Albumar Uses

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What is Albumar?

Albumar (human) injection is used to treat low blood volume (hypovolemia). It is also used to treat low Albumar levels in the blood (hypoalbuminemia) caused by: not enough Albumar produced by the body (eg, malnutrition, burns, major injury, infections), excessive breakdown of Albumar (eg, burns, major injury, pancreatitis), loss of Albumar from the body (eg, bleeding, excessive kidney excretion, burn exudates), or redistribution of Albumar from the body (eg, major surgery, inflammatory conditions).

Albumar (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.

Albumar (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.

Albumar human is to be given only by or under the direct supervision of your doctor.

Albumar indications

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Hypovolemia

Albumar (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% Albumar solutions should be used. [ ]

Hypoalbuminemia

For subjects with hypoalbuminemia who are critically ill and/or are bleeding actively, Albumar (HUMAN) 20% infusions may be indicated. [ ] When Albumar deficit is the result of excessive protein loss, the effect of administration of Albumar (Human) 20% will be temporary unless the underlying disorder is reversed.

Prevention of Central Volume Depletion after Paracentesis due to Cirrhotic Ascites (Treatment Adjunct)

Albumar (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)

Albumar (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)

Albumar (Human) 20% infusions may be indicated in conjunction with diuretics to correct the fluid volume overload associated with ARDS. [ ]

Acute Nephrosis (Treatment Adjunct)

Albumar (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)

Albumar (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 Albumar?

Use Albumar (human) as directed by your doctor. Check the label on the medicine for exact dosing instructions.

Ask your health care provider any questions you may have about how to use Albumar (human).

Uses of Albumar in details

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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 Albumar in the treatment of cirrhosis (in combination with diuretics) to facilitate diuresis. Additional trials may be necessary to further define the role of Albumar 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, Albumar given for cirrhosis (in combination with diuretics) to facilitate diuresis is possibly effective, but further studies are needed before Albumar 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 Albumar in conjunction with antibiotic therapy for treatment of cirrhotic patients with SBP. In controlled trials, the addition of Albumar 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, Albumar given for volume expansion in dehydrated, mildly hypotensive patients with cirrhosis is effective and recommended in the management of this condition.

Albumar dosage

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Usual Adult Dose for Peritonitis

Albumar 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 Albumar within 15 to 30 minutes if the response is inadequate.

Albumar 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 Albumar 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 Albumar 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

Albumar 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 Albumar within 15 to 30 minutes if the response is inadequate.

Albumar 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 Albumar 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 Albumar 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

Albumar 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 Albumar within 15 to 30 minutes if the response is inadequate.

Albumar 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 Albumar 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 Albumar 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

Albumar 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 Albumar within 15 to 30 minutes if the response is inadequate.

Albumar 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 Albumar 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 Albumar 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

Albumar 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 Albumar within 15 to 30 minutes if the response is inadequate.

Albumar 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 Albumar 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 Albumar 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 Albumar Loss

Albumar 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 Albumar within 15 to 30 minutes if the response is inadequate.

Albumar 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 Albumar 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 Albumar 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

Albumar 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

Albumar 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

Albumar 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

Albumar 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

Albumar 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 Albumar Loss

Albumar 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 Albumar 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 Albumar 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 Albumar 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 Albumar, 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 Albumar 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 Albumar synthesis. Attempts to raise the Albumar level above 4 g/100 mL may only result in an increased rate of catabolism.

Precautions

When dosing Albumar, 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 Albumar if the patient is dehydrated.

Administration of large quantities of Albumar should be supplemented with or replaced by packed red blood cells to combat the relative anemia which would follow such use.

Albumar should be administered with caution to patients with low cardiac reserve or with no Albumar 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 Albumar solution may be mixed with 300 mL of 10% dextrose solution and administered at a rate of 10 g of Albumar (100 mL) per hour.

No clinical studies using Albumar 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 Albumar 25% in the same manner as adults.

Dialysis

Data not available

Other Comments

The manufacturer does not recommend diluting Albumar 5% solution.

Albumar 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).

Albumar, unlike whole blood or plasma, is considered free of the danger of homologous serum hepatitis. Albumar 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.

Albumar human solution is compatible with whole blood or packed red blood cells as well as the usual electrolyte and carbohydrate solutions intended for intravenous use. Albumar 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.

Albumar interactions

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What other drugs will affect Albumar?

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There are no known significant interactions.

Albumar side effects

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What are the possible side effects of Albumar?

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 Albumar (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 Albumar (Human) 20%

Postmarketing Experience

The following adverse reactions have been identified during post-approval use of Albumar (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 Albumar HUMAN (any strength) during post-marketing phase (in decreasing order of severity)

No drug interaction studies have been conducted.

Albumar contraindications

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What is the most important information I should know about Albumar?

Hypersensitivity to Albumar 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 Albumar:

Albumin in Mexico.


List of Albumar substitutes (brand and generic names)

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Unit description / dosage (Manufacturer)Price, USD
Injectable; Injection; Albumin Human 10%
Injectable; Injection; Albumin Human 5%
Injectable; Injection; Albumin Human 20%
Injectable; Injection; Albumin Human 25%
ALBUMIN 20% INJECTION 1 vial / 1 injection each (Bayer Pharmaceuticals Pvt Ltd)$ 19.58
ALBUMIN-GRIFOLS 20% PREFILLED SYRINGE 1 packet / 100 ML prefilled syringe each (Bharat Serums & Vaccines Ltd)$ 84.34
Albuprime 20% Injection (Intas Pharmaceuticals Ltd)$ 0.54
Alburel-T 20gm Injection (Reliance Life Sciences)$ 0.55
Albutas 20% Injection (Intas Pharmaceuticals Ltd)$ 0.51
HUMAN ALBUMIN 5% INFUSION 1 bottle / 100 ML infusion each (Serum Institute Of India Ltd)$ 41.79
HUMAN ALBUMIN 20% INFUSION 1 bottle / 100 ML infusion each (Bharat Serums & Vaccines Ltd)$ 60.24
OPV Drops / NA / 10 x 10 units (Aventis pasteur)$ 8.77
10's (Aventis pasteur)$ 8.77
OPV INJECTION 1 vial / 1 injection each (Aventis pasteur)$ 2.77
Relab 20 % x 1 Bottle 100 mL
Relab 20 % x 1 Bottle 50 mL

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The results of a survey conducted on ndrugs.com for Albumar are given in detail below. The results of the survey conducted are based on the impressions and views of the website users and consumers taking Albumar. We implore you to kindly base your medical condition or therapeutic choices on the result or test conducted by a physician or licensed medical practitioners.

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