal dysfunction, accompanied by oligo- and anuria

Severe allergic conditions of unknown etiology

Hypervolemia, hyperhydration and other situations in which the introduction of massive doses of fluids is contraindicated

Children and adolescents under 18 years of age (due to the lack of clinical data on safety and efficacy)

Pregnancy and lactation (due to the lack of clinical data on safety and efficacy)

In patients with reduced filtration capacity of the kidneys, it is necessary to limit the introduction of sodium chloride.

Drug Interactions

special instructions

Dextrans are able to envelop the surface of erythrocytes, preventing the determination of the blood group, therefore, washed erythrocytes must be used for analysis.

Before use, make sure that the packaging is intact and the solution is clear.

Features of the influence of the drug on the ability to drive a vehicle and potentially dangerous mechanisms

Given the side effects of the drug, care should be taken when driving vehicles or other potentially dangerous mechanisms.

Overdose

Treatment: symptomatic therapy.

Release form and packaging

30 or 40 bottles, together with the appropriate number of instructions for medical use in the state and Russian languages, are placed in a group package from a cardboard box.

Storage conditions

Store in a place protected from light, at a temperature not exceeding 25º C.

Keep out of the reach of children!

Shelf life

Do not use after the expiration date.

Terms of dispensing from pharmacies

On prescription

Manufacturer

LLP "Kelun-Kazpharm" (Kelun-Kazpharm), Almaty region, Karasai district, Eltai village, s. Kokozek.

Name and country of the marketing authorization holder

Name and country of the packaging organization

Kelun-Kazpharm LLP (Kelun-Kazpharm), Kazakhstan

Address of the organization accepting claims from consumers on the quality of products in the territory of the Republic of Kazakhstan:

In / in, jet, jet-drip and drip, using electrophoresis.
Dosing regimen - individual, determined by the patient's condition, the value of blood pressure, heart rate, hematocrit.
Doses and rate of administration of the drug should be selected individually, in accordance with the indications and the patient's condition.
When using the drug, a bioassay is mandatory: after a slow introduction of the first 5 drops of the drug, the transfusion is stopped for 3 minutes, then another 30 drops are injected and the infusion is stopped again for 3 minutes. In the absence of a reaction, the drug is continued. The results of the bioassay must be recorded in the medical history.
In case of violation of capillary blood flow (various forms of shock), it is administered intravenously by drip or jet-drip, at a dose of 0.5 to 1.5 liters, until hemodynamic parameters stabilize at a life-supporting level. If necessary, the amount of the drug can be increased to 2 liters.
In children with various forms of shock, it is administered at the rate of 5-10 ml / kg, the dose can be increased if necessary up to 15 ml / kg. It is not recommended to reduce the hematocrit value below 25%.
In cardiovascular operations, it is administered intravenously, immediately before surgery, for 30-60 minutes for adults and children at a dose of 10 ml / kg, during surgery for adults - 500 ml, for children - 15 ml / kg.
After the operation, the drug is administered intravenously (within 60 minutes) for 5-6 days at the rate of: adults - 10 ml / kg once, children under 2-3 years old - 10 ml / kg 1 time per day, up to 8 years - 7-10 ml / kg 1-2 times a day, up to 13 years - 5-7 ml / kg 1-2 times a day. For children over 14 years of age, the doses are the same as for adults.
During operations under cardiopulmonary bypass, the drug is added to the blood at the rate of 10–20 ml/kg of the patient to fill the oxygenator pump.
The concentration of dextran in the perfusion solution should not exceed 3%. In the postoperative period, the doses of the drug are the same as in violation of capillary blood flow.
For the purpose of detoxification, it is administered intravenously in a single dose of 500 to 1250 ml (in children - 5–10 ml/kg) for 60–90 minutes. If necessary, you can pour another 500 ml of the drug on the first day (in children, the administration of the drug on the first day can be repeated in the same doses). In the following days, the drug is administered by drip, adults - at a daily dose of 500 ml, children - at the rate of 5-10 ml / kg. Together, it is advisable to administer crystalloid solutions (Ringer's and Ringer's acetate) in such an amount as to normalize the water and electrolyte balance (especially important in the treatment of dehydrated patients and after surgical operations), the drug, as a rule, causes an increase in diuresis (a decrease in diuresis indicates dehydration of the body patient).
In ophthalmic practice, it is used by electrophoresis, which is carried out in a conventional way. The consumption of the drug for one procedure is 10 ml. The procedure is carried out 1 time per day, injected from both the positive and negative poles. Current density - up to 1.5 mA / cm 2. Procedure duration - 15–20 minutes. The course of treatment consists of 5-10 procedures.

