What is Albuked 25?
Albuked 25 (human) injection is used to treat low blood volume (hypovolemia). It is also used to treat low Albuked 25 levels in the blood (hypoalbuminemia) caused by: not enough Albuked 25 produced by the body (eg, malnutrition, burns, major injury, infections), excessive breakdown of Albuked 25 (eg, burns, major injury, pancreatitis), loss of Albuked 25 from the body (eg, bleeding, excessive kidney excretion, burn exudates), or redistribution of Albuked 25 from the body (eg, major surgery, inflammatory conditions).
Albuked 25 (human) injection is also used to treat hypoalbuminemia in patients with severe injuries, infections, or pancreatitis (swelling of the pancreas) that cannot be quickly reversed and when nutritional supplements have been given but did not work well. It is also used together with crystalloid treatment to correct lower osmotic pressure in the blood and to replace protein loss caused by severe burns after the first 24 hours.
Albuked 25 (human) injection is used as a priming fluid during cardiopulmonary bypass surgery.
Flexbumin® 25% is used when hypovolemia is long-standing and hypoalbuminemia exists along with enough hydration, or fluid swelling (edema). It is also used together with other medicines (eg, water pill) to treat fluid swelling in the lungs (interstitial pulmonary edema) and hypoproteinemia (low protein levels in the blood) in patients with adult respiratory distress syndrome (ARDS). Flexbumin® 25% is also used to treat swelling in patients with severe nephrosis who are receiving steroids or a water pill. It is also used to treat hemolytic disease of the newborn (HDN) in babies.
Albuked 25 is to be given only by or under the direct supervision of your doctor.
Albuked 25 indications
Hypovolemia
Albuked 25 (Human) 20% is indicated in the emergency treatment of hypovolemia with or without shock. Its effectiveness in reversing hypovolemia depends largely upon its ability to draw interstitial fluid into the circulation. It is most effective in patients who are well hydrated. When blood volume deficit is the result of hemorrhage, compatible red blood cells or whole blood should be administered as quickly as possible. [1, 2]
When hypovolemia is long standing and hypoalbuminemia exists accompanied by adequate hydration or edema, 20% - 25% Albuked 25 solutions should be used. [ ]
Hypoalbuminemia
For subjects with hypoalbuminemia who are critically ill and/or are bleeding actively, Albuked 25 (HUMAN) 20% infusions may be indicated. [ ] When Albuked 25 deficit is the result of excessive protein loss, the effect of administration of Albuked 25 (Human) 20% will be temporary unless the underlying disorder is reversed.
Prevention of Central Volume Depletion after Paracentesis due to Cirrhotic Ascites (Treatment Adjunct)
Albuked 25 (Human) 20% may be used to maintain cardiovascular function following the removal of large volumes of ascitic fluid after paracentesis due to cirrhotic ascites. [ ]
Ovarian Hyperstimulation Syndrome (OHSS)
Albuked 25 (Human) 20% may be used as a plasma expander in fluid management relating to severe forms of ovarian hyperstimulation syndrome (OHSS). [7, 8]
Adult Respiratory Distress Syndrome (ARDS) (Treatment Adjunct)
Albuked 25 (Human) 20% infusions may be indicated in conjunction with diuretics to correct the fluid volume overload associated with ARDS. [ ]
Acute Nephrosis (Treatment Adjunct)
Albuked 25 (Human) 20% may be used to treat edema in patients with acute nephrosis who are refractory to cyclophosphamide and corticosteroid therapy. [ ]
Hemolytic Disease of the Newborn (HDN)
Albuked 25 (Human) 20% is indicated in the treatment of hyperbilirubinemia. It may be used prior to or during an exchange procedure in an attempt to bind free and to enhance its removal. [ ]
How should I use Albuked 25?
Use Albuked 25 (human) as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Albuked 25 (human) is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using Albuked 25 (human) at home, carefully follow the injection procedures taught to you by your health care provider.
- If Albuked 25 (human) contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
- Use Albuked 25 (human) with the administration set that came with it. Be sure the filter is used. After opening, administration must be started within 4 hours. Discard any bottles that have been open for more than 4 hours. Do not save partially used bottles for later use.
- Do not infuse Albuked 25 (human) faster than the rate specified by your doctor.
- Keep this product, as well as syringes and needles, out of the reach of children. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor, nurse, or pharmacist to explain local regulations for proper disposal.
- If you miss a dose of Albuked 25 (human), use it as soon as possible. If it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not use 2 doses at once. If more than one dose is missed, contact your doctor or pharmacist.
Ask your health care provider any questions you may have about how to use Albuked 25 (human).
