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Solution for Infusion
Solution for Infusion
The concentration of the albumin preparation, dosage and infusion-rate should be adjusted to the patient’s individual requirements.
The dose required depends on the size of the patient, the severity of trauma or illness and on continuing fluid and protein losses. Measures of adequacy of circulating volume and not plasma albumin levels should be used to determine the dose required.
If human albumin is to be administered, haemodynamic performance should be
monitored regularly. This may include:
– arterial blood pressure and pulse rate
– central venous pressure
– pulmonary artery wedge pressure
– urine output
UMAN ALBUMIN can be administered to premature infants and dialysis patients as the aluminium content of the finished product is not more than 200 μg/l.
Method of administration: Human albumin can be directly administered by the intravenous route, or it can also be diluted in an isotonic solution (e.g. 5% glucose or 0.9% sodium chloride).
The infusion rate should be adjusted according to the individual circumstances and the indication.
In plasma exchange the infusion-rate should be adjusted to the rate of removal.
Restoration and maintenance of circulating blood volume where volume deficiency has been demonstrated, and use of a colloid is appropriate.
The choice of albumin rather than artificial colloid will depend on the clinical situation of the individual patient, based on official recommendations.
Hypersensitivity to albumin preparations or to any of the excipients.
Suspicion of allergic or anaphylactic type reactions requires immediate discontinuation of the injection. In case of shock, standard medical treatment for shock should be implemented.
Albumin should be used with caution in conditions where hypervolaemia and its
consequences or haemodilution could represent a special risk for the patient. Examples of such conditions are:
– decompensated cardiac insufficiency
– arterial hypertension
– oesophageal varices
– pulmonary oedema
– haemorrhagic diathesis
– severe anaemia
– renal and post-renal anuria
The colloid-osmotic effect of human albumin 200 or 250 g/l is approximately four times that of blood plasma. Therefore, when concentrated albumin is administered, care must be taken to assure adequate hydration of the patient. Patients should be monitored carefully to guard against circulatory overload and hyperhydration.
200 – 250 g/l human albumin solutions are relatively low in electrolytes compared to the 40-50 g/l human albumin solutions. When albumin is given, the electrolyte status of the patients should be monitored and appropriate steps taken to restore or maintain the electrolyte balance.
Albumin solutions must not be diluted with water for injections as this may cause haemolysis in recipients.
If comparatively large volumes are to be replaced, controls of coagulation and
haematocrit are necessary. Care must be taken to ensure adequate substitution of other blood constituents (coagulation factors, electrolytes, platelets and erythrocytes).
If the haematocrit drops below 30%, packed red cells should be given in order to maintain the oxygen transport capacity of the blood.
Hypervolaemia may occur if the dosage and rate of infusion are not adjusted to the patients circulatory situation. At the first clinical signs of cardiovascular overload (headache, dyspnoea, jugular vein congestion), or increased blood pressure, raised venous pressure and pulmonary oedema, the infusion is to be stopped immediately.
Viral safety: Standard measures to prevent infections resulting from the use of medicinal products prepared from human blood or plasma include selection of donors, screening of individual donations and plasma pools for specific markers of infection and the inclusion of effective manufacturing steps for the inactivation/removal of viruses.
Despite this, when medicinal products prepared from human blood or plasma are administered, the possibility of transmitting infective agents cannot be totally excluded.
This also applies to unknown or emerging viruses and other pathogens.
There are no reports of virus transmissions with albumin manufactured to European Pharmacopoeia specifications by established processes.
It is strongly recommended that every time that KEDRION ALBUMIN is administered to a patient, the name and the batch number of the product are recorded in order to maintain a link between the patient and the batch of the product.
Mild reactions such as flush, urticaria, fever, and nausea occur rarely. These reactions normally disappear rapidly when the infusion rate is slowed down or the infusion is stopped. Very rarely, severe reactions such as shock may occur. In these cases, the infusion should be stopped and an appropriate treatment should be initiated.
No specific interactions of human albumin with other medicinal products are known.
Pregnancy and Lactation
The safety of UMAN ALBUMIN for use in human pregnancy has not been established in controlled clinical trials. However, clinical experience with albumin suggests that no harmful effects on the course of pregnancy, or on the foetus and the neonate are to be expected.
No animal reproduction studies have been conducted with UMAN ALBUMIN.
However human albumin is a normal constituent of human blood.
In general, particular attention must be paid when a substitution of volume is effected in a pregnant patient.
Hypervolaemia may occur if the dosage and rate of infusion are too high. At the first clinical signs of cardiovascular overload (headache, dyspnoea, jugular vein congestion), or increased blood pressure, raised central venous pressure and pulmonary oedema, the infusion should be stopped immediately and the patient’s haemodynamic parameters carefully monitored. Additionally, diuresis or cardiac output should be increased in accordance to the severity of the clinical situation.
Shelf life: In its intact packaging and if the storage instructions have been fully followed, UMAN ALBUMIN has a validity of 3 years from the date of production.
Storage: Do not store the product above 30°C. Keep the vial in the outer carton in order to protect from light. Do not freeze. The storage conditions should be strictly followed.