Polysaccharides produced from sucrose by bacteria Leuconostoc mesenteroides

Chemical properties

In general, the Dextran group of substances is bacterial polysaccharides , which are made up of residues alpha-D-glucopyranose . Their molecule contains branched chains, the linear part of which contains 1,6 or 1,3 bonds. The molecular weight of the compounds is on the order of 10 to 7 - 10 to the 8th power of grams per mole.

Chemical properties polysaccharides largely depend on their structure and molecular weight.

pharmachologic effect

Plasma substituting.

Pharmacodynamics and pharmacokinetics

Polymers glucose with varying degrees polymerization have different pharmacological properties. Dextran, whose molecular weight is 60,000, is used as hemodynamic drugs, with their help restore the volume of circulating blood. Such Dextrans slowly overcome the walls of blood vessels and remain in the vascular bed for a long time, thereby normalizing hemodynamic parameters , providing a normal flow of fluid (into vessels from nearby tissues). Such compounds quickly increase and keep at a normal level for a long time. arterial pressure , relieve swelling of tissues.

Solutions containing dextrans with a molecular weight of 30-40 thousand are used for detoxification . After the introduction of such compounds, the fluidity of the blood improves, the degree of aggregation of blood cells decreases. The drug also has diuretic effect , as it contributes to the creation in the primary urine of high oncotic pressure and prevents the processes of fluid reabsorption in the tubules. Thus, the process of removing poisons and out of the body is greatly accelerated.

Substances-dextrans are not toxic. After performing their function, they are excreted with the help of the kidneys and unchanged. The tool does not take part in carbohydrate metabolism.

It has been found in laboratory and clinical studies that some macromolecular compounds when taking large doses can accumulate in the cells of the reticular system, where it subsequently undergoes metabolic reactions and turns into glucose .

Indications for use

Dextran solutions with high molecular weight use:

with severe posthemorrhagic hypovolemia ;
for elimination hypovolemic shock after injury;
for the prevention of development before surgery and after surgery;
as a means of replenishing blood loss during childbirth, with;
in patients with hypovolemia , resulting from the loss of plasma (after burns , frostbite, compression syndrome ).

Low molecular weight compounds are used:

for violations microcirculation ;
after traumatic shock or burn shock, compression syndrome;
at septic shock ;
to replace the volume of plasma with heavy blood loss in pediatric practice;
in combination with blood as a filler for heart-lung machines.

Compounds with a molecular weight of about 1000 are also used. They are prescribed for the prevention of severe allergic reactions that can develop after intravenous administration of high and medium molecular weight solutions of Dextran.

Contraindications

The use of drugs is contraindicated:

with injuries of the skull, accompanied by an increase, hemorrhages into the brain;
if the patient is contraindicated in the introduction of a large amount of liquid;
at and oliguria arising from organic kidney disease;
persons suffering from heart failure;
for violations hemostasis and ;
patients who are prone to developing allergic reactions .

If the drug needs to be diluted with glucose , then it should not be prescribed to patients or patients with other disorders of carbohydrate metabolism.

Side effects

Dextran preparations are usually well tolerated by patients. Sometimes occur after the introduction of the solution. There is rarely a decrease blood pressure .

Dextran, instructions for use (Method and dosage)

High molecular weight solutions are injected intravenously . The infusion rate is 60 to 80 drops per minute. The amount of medicine is up to 2.5 liters. With severe blood loss, additional blood injection is indicated.

Solutions of high molecular weight, if they are used as a blood substitute, are administered in the same dosages. In general, the amount of solution administered per day should not exceed 20 ml per kg. The rate of infusion depends on the patient's condition and indications.

Dextran, having a molecular weight of about 1000, is administered by jet, intravenously. Dosage for adults - 20 ml of solution. For children, use 0.3 ml per kg of weight. The infusion is performed 1-2 minutes before the introduction of a medium or high molecular weight drug.

The introduction of a low molecular weight agent should be carried out before each subsequent infusion of Dextran, especially if more than 2 days have passed since the previous one.

Overdose

Cases of drug overdose are not described.

Most likely, when using doses significantly higher than recommended, it may develop bleeding ,arterial hypotension , . Treatment is carried out according to the symptoms.

Interaction

When combined with the drug increases the risk of unwanted side reactions.

The substance is not compatible with , hydralazine, suxamethonium iodide and suxamethonium chloride .

Apixaban, nadroparin calcium and parnaparin sodium increase the risk of bleeding. It is recommended to adjust the dosage parnaparin sodium to prevent a decrease in blood coagulation by more than 1.5 times.

Terms of sale

On prescription.

special instructions

Since during the use of the substance the patient may develop allergic reactions, it is recommended to monitor the patient's condition when administering the first 10-20 ml of the solution. Input must be slow. There should be facilities for intensive care nearby.

Low molecular weight Dextran (molecular weight 1000) must not be diluted or mixed in the same infusion bag with Dextran infusion solutions. It is allowed to administer the substance intravenously using a Y-shaped branch or a rubber tube, if the drug is not diluted during the injection.

