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Pronounciation and Trade Name(s)

Pronounciation

Trade Name(s)

Drug Category(ies)

Usual Dose

Availability in the United States is extremely limited.

20 mL (150 mg/mL) 1 to 2 minutes before every IV clinical dextran infusion. If 15 minutes or more elapses before the clinical dextran infusion is started, a full dose of dextran 1 must be repeated before the infusion.

Pediatric Dose

0.3 mL/kg of body weight. To be given in same manner as adult dose.

Dilution

May be given undiluted. May be given through Y-tube of an infusion set if there is minimum dilution with the primary IV. May not be diluted with or administered through an IV tubing containing clinical dextran infusion.

Compatibality

According to the manufacturer, dextran 1 should not be diluted or admixed with clinical dextran (high molecular weight or low molecular weight) and should not be given through an IV set used to infuse clinical dextran. Use of a heparin lock is suggested.

Rate of Administration

IV injection:

A single dose over 1 minute.

Actions

A monovalent hapten, it binds to one of two available sites on dextran-reacting antibodies. An adequate dose (molar excess) given just before the IV administration of clinical dextran solution prevents the formation of immune complexes with the polyvalent clinical dextrans and helps prevent severe anaphylaxis. Incidence of anaphylaxis is 15 to 20 times less. Rapidly excreted in urine.

Indications and Uses

Prophylaxis of serious anaphylactic reactions associated with IV infusion of clinical dextran solutions.

Contraindications

Do not give if clinical dextran is contraindicated (severe bleeding disorders; marked hemostatic defects [e.g., thrombocytopenia, hypofibrinogenemia], even if drug-induced [e.g., heparin, warfarin]; breast-feeding and pregnancy unless a life-saving measure; severe congestive cardiac failure; renal failure).

Precautions

For IV use only.
Will not prevent mild allergic/hypersensitivity reactions induced by clinical dextran solutions.
If any reaction occurs to dextran 1, do not administer clinical dextran infusion.

Monitor:

May cause severe hypotension and bradycardia.

Maternal/Child:

Category B: see Contraindications.

Drug/Lab Interactions

See Precautions and Dilution.

Side Effects

Bradycardia, cutaneous reactions, hypotension (moderate to severe), nausea, pallor, shivering.

Antidote

Discontinue drug immediately and notify physician at the first sign of a hypersensitivity reaction or side effects. Do not administer clinical dextran solution. Use epinephrine and/or antihistamines (diphenhydramine) as indicated. Resuscitate as necessary.