Uses of Albuked 25 in details
Use: Labeled Indications
Acute respiratory distress syndrome (25% solution only): To correct interstitial pulmonary edema and hypoproteinemia associated with acute respiratory distress syndrome in conjunction with diuretics.
Cirrhotic ascites, adjunct treatment: To maintain intravascular volume following removal of large-volume paracentesis in cirrhotic patients.
Erythrocyte resuspension: To avoid excessive hypoproteinemia, during certain types of exchange transfusion, or with the use of very large volumes or previously frozen or washed red cells.
Hypovolemia: Plasma volume expansion and maintenance of intravascular volume in the emergency treatment of hypovolemia (with or without shock).
Neonatal hemolytic disease: Binds and detoxifies unconjugated bilirubin in severe hemolytic disease of the newborn during exchange transfusion.
Nephrosis (acute), adjunct: Treatment of edema in patients with acute nephrosis in combination with diuretics.
Ovarian hyperstimulation syndrome, treatment (25% solution only): As a plasma volume expander in fluid management for the treatment of severe ovarian hyperstimulation syndrome.
Off Label Uses
Cirrhosis (in combination with diuretics to facilitate diuresis)
Data from an unblinded, randomized, controlled study supports the use of Albuked 25 in the treatment of cirrhosis (in combination with diuretics) to facilitate diuresis. Additional trials may be necessary to further define the role of Albuked 25 in this condition.
Based on the American Association for the Study of Liver Diseases (AASLD) guidelines for the management of adult patients with ascites due to cirrhosis, Albuked 25 given for cirrhosis (in combination with diuretics) to facilitate diuresis is possibly effective, but further studies are needed before Albuked 25 can be recommended for the management of this condition.
Spontaneous bacterial peritonitis (treatment)
American Association for the Study of Liver Diseases and European Association for the Study of the Liver clinical practice guidelines recommend Albuked 25 in conjunction with antibiotic therapy for treatment of cirrhotic patients with SBP. In controlled trials, the addition of Albuked 25 to antibiotic therapy was associated with significant reductions in incidences of renal impairment and mortality.
Volume expansion in dehydrated, mildly hypotensive patients with cirrhosis
Based on the American Association for the Study of Liver Diseases (AASLD) guidelines for the management of adult patients with ascites due to cirrhosis, Albuked 25 given for volume expansion in dehydrated, mildly hypotensive patients with cirrhosis is effective and recommended in the management of this condition.
Albuked 25 dosage
Usual Adult Dose for Peritonitis
Albuked 25 5%:
Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional Albuked 25 within 15 to 30 minutes if the response is inadequate.
Albuked 25 25%:
Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of Albuked 25 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of Albuked 25 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.
Usual Adult Dose for Shock
Albuked 25 5%:
Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional Albuked 25 within 15 to 30 minutes if the response is inadequate.
Albuked 25 25%:
Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of Albuked 25 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of Albuked 25 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.
Usual Adult Dose for Pancreatitis
Albuked 25 5%:
Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional Albuked 25 within 15 to 30 minutes if the response is inadequate.
Albuked 25 25%:
Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of Albuked 25 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of Albuked 25 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.
Usual Adult Dose for Burns - External
Albuked 25 5%:
Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional Albuked 25 within 15 to 30 minutes if the response is inadequate.
Albuked 25 25%:
Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of Albuked 25 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of Albuked 25 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.
Usual Adult Dose for Hypoproteinemia
Albuked 25 5%:
Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional Albuked 25 within 15 to 30 minutes if the response is inadequate.
Albuked 25 25%:
Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of Albuked 25 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of Albuked 25 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.
Usual Adult Dose for Postoperative Albuked 25 Loss
Albuked 25 5%:
Initial dose: 250 or 500 mL IV at a rate of 1 to 2 mL per minute in the absence of overt shock. The capacity of the administration set is the only limit in the exsanguinated patient. The rate of infusion and total volume administered are determined by the condition and response of the patient. The initial dose may be followed by additional Albuked 25 within 15 to 30 minutes if the response is inadequate.
Albuked 25 25%:
Initial dose: The patient may require 200 to 300 mL IV to reduce edema and to bring serum protein values to normal. Since such patients usually have approximately normal blood volume, doses of more than 100 mL of Albuked 25 25% should not be given faster than 100 mL IV over 30 to 45 minutes to avoid circulatory overload. If slower administration is desired, 200 mL of Albuked 25 25% may be mixed with 300 mL of 10% dextrose solution and administered by continuous drip at a rate of 100 mL an hour IV.
