Table of contents:
- Release form and composition
- Indications for use
- Method of administration and dosage
- Side effects
- special instructions
- Drug interactions
- Terms and conditions of storage
- Terms of dispensing from pharmacies
- Reopoliglyukin: prices in online pharmacies
Video: Reopoliglyukin - Instructions For Use, Indications, Doses, Analogues
Instructions for use:
- 1. Release form and composition
- 2. Indications for use
- 3. Contraindications
- 4. Method of application and dosage
- 5. Side effects
- 6. Special instructions
- 7. Drug interactions
- 8. Analogs
- 9. Terms and conditions of storage
- 10. Terms of dispensing from pharmacies
Prices in online pharmacies:
from 80 rubles.
Reopolyglyukin is a plasma-substituting anti-shock drug of hemodynamic action; quickly and for a long time increases blood pressure, improves microcirculation in tissues (reducing edema), prevents platelet aggregation and their adhesion to the walls of blood vessels, eliminates thrombus formation and increases thrombolysis, stimulates diuresis (contributing to accelerated detoxification of the body).
Release form and composition
Dosage form of Reopolyglyukin - solution for infusion 10%: colorless or slightly yellow transparent liquid (100, 250, 500 or 1000 ml in polymer containers, in a cardboard box 1 container; 500 ml in polymer containers, 12 or 24 containers in polymer bags, in a cardboard box 1 bag; 100, 200 or 400 ml in glass bottles; 200 or 400 ml in bottles for blood and blood substitutes, in a cardboard box 1 bottle, for hospitals - in a cardboard box 24 or 40 bottles).
1000 ml of Reopolyglucin solution contains:
- active substance: dextran (average molecular weight 30,000-40,000 D) - 100 g;
- auxiliary components: sodium chloride, water for injection up to 1000 ml.
Indications for use
- shock (traumatic, operational and burn) - prevention and treatment;
- circulatory disorders (arterial, venous, capillary) - prevention and treatment of thrombophlebitis, thrombosis, endarteritis, Raynaud's disease;
- surgical interventions on the heart, carried out using the AIK (heart-lung machine) - adding to the perfusion fluid;
- vascular and plastic surgery - improving local circulation;
- burns, peritonitis, pancreatitis - acceleration of detoxification;
- eye diseases (retina and optic nerve, inflammation of the cornea and choroid) - treatment.
- pulmonary edema;
- SDS (decompensated heart failure);
- severe renal failure, accompanied by oligo- and anuria;
- ongoing internal bleeding;
- hemorrhagic stroke;
- traumatic brain injury, accompanied by an increase in intracranial pressure;
- hyperhydration, hypervolemia, other situations in which the introduction of fluids in large volumes is contraindicated;
- hypersensitivity to any of the components of the solution.
Relative (use with caution):
- disorders of the blood coagulation system;
- diabetes mellitus with severe hyperglycemia;
- violations of water and electrolyte balance.
During pregnancy, Rheopolyglucin is administered if the expected benefit to the mother is higher than the possible risk to the fetus.
During lactation, breastfeeding should be interrupted for the duration of drug therapy, since there is insufficient reliable clinical data on the effect of dextran on the child's health.
Method of administration and dosage
Reopolyglyukin solution is administered intravenously (intravenously) by drop, intravenous jet and intravenous jet-drop.
The rate of administration and dose of the drug are selected individually according to the patient's condition, depending on the value of blood pressure (BP), heart rate and hematocrit.
1 day before the use of dextran (except for urgent cases), a skin test is required. Intradermally, on the inner surface of the forearm, shoulder, or other area accessible for examination and evaluation of the skin test, 0.05 ml of the solution is injected, until the appearance of the "lemon peel" effect. The doctor evaluates the reaction after a day has passed from the moment the sample was taken.
With the formation of redness, papules at the injection site or the appearance of symptoms of a general allergic reaction in the form of dizziness, nausea, and other effects, 10-15 minutes after the injection of the solution, we can talk about the patient's increased individual sensitivity to the drug and the impossibility of using it.
In the absence of any reactions, the patient can be injected with the required amount of the drug using a solution of the series that was taken for the intradermal test. The results of the sample should be entered into the medical history.
A skin test does not guarantee 100% results for detecting sensitization of patients to dextran. Therefore, with intravenous administration of the drug in the first 5-10 minutes, it is necessary to closely monitor the patient's condition in each case.
When using the drug for the treatment of emergency conditions, a bioassay is mandatory, for which the first 5 drops of the solution are injected slowly, then the procedure is stopped for 3 minutes, then another 30 drops are injected and again paused for 3 minutes. If the patient does not respond to the drug, continue the infusion at the recommended rate. Upon completion, the results of the test should be entered into the medical history.
