It is indicated as an aid in hysteroscopy, thromboembolic disorders, and for the prophylaxis of pulmonary embolism or venous thrombosis in moderate- to high-risk patients undergoing surgery. It is also used for the prevention of postoperative thromboembolic disorders and in hypovolaemic shock.

Dextran causes expansion of plasma volume. It also reduces blood viscosity and inhibits sludging or aggregation of red blood cells.

Sodium chloride is the major extracellular cation. It plays an important role in electrolyte and fluid balance, osmotic pressure regulation, and water distribution by restoring sodium ions. It is used as a source of electrolytes and water for hydration, treatment of metabolic acidosis, priming solution in haemodialysis, and management of hyperosmolar diabetes. It is also used as a diluent for infusion of compatible drug additives.

Intrauterine

Aid in hysteroscopy:

• Adult: As dextran 70: 50-100 mL of a 32% solution instilled into the uterus as a rinsing and dilatation fluid.

Intravenous

Thromboembolic disorders:

• Adult: As dextran 40: Initially, 500 ml of a 10% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr, followed by 500 ml infused over 4-6 hr on the next and subsequent alternate days for not more than 10 days.
• Child: As dextran 40: Up to 5 ml/kg in infants and 10 ml/kg in children.

Intravenous

Prophylaxis of pulmonary embolism or venous thrombosis in moderate- to high-risk patients undergoing surgery:

• Adult: As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr during or immediately after surgery, followed by 500 mL on the next day and on subsequent alternate days for up to 2 wk after surgery in high-risk patients.

Intravenous

Prophylaxis of postoperative thromboembolic disorders:

• Adult: As dextran 40: 500 ml of a 10% solution in sodium chloride 0.9% or glucose 5% infused over 4-6 hr during or at the end of the surgery. Dose may be repeated the following day and treatment may be continued on alternate days for up to 10 days in high-risk patient.
• Child: As dextran 40: Up to 10 ml/kg in children.

Intravenous

Hypovolaemic shock:

• Adult: As dextran 40: Initially, 10 ml/kg given by rapid infusion as a 10% solution in sodium chloride 0.9% or glucose 5%. Doses may be given daily for up to 5 days. As dextran 70: Initially, 500-1000 mL of a 6% solution in sodium chloride 0.9% or glucose 5% infused at a rate of 20-40 mL/min. Maintenance: 10 ml/kg/day for 3 days (Dextran 70).

Dextran may interact with enzyme inducers such as phenytoin or carbamazepine and enzyme inhibitors such as cimetidine. Sodium chloride may affect serum concentrations of lithium.

Hypersensitivity, severe renal disease with oliguria or anuria, marked cardiac decompensation, and pregnancy.

Gastrointestinal disturbances, headache, dizziness, allergic reactions, elevated liver enzyme levels, alopecia, and bone marrow suppression.

Category C. Animal studies have shown adverse effects on the fetus, and there are no adequate controlled studies in humans. The drug should be used only if the potential benefit justifies the potential risk to the fetus.

Caution should be taken during lactation.

Plasma expanders.

Store at 25°C.