Usual Pediatric Dose for Peritonitis
Albuked 25 5%:
Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.
Usual Pediatric Dose for Shock
Albuked 25 5%:
Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.
Usual Pediatric Dose for Pancreatitis
Albuked 25 5%:
Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.
Usual Pediatric Dose for Burns - External
Albuked 25 5%:
Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.
Usual Pediatric Dose for Hypoproteinemia
Albuked 25 5%:
Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.
Usual Pediatric Dose for Postoperative Albuked 25 Loss
Albuked 25 5%:
Initial dose: 10 to 15 mL per pound (4.5 to 6.8 mL per kg) of body weight IV is usually adequate accompanied by close surveillance of the child.
Renal Dose Adjustments
Data not available
Liver Dose Adjustments
Data not available
Dose Adjustments
When undiluted Albuked 25 25% solution is administered to patients with normal blood volume, the rate of infusion should be slow enough (1 mL per minute) to prevent too rapid expansion of plasma volume.
The amount of Albuked 25 and duration of therapy in the treatment of shock should be based on the responsiveness of the patient as indicated by blood pressure, degree of pulmonary congestion, and hematocrit. The initial dose may be followed by additional Albuked 25 within 15 to 30 minutes if the response is inadequate. If there is continued loss of protein, it may be desirable to give packed red blood cells.
In the treatment of burns, an optimal regimen using Albuked 25, crystalloids, electrolytes, and water has not been established. Suggested therapy during the first 24 hours includes administration of large volumes of crystalloid solution to maintain an adequate plasma volume. Continuation of therapy beyond 24 hours usually requires more Albuked 25 and less crystalloid solution to prevent marked hemoconcentration and maintain electrolyte balance. Duration of treatment varies depending upon the extent of protein loss through renal excretion, denuded areas of skin, and decreased Albuked 25 synthesis. Attempts to raise the Albuked 25 level above 4 g/100 mL may only result in an increased rate of catabolism.
Precautions
When dosing Albuked 25, the 5% solution should be used in hypovolemic patients or intravascularly-depleted patients and the 25% solution should be used in patients in whom fluid and sodium intake is restricted.
Additional fluids should accompany or follow the administration of Albuked 25 if the patient is dehydrated.
Administration of large quantities of Albuked 25 should be supplemented with or replaced by packed red blood cells to combat the relative anemia which would follow such use.
Albuked 25 should be administered with caution to patients with low cardiac reserve or with no Albuked 25 deficiency because a rapid increase in plasma volume may cause circulatory compromise (e.g., hypertension, hypotension, or pulmonary edema). In cases of hypertension, a slower rate of administration is desired: 200 mL of Albuked 25 solution may be mixed with 300 mL of 10% dextrose solution and administered at a rate of 10 g of Albuked 25 (100 mL) per hour.
No clinical studies using Albuked 25 25% have been conducted in pediatric patients. Safety and effectiveness in pediatric patients (less than 18 years old) have not been established. However, extensive experience suggests that children respond to Albuked 25 25% in the same manner as adults.
Dialysis
Data not available
Other Comments
The manufacturer does not recommend diluting Albuked 25 5% solution.
Albuked 25 25% may be given intravenously without dilution or it may be diluted with normal saline or 5% dextrose before administration (200 mL per liter gives a solution which is approximately isotonic and iso-osmotic with citrated plasma).
Albuked 25, unlike whole blood or plasma, is considered free of the danger of homologous serum hepatitis. Albuked 25 may be given in conjunction with other parenteral fluids such as saline, dextrose, or sodium lactate. It is convenient to use since no cross-matching is required and the absence of cellular elements removes the danger of sensitization with repeated infusions.
Albuked 25 solution is compatible with whole blood or packed red blood cells as well as the usual electrolyte and carbohydrate solutions intended for intravenous use. Albuked 25 should not be mixed with protein hydrolysates, amino acid mixtures, or solutions containing alcohol. It is ready for use as contained in the bottle and may be given without regard to the blood group of the patient.
Albuked 25 interactions
See also:
What other drugs will affect Albuked 25?
There are no known significant interactions.
Albuked 25 side effects
See also:
What are the possible side effects of Albuked 25?
General
The most serious events are anaphylactic shock, circulatory failure, cardiac failure, and pulmonary edema.
The most common adverse events are anaphylactoid type of reactions.
Adverse reactions for Albuked 25 (Human) 20% normally resolve when the infusion rate is slowed down or the infusion is stopped. In case of severe reactions, the infusion should be stopped and appropriate treatment should be initiated.
