IntravenousNeonatal hyperbilirubinaemiaChild: As human albumin 20% or 25% solution: 1 g/kg before or during exchange transfusion. Treatment recommendations may vary among countries and individual product (refer to detailed product or local treatment guidelines).
IntravenousHypoproteinaemiaAdult: As human albumin 25% solution: 200-300 mL; given at a rate not faster than 100 mL in 30-45 minutes. If slower infusion is desired, 200 mL human albumin 25% solution may be diluted with 300 mL of 10% dextrose solution and given via continuous drip at a rate of 100 mL/hour. Treatment and dosage recommendations may vary among countries and individual product (refer to detailed product or local treatment guidelines).
IntravenousHypovolaemiaAdult: For restoration and maintenance of circulating blood volume: Dosage requirement depends on the weight of the patient, severity of trauma or illness, and on continuing fluid and protein losses. Adjust the concentration of human albumin preparation, dosage, and infusion rate according to individual patient requirements. Low concentration (e.g. 4% or 5% solution) of human albumin is generally preferred for replacement of volume deficit. As human albumin 5% solution: Initially, 12.5-25 g; may repeat after 15-30 minutes if response is inadequate. Human albumin 20-25% solution is recommended if hypovolaemia is long-standing and hypoalbuminaemia exists accompanied by adequate hydration or oedema. Treatment and dosage recommendations may vary among countries and individual product (refer to detailed product or local treatment guidelines).
Child: As human albumin 5% solution: 0.5-1 g/kg (10-20 mL/kg) over 5-10 minutes. Treatment and dosage recommendations may vary among countries and individual product (refer to detailed product or local treatment guidelines).
IntravenousPrevention of central volume depletion following paracentesis due to cirrhotic ascitesAdult: As human albumin 20% or 25% solution: Adjunct treatment: 8 g for every 1,000 mL of ascitic fluid removed. Treatment recommendations may vary among countries and individual product (refer to detailed product or local treatment guidelines).
IntravenousPlasma volume expander in severe ovarian hyperstimulation syndromeAdult: In patients who fail to achieve or maintain urine output and haemodynamic stability with 0.9% NaCl solution: As human albumin 20% or 25% solution: 50-100 g over 4 hours, repeated at 4- to 12-hour intervals as needed. Treatment recommendations may vary among countries and individual product (refer to detailed product or local treatment guidelines).
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Human albumin 20% or 25% solution: May be diluted in isotonic solution (e.g. 0.9% NaCl, 5% dextrose).
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Dilution with sterile water will produce a hypotonic solution that may cause haemolysis and acute renal failure.
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Hypersensitivity. Heart failure with normal or increased intravascular volume, severe anaemia. Dilution with sterile water for inj.
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Patient with conditions where hypervolaemia and its consequences or haemodilution may increase the risk of adverse reactions (e.g. hypertension, oesophageal varices, pulmonary oedema, haemorrhagic diathesis, renal and post-renal anuria); severe traumatic brain injury, low cardiac reserve. Postoperative or injured patient. Avoid rapid infusion in patients with history of CV disease. Not recommended as a source of supplemental caloric protein in patients requiring nutritional support. Renal and hepatic impairment. Children. Pregnancy and lactation.
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Significant: Severe allergic or anaphylactic reactions, coagulation abnormality, electrolyte imbalance (large volume replacement); cardiac, respiratory, or renal failure; increased intracranial pressure; hypervolaemia.
Cardiac disorders: Tachycardia, bradycardia.
Gastrointestinal disorders: Vomiting, nausea.
General disorders and administration site conditions: Chills, fever, chest tightness.
Nervous system disorders: Headache, tremor, dizziness.
Psychiatric disorders: Confusional state.
Respiratory, thoracic and mediastinal disorders: Stridor, bronchospasm, dyspnoea.
Skin and subcutaneous tissue disorders: Rash erythematosus, angioneurotic oedema, hyperhidrosis, urticaria.
Vascular disorders: Hypertension, hypotension, flushing.
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Regularly monitor electrolyte levels, haematocrit or Hb levels, urine output, central venous pressure, pulmonary artery wedge pressure, arterial blood pressure and pulse rate. Closely observe for heart failure and pulmonary oedema during administration.
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Symptoms: CV overload (e.g. headache, dyspnoea, jugular vein congestion, increased blood pressure, raised central venous pressure, pulmonary oedema). Management: Discontinue infusion immediately. Carefully monitor haemodynamic parameters of the patient.
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Description:
Mechanism of Action: Human albumin, a protein colloid, is a normal component of the plasma and acts like physiological albumin, an essential factor in the regulation of plasma volume and tissue fluid balance. It increases intravascular oncotic pressure, causing movement of fluids from interstitial into intravascular space. It also binds and acts as a carrier of intermediate metabolites (including bilirubin), acidic drugs, fatty acids, hormones, enzymes, trace metals, and dyes.
Pharmacokinetics:
Excretion: Half-life: 15-20 days.
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Store below 30°C. Do not freeze. Protect from light.
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Albuminar-25 Solution (CSL Behring LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/11/2021. Albunorm 20%, 200 g/L, Solution for Infusion (Medlink Marketing). MIMS Philippines. http://www.mims.com/philippines. Accessed 24/11/2021. Albunorm 20%, 200 g/L, Solution for Infusion (Octapharma Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 23/11/2021. Albunorm 25%, 250 g/L Solution for Infusion (Pharmaniaga Marketing Sdn Bhd). National Pharmaceutical Regulatory Agency - Ministry of Health Malaysia. https://www.npra.gov.my. Accessed 10/11/2021. Albunorm 25%, 250 g/L, Solution for Infusion (Medlink Marketing). MIMS Philippines. http://www.mims.com/philippines. Accessed 24/11/2021. Albunorm 25%, 250 g/L, Solution for Infusion (Octapharma Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 23/11/2021. Albunorm 4%, 40 g/L, Solution for Infusion (Octapharma Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 23/11/2021. Albunorm 5%, 50 g/L, Solution for Infusion (Octapharma Ltd.). MHRA. https://products.mhra.gov.uk. Accessed 23/11/2021. Albutein 20% Injection, Solution (Grifols USA, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 24/11/2021. Albutein 25% Injection, Solution (Grifols USA, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 24/11/2021. Anon. Albumin Human. AHFS Clinical Drug Information [online]. Bethesda, MD. American Society of Health-System Pharmacists, Inc. https://www.ahfscdi.com. Accessed 23/11/2021. Anon. Albumin. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 10/11/2021. Buckingham R (ed). Albumin. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/11/2021. Flexbumin Injection, Solution (Baxalta US Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 10/11/2021. Human Albumin 200 g/L Baxter (Takeda Pharmaceuticals [Hong Kong] Ltd). MIMS Hong Kong. http://www.mims.com/hongkong. Accessed 24/11/2021. Joint Formulary Committee. Albumin Solution. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/11/2021. Zenalb 4.5%, 20% Solution (Germax Sdn. Bhd.). MIMS Malaysia. http://www.mims.com/malaysia. Accessed 24/11/2021. Zenalb 4.5, 45 g/L Solution for Infusion (Bio Products Laboratory Limited). MHRA. https://products.mhra.gov.uk. Accessed 10/11/2021.
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