Brand Name: Hextend

GENERIC NAME: 6% Hetastarch in Lactated Electrolyte Injection

MANUFACTURER: Biotime inc.
DATE OF FDA APPROVAL: November 2013
DESCRIPTION: Hextend is a sterile medical IV solution used as a blood plasma
volume expander to replace blood volume lost in routine surgery, emergency trauma
surgery and other applications, a condition known as hypovolemia (low blood volume).
Hextends unique formulation contains a modified form of starch (6% hetastarch)
suspended in a balanced electrolyte solution. The product more closely mirrors the
electrolyte balance of blood than other products that contain 6% hetastarch in simple
salt (sodium chloride, or saline) solutions. Hextend is not a substitute for blood or
plasma.
CLASSIFICATION: Plasma expander
MECHANISM OF ACTION: The body automatically detects the lower haemoglobin level,
and compensatory mechanisms start up. The heart pumps more blood with each beat. Since the
lost blood was replaced with a suitable fluid, the now diluted blood flows more easily, even in
the small vessels. As a result of chemical changes, more oxygen is released to the tissues. These
adaptations are so effective that if only half of the red blood cells remain, oxygen delivery may
still be about 75 percent of normal. A patient at rest uses only 25 percent of the oxygen available
in his blood. In extreme cases, patients have survived with a haemoglobin level of 2 g/dl, about
1/7 the norm, although levels this low are very dangerous.

INDICATION: Hetastarch is used to treat or prevent hypovolemia (decreased blood plasma

volume, also called "shock") that may occur as a result of serious injury, surgery, severe blood
loss, burns, or other trauma.

SIDE EFFECTS: Constipation, nausea, somnolence, fatigue, headache, dizziness, dry

mouth, vomiting , pruritus, abdominal pain, edema peripheral, upper respiratory tract
infection
FOOD INTERACTION: .not indicated
SPECIAL INSTRUCTION:
Hetastarch is injected into a vein through an IV. A healthcare provider will give you this
injection.

Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will
be watched closely while you are receiving hetastarch. Your blood will also need to be
tested daily during treatment.
DOSE:
Dosage for Acute Use in Plasma Volume Expansion
HEXTEND is administered by intravenous infusion only. Total dosage and rate of
infusion depend upon the amount of blood or plasma lost and the resultant
hemoconcentration as well as age, weight, and clinical condition of the patient.
Adults: The amount usually administered is 500 to 1000 mL. Doses of more than 1500
mL per day for the typical 70 kg patient (approximately 20 mL per kg of body weight)
are usually not required although doses of isotonic solutions containing 6% hetastarch
up to 1500 mL have been used during major surgery generally without a need for blood
or blood products. Volumes in excess of 1500 mL per day have been used where severe
blood loss has occurred although generally only in conjunction with the administration
of blood and blood products