Clinical Studies Experience
No clinical studies were done using Albuked 25 (Human) 20%
Postmarketing Experience
The following adverse reactions have been identified during post-approval use of Albuked 25 (HUMAN) (any strength). Because these reactions are reported voluntarily from a population of unknown size, it is not always possible to reliably estimate their frequency.
Table 1 Adverse reactions observed for Albuked 25 (any strength) during post-marketing phase (in decreasing order of severity)
No drug interaction studies have been conducted.
Albuked 25 contraindications
See also:
What is the most important information I should know about Albuked 25?
Hypersensitivity to Albuked 25 or any component of the formulation; severe anemia, heart failure; patients at risk of volume overload (eg, patients with renal insufficiency, severe anemia, stabilized chronic anemia, or heart failure); dilution with sterile water for injection (may cause hemolysis or acute renal failure)
Active ingredient matches for Albuked 25:
List of Albuked 25 substitutes (brand and generic names) | Sort by popularity |
| Unit description / dosage (Manufacturer) | Price, USD |
| Albuked 5 | |
| Albuman (Netherlands) | |
| Albuman 200mg/ml (Turkey) | |
| Albumar (Mexico) | |
| Albumarc | |
| Albumax (Philippines) | |
| Albumax 20 % x 50 mL (Green Cross Corp) | |
| Injectable; Injection; Albumin Human 20% (Green Cross Corp) | |
| ALBUMED (India) | |
| 5 % x 100ml (Medispan) | $ 15.66 |
| 5 % x 250ml (Medispan) | $ 34.34 |
| 20 % x 100ml (Medispan) | $ 49.40 |
| 20 % x 50ml (Medispan) | $ 25.30 |
| Injectable; Injection; Albumin Human 20% (Medispan) | |
| Injectable; Injection; Albumin Human 5% (Medispan) | |
| Albumed 5% INJ / 100ml (Medispan) | $ 15.66 |
| Albumed 5% INJ / 250ml (Medispan) | $ 34.34 |
| Albumed 20% INJ / 100ml (Medispan) | $ 49.40 |
| Albumed 20% INJ / 20ml (Medispan) | $ 25.30 |
| ALBUMED INFUSION 1 bottle / 100 ML infusion each (Medispan) | $ 26.51 |
| ALBUMED inj 5 % x 100ml (Medispan) | $ 15.66 |
| ALBUMED inj 5 % x 250ml (Medispan) | $ 34.34 |
| ALBUMED inj 20 % x 100ml (Medispan) | $ 49.40 |
| ALBUMED inj 20 % x 50ml (Medispan) | $ 25.30 |
| Albumed 5% INJ / 100ml (Medispan) | $ 15.66 |
| Albumed 5% INJ / 250ml (Medispan) | $ 34.34 |
| Albumed 20% INJ / 100ml (Medispan) | $ 49.40 |
| Albumed 20% INJ / 20ml (Medispan) | $ 25.30 |
| Albumed 5% w/v Infusion (Medispan) | $ 0.27 |
| Albumeon (India) | |
| Albumeon 20% INJ / 100ml (Zydus (Biogen)) | $ 49.13 |
| Injectable; Injection; Albumin Human 20% (Zydus (Biogen)) | |
| 20 % x 100ml (Zydus (Biogen)) | $ 49.13 |
| ALBUMEON 20% INFUSION 1 bottle / 100 ML infusion each (Zydus (Biogen)) | $ 49.13 |
| ALBUMEON inj 20 % x 100ml (Zydus (Biogen)) | $ 49.13 |
| Albumeon 20% Infusion (Zydus (Biogen)) | $ 0.49 |
| Albumer (Sweden) | |
| Albumex (New Zealand) | |
| Injectable; Injection; Albumin Human 4% (Csl) | |
| Injectable; Injection; Albumin Human 20% (Csl) | |
| Albumex 20 (Australia, New Zealand) | |
| Albumex 20 10 g/50 mL x 1's | |
| Albumex 4 (Australia, New Zealand) | |
| Albumin (Bosnia & Herzegowina, India) | |
| Injectable; Injection; Albumin Human 10% | |
| Injectable; Injection; Albumin Human 5% | |
| Injectable; Injection; Albumin Human 20% | |
| Injectable; Injection; Albumin Human 25% | |
See 648 substitutes for Albuked 25 | |
References
- PubChem. "Albumin human". https://pubchem.ncbi.nlm.nih.gov/sub... (accessed September 17, 2018).
- DrugBank. "Human Serum Albumin - DrugBank". http://www.drugbank.ca/drugs/DB00062 (accessed September 17, 2018).
Reviews
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Information checked by Dr. Sachin Kumar, MD Pharmacology