Dosage regimen depending on the condition / disease:
- shock (various forms) with impaired capillary blood flow: once a day, for adults - 400-1000 ml, the maximum dose is 1500 ml; children - at the rate of 5-10 ml / kg, the maximum dose is 15 ml / kg; infusion time - 30-60 minutes;
- cardiovascular and plastic surgery: immediately before the start of the operation at a dose of 10 ml / kg (infusion time - 30-60 minutes); during the operation: adults - 400-500 ml, children - 15 ml / kg; after surgery for 5-6 days, infusion time - 60 minutes, for adults - 10 ml / kg once; children under 2-3 years old - 10 ml / kg 1 time / day; up to 8 years old - 7-10 ml / kg 1-2 times / day; up to 13 years old - 5-7 ml / kg 1-2 times / day; 14 years and older - adult doses;
- operations using AIK: the solution is added to the blood at a dose of 10-20 ml / kg to fill the oxygenator pump, while the dextran concentration in the perfusion solution should not exceed 3%; after surgery Reopolyglucin is used in doses recommended for the treatment of capillary blood flow disorders;
- detoxification (drip) for adults - 400-1000 ml, if necessary, you can increase the dose on the first day by 400-500, for children - 5-10 ml / kg, if necessary, you can repeat the introduction on the first day at the same dose; infusion time - 60-90 minutes; then the solution is injected for adults at a rate of 400 ml / day, for children - in doses recommended for the postoperative period;
- ophthalmological practice (by electrophoresis, carried out in a conventional way): 10 ml of Reopolyglucin, at a current density of up to 1.5 mA / cm 3, the procedure time is 10-20 minutes, once a day; the course of therapy - 10 procedures.
When using dextran in patients, the following undesirable effects may develop: hypersensitivity reactions - skin rash, skin flushing, itching; pseudoallergic (anaphylactoid) reactions - lowering blood pressure, oliguria, collapse, up to anaphylactic shock; nausea; fever.
Rheopolyglucin can provoke increased bleeding and the development of acute renal dysfunction.
In case of a significant excess of the recommended rate of dextran infusion or administration of the drug in obviously large volumes, the following overdose symptoms may appear: arrhythmias, left ventricular heart failure, pulmonary hypertension, allergic reactions.
For the treatment of the condition, in most cases, it is enough to stop the infusion, but in difficult situations, symptomatic therapeutic measures, including urgent ones, may be required.
If anaphylactic-type reactions occur during the infusion process, such as itching, redness of the skin, Quincke's edema, etc., the administration of dextran should be stopped immediately, after which, without removing the needle from the vein, proceed with the therapeutic measures provided for by the appropriate instructions to eliminate the transfusion reactions (antihistamines and cardiovascular drugs, corticosteroids, calcium preparations, respiratory analeptics, etc.) or, if necessary, start resuscitation measures. Plasmapheresis is possible, hemodialysis is ineffective in this case.
During transportation of the drug in glass containers, it is allowed to freeze. In this case, due to the temperature difference, white films or flakes, which are dextran particles, can form in the solution. In this case, it is required to dissolve the formations by autoclaving at temperatures up to 120 ° C for 20 minutes or heating the bottle in a boiling water bath, with periodic shaking, for 1 hour. After that, the solution is cooled to body temperature and used as directed.
In polymer containers, the non-wetting of the inner surface of the package is not a contraindication to its use.
The introduction of the drug into the peripheral vessels can cause a feeling of soreness and burning in the extremities along the vein.
Simultaneously with Reopolyglucin, it is advisable to inject crystalloid solutions, such as 5% dextrose solution or 0.9% sodium chloride solution, in an amount sufficient to replenish and maintain the water-electrolyte balance. This is especially important after severe surgical interventions and in the treatment of dehydrated patients.
Extreme caution should be exercised when there is a risk of circulatory overload, especially in the case of clinically overt or latent heart failure.
Against the background of dextran-induced hemodilution, the plasma levels of coagulation factor VIII and VWF (von Willebrand factor) may decrease, which can cause bleeding, especially in patients with a deficiency of these factors, if the drug is used in daily doses exceeding 1.5 g / kg body weight (corresponds to 15 ml / kg body weight). Simultaneous use with anticoagulants requires a reduction in the doses of the latter.
Dextran increases diuresis, but if during therapy there is a decrease in diuresis and the release of viscous syrupy urine, this may be a sign of dehydration. In this case, the intravenous administration of crystalloid solutions should be carried out without delay in order to replenish and maintain the water-electrolyte balance. When oliguria occurs, it is required to intensify the treatment and take furosemide.
In the course of therapy with Rheopolyglucin, it is recommended to limit the administration of NaCl to patients with reduced renal filtration function.
Given the ability of dextran to envelop the surface of red blood cells, which interferes with the determination of the blood group, washed red blood cells should be used for this analysis.
Sharing with other traditional transfusion solutions is allowed.
All medicinal products planned for introduction into the infusion solution are pre-checked for compatibility.
It is necessary to reduce the dose of anticoagulants and antiplatelet agents when combined with Reopolyglucin, since dextran is able to potentiate their effect.
Analogs of Reopolyglyukin are: ReoDex 60, Neorondex, Dextran 40, Promit-infusion, Hemostabil, Polyglyukin, ReoDex 40, Polydextran, Reopolyglyukin-40.
Terms and conditions of storage
Keep out of the reach of children: bottles - at a temperature of 10-25 ° C; polymer containers - without moisture access, at temperatures up to 25 ° С.
If the temperature conditions are not observed during transportation or storage, dextran may fall out in the form of white films or flakes.
The shelf life of the solution in bottles is 4 years, in polymer containers - 2 years.
Terms of dispensing from pharmacies
Dispensed by prescription.
Reopoliglyukin: prices in online pharmacies
Reopolyglukin 10% solution for infusion 200 ml 1 pc.
Reopolyglukin 10% solution for infusion 200 ml 1 pc.
Reopolyglyukin 10% solution for infusion 400 ml 1 pc.
Reopolyglyukin 10% solution for infusion 400 ml 15 pcs.
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!