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Perit Dial Int 27(Supplement_3): 15- 2007
© 2007 International Society for Peritoneal Dialysis
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Clinical Experience

Medications Compatible with 7.5% Icodextrin Peritoneal Dialysis Solution

N. Patel2 and S.S. Guest1

Nephrology,1 Kaiser Permanente, Santa Clara; Western University of Health Sciences/College of Osteopathic Medicine of the Pacific,2 Pomona, California, USA.

Objective: Extraneal® is a newer peritoneal dialysis solution that contains the glucose polymer icodextrin (Ico). Extraneal® is indicated for the long dwell during CAPD or APD and the larger glucose polymers create a colloidal osmotic pressure across the peritoneal membrane and improved ultrafiltration. Understanding the compatibility of the solution with medication additives is important and in this presentation we review all known medication additives that have been compatible with Ico. Methods: Literature search; contact with Baxter Renal Division. Results: We identified 14 medications determined to be compatible with Ico: insulin, heparin, low molecular weight heparin, vancomycin, cefazolin, flucloxacillin, ampicillin, ceftazidime, cefepime, gentamicin, tobramycin, netilmycin, and amphotericin. The recommended dose added to a 2-L Ico bag is detailed below.

Table: Medication Additives Compatible with 7.5% Ico Solution Medication additive Dose injected into 2-L Ico bag Regular insulin Sliding scale regular insulin 0.1 U/kg LBM (Opinion) Heparin 500-2000 units Low molecular weight heparin Enoxaparin 40 mg Vancomycin 15-30 mg/kg Cefazolin 1000 mg Flucloxacillin 2-g loading dose Ampicillin 250 mg Ceftazidime 1000-1500 mg Cefepime 1000 mg Gentamicin 0.6 mg/kg Tobramycin 0.6 mg/kg Netilmycin 0.6 mg/kg Amphotericin B Compatible but infusion pain: IV recommended Potassium chloride Typically 6-8 mEq

Conclusions: Ico provides enhanced ultrafiltration due to a glucose polymer functioning as a colloidal osmotic agent. A variety of antibiotics, heparins, insulins, and other injectable medications are compatible with this newer solution.






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