Albumin

Name: Albumin

Albumin Interactions

This is not a complete list of Albumindrug interactions. Ask your doctor or pharmacist for more information.

How is this medicine (Albumin) best taken?

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

  • It is given as an infusion into a vein over a period of time.

What do I do if I miss a dose?

  • Call your doctor to find out what to do.

Pharmacologic Category

  • Blood Product Derivative
  • Plasma Volume Expander, Colloid

Use Labeled Indications

Hypovolemia: Plasma volume expansion and maintenance of cardiac output in the treatment of certain types of shock or impending shock; adult respiratory distress syndrome (ARDS), acute/severe nephrosis, hemolytic disease of the newborn; cirrhotic ascites (prevention of central volume depletion after paracentesis); ovarian hyperstimulation syndrome (treatment); plasma volume exchange (replacement fluid); unless the condition responsible for hypoproteinemia can be corrected, albumin can provide only symptomatic relief or supportive treatment

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity: Severe allergic or anaphylactic reaction may occur. Discontinue immediately and manage appropriately if allergic or anaphylactic reactions are suspected.

• Coagulation abnormality: Large replacement volumes may result in coagulation abnormality. Monitor and replete with blood constituents if indicated.

• Electrolyte imbalance: Large replacement volumes may result in electrolyte imbalance. Monitor electrolytes and replace or maintain as indicated.

• Hemodynamic effects: Cardiac or respiratory failure, renal failure, or increasing intracranial pressure can occur; closely monitor hemodynamic parameters in all patients.

• Hypervolemia/hemodilution: Use with caution in conditions where hypervolemia and its consequences or hemodilution may increase the risk of adverse effects (eg, heart failure, pulmonary edema, hypertension, hemorrhagic diathesis, esophageal varices). Adjust rate of administration per hemodynamic status and solution concentration; monitor closely with rapid infusions. Avoid rapid infusions in patients with a history of cardiovascular disease (may cause circulatory overload and pulmonary edema). Discontinue at the first signs of cardiovascular overload (eg, headache, dyspnea, jugular venous distention, rales, abnormal elevations in systemic or central venous blood pressure). All patients should be observed for signs of hypervolemia, such as pulmonary edema. Monitor blood pressure.

Disease-related concerns:

• Critical illness: In patients with increased microvascular permeability (eg, sepsis, trauma, burn), the translocation of fluid from the interstitial compartment to the intravascular compartment may decrease due to increased albumin in the interstitial space. Furthermore, in extreme microvascular permeability states, administration of albumin (or other colloids) may increase the net flux of fluid into the interstitial space reducing intravascular volume and precipitating edematous states (eg, pulmonary edema) (Roberts, 1998).

• Hepatic impairment: Use with caution in patients with hepatic impairment; protein load may exacerbate or precipitate encephalopathy.

• Renal impairment: Use with caution in patients with renal impairment; protein load may precipitate azotemia. Patients with chronic renal insufficiency receiving albumin solution may be at risk for accumulation of aluminum and potential toxicities (eg, hypercalcemia, vitamin D refractory osteodystrophy, anemia, severe progressive encephalopathy).

Special populations:

• Sodium restricted patients: Use with caution in those patients for whom sodium restriction is necessary. Albumin 5% and 25% solutions contain 130 to 160 mEq/L sodium and are considered isotonic with plasma.

Dosage form specific issues:

• Aluminum: The parenteral product may contain aluminum (Kelly, 1989); toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register 2002). See manufacturer’s labeling.

• Dilution: Do not dilute 5% albumin with sterile water for injection (may result in hemolysis and/or renal failure).

• Human plasma: Product of human plasma; may potentially contain infectious agents which could transmit disease. Screening of donors, as well as testing and/or inactivation or removal of certain viruses, reduces the risk. Infections thought to be transmitted by this product should be reported to the manufacturer.

• Latex: Packaging may contain natural latex rubber.

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