During pregnancy and lactation

The drug can be prescribed to lactating and pregnant women.

Preparations containing (Analogues)

Coincidence in the ATX code of the 4th level:

Trade name of Dextran: ReoDEX 40, Dextran 40, Dextran 10, ReoDEX 60.

Combined remedy iron dextran is in the composition of drugs: , .

Publication date: 26-11-2019

How to treat pancreatitis with Dextran?

Dextran is a drug prescribed to patients with shock conditions caused by injuries, burns, and severe postoperative periods. The medicine contributes to the normalization and improvement of blood circulation processes and blood pressure indicators. The use of Dextran 40 is practiced in cosmetics for the treatment of allergic reactions on the skin.

Registration number and ATX

LS-000952 dated 09/05/2011.

ATX code: B05AA05.

Name

According to the INN (international non-proprietary name), it is called Dextran. The international trade name is Dextran. The Latin name of the drug is Dextranum.

Dextran is a drug prescribed to patients with shock conditions caused by injuries, burns, and severe postoperative periods.

Indications for use of Dextran

The drug is prescribed in the treatment of the following clinical cases:

fatty embolism;
severe and critical conditions, accompanied by hemorrhages in the brain;
shock conditions - toxic, burn, postoperative, hemorrhagic, traumatic;
thrombosis;
Raynaud's disease;
cases of detoxification in such acute diseases as peritonitis, pancreatitis;
food poisoning;
before plasmapheresis;
risks of gangrene;
stroke in the acute stage;
diseases accompanied by disorders of carbohydrate metabolism;
installation of implants, pacemakers;
hearing loss due to trauma;
diseases of the organs of vision: congenital and acquired pathologies of the retina, dystrophic processes of the retina, detachment, myopia in a complex form.

The medicine belongs to the group of plasma-substituting drugs, which makes it possible to use it in pediatrics in case of a child losing a large volume of blood.

pharmachologic effect

The active components of the drug, after their penetration into the body, increase the degree of suspension stability of the blood, making it less viscous, thereby preventing the risk of blood clots, and improving the blood circulation in the capillaries. This property of the drug, as a rapid blood thinning, contributes to the normalization of blood pressure. The drug belongs to the group of detoxification agents.

The pharmacodynamics of this agent lies in its osmotic mechanism. The active components stimulate the process of diuresis, due to which a high oncotic pressure is created in the urine of the primary type, the process of water reabsorption stops, which is extremely important in dehydrated conditions.

The medicine promotes the rapid removal of poisons, toxins and their compounds from the body. Due to the volemic effect, the drug has a beneficial effect on hemodynamics, which occurs simultaneously with the process of washing out metabolic products from the soft structures of the body. By increasing diuresis, the detoxification process is activated.

The drug is actively used in heart failure due to the ability to influence blood pressure, leading to its rapid increase.

The drug prevents the process of platelet aggregation, improving blood circulation in small blood vessels and expanding the bloodstream.

Pharmacokinetics means - active components are excreted from the body with by-products of life - with urine, through the kidneys.

Composition and form of release

Available as a solution for infusion. The solution is clear, colorless, may have a yellowish color. The active substance is dextran, with a molecular weight of 30,000-40,000. Excipients in the composition of the drug - sodium chloride, water for injection. The volume of the bottle is 200 ml and 400 ml.

Auxiliary substances in the composition of the drug - sodium chloride.

How to take Dextran correctly?

It is intended for intravenous administration, by jet, drip or jet-drip method. Perhaps the introduction of the drug by electrophoresis.

Dosage

The amount of the drug is determined individually, depending on the nature and severity of the clinical case:

In the case when the patient has impaired blood circulation in small blood vessels - capillaries: the dosage per day is from 0.5 liters to 1 liter. In severe conditions, with an exacerbation of the pathological process, an increase in dosage to 2 liters is allowed.
Treatment of children in the presence of shock conditions of a different nature, the amount of medication is calculated according to the scheme from 5 to 10 ml per kilogram of body weight. It is allowed to increase the amount of dextran up to 15 ml.
Therapy of diseases, including those occurring in a chronic form, of the cardiovascular system and before surgical operations - for 60-70 minutes in the same dosage, regardless of the age of the patient - 10 ml per kg of body weight. Directly during the operation - 500 ml for adult patients, for children - 15 ml for each kg of weight.
At the end of the operation, to stabilize the patient, Dextran is administered intravenously for 1 hour, the course of therapy is from 5 to 6 days. Dosage for adult patients - 10 ml per kg of body weight, administered at a time. The dosage for children in the age group from 2 to 3 years is 10 ml for each kg administered during the day, children from 3 to 8 years - from 7 to 10 ml, children from 8 to 13 years - from 5 to 7 ml.
During operations with the patient connected to artificial lung ventilation, the drug is administered at a dosage calculated according to the scheme - from 10 to 20 ml per kg of body weight.
Use in ophthalmology: as eye drops by electrophoresis. Dosage - 10 ml at a time. Frequency rate - once a day. The duration of the therapeutic course is from 5 to 10 sessions.
For detoxification, intravenous administration of the drug is carried out. The dosage for children is 500-1250 ml, the medicine is administered within 1-1.5 hours. Dosage for adults - 500 ml per day, children - from 5 to 10 ml per kg of weight.

