albumin (human)

REMS

Expansion of plasma volume and maintenance of cardiac output in situations associated with fluid volume deficit, including shock, hemorrhage, and burns.
Temporary replacement of albumin in diseases associated with low levels of plasma proteins, such as nephrotic syndrome or end-stage liver disease, resulting in relief or reduction of associated edema.

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Allergic reactions to albumin;
Severe anemia;
HF;
Normal or increased intravascular volume.

Use Cautiously in:

Severe hepatic or renal disease;
Dehydration (additional fluids may be required);
Patients requiring sodium restriction;
Preterm neonates (infuse slowly due to increased risk of intravascular hemorrhage).

Adv. Reactions/Side Effects ⬆ ⬇

CV: fluid overload, hypertension, hypotension, PULMONARY EDEMA, tachycardia

Derm: rash, urticaria

GI: increased salivation, nausea, vomiting

MS: back pain

Neuro: headache

Misc: chills, fever, flushing

Interactions ⬆ ⬇

Drug-drug:

None significant.

Availability ⬆ ⬇

Injection: 5% (50 mg/mL); 25% (250 mg/mL)

Route/Dosage ⬆ ⬇

Dose is highly individualized and depends on condition being treated

Hypovolemic shock—5% Albumin

IV (Adults ): 25 g (500 mL), may be repeated within 30 min.
IV (Children ): 0.5–1 g/kg/dose (10–20 mL/kg/dose) may repeat as needed (maximum 6 g/kg/day).
IV (Infants and Neonates): 0.25–0.5 g/kg/dose (5–10 mL/kg/dose).

Hypoproteinemia—25% Albumin

IV (Adults ): 50–75 g.
IV (Children , Infants, and Neonates): 0.5–1 g/kg/dose, may repeat every 1–2 days; doses up to 1.5 g/kg/day have been added to hyperalimentation solutions and given over 24 hr.

Nephrotic Syndrome—25% Albumin

IV (Adults ): 12.5–50 g/day in 3–4 divided doses.
IV (Children and Infants): 0.25–1 g/kg/dose.

US Brand Names ⬆ ⬇

Albuminar, Albutein, Buminate, normal human serum albumin, Plasbumin

Action ⬆ ⬇

Provides colloidal oncotic pressure, which serves to mobilize fluid from extravascular tissues back into the intravascular space.
Requires concurrent administration of appropriate crystalloid.

Therapeutic effects:

Increase in intravascular fluid volume.

Classifications ⬆ ⬇

Therapeutic Classification: volume expanders

Pharmacologic Classification: blood products, colloids

Pharmacokinetics ⬆ ⬇

Absorption: Following IV administration, absorption is essentially complete.

Distribution: Confined to the intravascular space, unless capillary permeability is increased.

Metabolism/Excretion: Probably degraded by the liver.

Half-Life: 2–3 wk.

section name header

Indications ⬇