It is recommended, in addition to Dextran, to introduce crystalloid solutions, for example, Ringer-acetate or Ringer solutions, glucose, iron hydroxide can be used. The dosage of solutions is selected individually, the main condition: their quantity should be enough to normalize the water and electrolyte balance, it is especially important to follow this rule in cases where the patient is dehydrated.

Before meals or after

There is no attachment to food intake. If the drug is used in dentistry, its administration is carried out through electrophoresis after meals.

Application duration

Features of the use of Dextran

Before the introduction of the drug, it is necessary to conduct an allergic test. The only exceptions are the extremely severe conditions of the patient, when the administration of the medication must be urgent.

The test is carried out as follows - the skin is treated with an antiseptic agent (the inner part of the forearm), then a small amount of the drug is injected, not more than 0.05 ml. If within 15 minutes after the administration of the solution there was a reaction in the form of nausea and dizziness, redness of the skin at the injection site, worsening of the general condition, the medicine cannot be used due to the patient's hypersensitivity to the main component.

The drug begins to act instantly, so the first infusion of Dextran should be carried out with a biological test - the first 5 drops of the solution should be injected slowly, after which it is necessary to pause for three minutes, then slowly inject another 30 drops, pause again for 3 minutes. If there is no negative reaction, the introduction of the solution can be continued.

Pregnancy and lactation

When breastfeeding and the entire period of pregnancy, the use of Dextran is not recommended. This medication is used only when other drugs cannot give the desired positive result, and its effectiveness exceeds the risks of possible complications.

Childhood

It is used for children over the age of 2 years, the dosage is individual, calculated by weight.

Elderly age

With the introduction of Dextran to the elderly, dosage adjustment is not required.

For impaired liver function

It is allowed to use Dextran in the minimum dosage, for a short course, with constant monitoring of the state and functioning of the organ.

For impaired renal function

It is prescribed only if it is not possible to achieve a positive result from other drugs. Dosage is minimal.

Side effects

A negative reaction may be caused by an excess of dosage or by the patient's individual intolerance to the main component of the drug.

Possible manifestations:

From the side of the skin and the immune system, allergic manifestations on the skin, hyperemia can develop.
Possible deterioration of the general condition: nausea, rarely vomiting, dizziness, fever.
In rare cases (with hypersensitivity) - the development of anaphylactic shock.
Rarely, against the background of long-term use of Dextran, internal bleeding may open, the risk that acute renal failure will appear is not excluded.

In the event of the development of allergic and other negative reactions to the medicinal product, its administration must be immediately canceled.

Impact on vehicle control

The drug does not affect the central nervous system. During drug therapy, there are no restrictions on driving and working with heavy machinery. An exception is an individual reaction to the administration of the drug, which can manifest itself in sudden attacks of dizziness.

Contraindications

It is forbidden to use in the following cases:

individual intolerance to individual components of the drug;
cardiovascular insufficiency of the decompensated type;
previous brain injuries, due to which intracranial pressure is increased;
swelling in the lungs;
a stroke of a hemorrhagic type;
diseases and pathologies of the kidneys with an intense symptomatic picture;
an intense allergic reaction, the etiology of which is unknown;
hyperhydration.

The use of Dextran in the presence of contraindications in the patient can provoke the development of severe complications.

Interaction with other drugs

Dose adjustment is required with the simultaneous administration of Dextran and medications from the group of anticoagulants. Joint administration of the drug with the means of the transfusion group is allowed.

Alcohol compatibility

Overdose

Cases of overdose from the use of Dextran are unknown. This is due to the fact that the drug is used only in a hospital under the supervision of doctors and with a clear dosage. Rarely - with the introduction at a time of the amount of the drug more than 15 ml per kg of body weight - a person may open bleeding, develop renal failure. Therapy in these cases is symptomatic.

Terms of dispensing from pharmacies

A prescription from a doctor is required. The drug is intended only for use in a hospital setting.

What is the price?

From 90 rubles.

Storage conditions

The temperature regime should not exceed 25°C.

Best before date

24 months, the use of the solution in the future is strictly prohibited.

Analogues

Drugs with a similar spectrum of action: Reopoliglyukin, Poliglukin, Poliglukin-RT.