Hydroxyethyl Starch

Identification

Summary

Hydroxyethyl Starch is a plasma volume substitute used to treat and prevent hypovolemia.

Brand Names
Hespan, Hextend, Volulyte, Voluven
Generic Name
Hydroxyethyl Starch
DrugBank Accession Number
DB09106
Background

Hydroxyethyl starch (HES/HAES) is a nonionic starch derivative. Hydroxyethyl starches (HES) are synthetic colloids commonly used for fluid resuscitation to replace intravascular volume. HES is a general term and can be sub-classified according to average molecular weight, molar substitution, concentration, C2/C6 ratio and Maximum Daily Dose.

Type
Small Molecule
Groups
Approved
Synonyms
  • HAES
  • HES
  • Hetastarch
  • Hydroxyethylstarch

Pharmacology

Indication

An intravenous solution of hydroxyethyl starch is used to prevent shock following severe blood loss caused by trauma, surgery, or other issues.

Pharmacology
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Associated Conditions
Associated Therapies
Contraindications & Blackbox Warnings
Contraindications
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Pharmacodynamics

After isovolemic exchange of blood with 500 mL of HES in healthy volunteers, blood volume is maintained for at least 6 hours

Mechanism of action

Hydroxyethyl starch (HES) is one of the most frequently used plasma substitutes. Recent studies have indicated that HES may reduce capillary leakage.

Absorption

Peak concentration (C(max), 4.34 mg/mL)

Volume of distribution

5.9 L.

Protein binding

Data not found.

Metabolism

When given intravenously, molecules smaller than the renal threshold (60,000-70,000 daltons) are readily and rapidly excreted in the urine, while molecules with higher molecular weights are metabolized by plasma α-amylase prior to excretion via the renal route.

Route of elimination

Approximately 62 % of HES was excreted as hydroxyethyl starch molecules in urine within 72 hours.

Half-life

Terminal half-life is 16.1 h. Elimination half-life is 12 h.

Clearance

31.4 mL/min

Adverse Effects
Adverseeffects
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Toxicity

LDF50 (IV, rabbit): 8460 mg/Kg.

Pathways
Not Available
Pharmacogenomic Effects/ADRs
Not Available

Interactions

Drug Interactions
This information should not be interpreted without the help of a healthcare provider. If you believe you are experiencing an interaction, contact a healthcare provider immediately. The absence of an interaction does not necessarily mean no interactions exist.
DrugInteraction
AbacavirAbacavir may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
AceclofenacAceclofenac may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
AcemetacinAcemetacin may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
AcetaminophenAcetaminophen may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Hydroxyethyl Starch which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
AclidiniumAclidinium may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
AcrivastineHydroxyethyl Starch may decrease the excretion rate of Acrivastine which could result in a higher serum level.
AcyclovirAcyclovir may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
Adefovir dipivoxilAdefovir dipivoxil may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
Interactions
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Food Interactions
No interactions found.

Products

Products2
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Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
HextendSolution6 g / 100 mLIntravenousBiotime Inc2003-12-112013-07-12Canada flag
HextendInjection, solution6 g/100mLIntravenousHospira, Inc.2005-02-02Not applicableUS flag
VolulyteSolution6 %IntravenousFresenius Kabi2011-05-16Not applicableCanada flag
VoluvenInjection, solution6 g/100mLIntravenousHospira, Inc.2010-06-252020-02-28US flag
VoluvenSolution6 %IntravenousFresenius Kabi2006-09-18Not applicableCanada flag
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
6% Hetastarch In 0.9% Sodium ChlorideInjection, solution6 g/100mLIntravenousHF Acquisition Co LLC, DBA HealthFirst2018-11-26Not applicableUS flag
HetastarchInjection6 g/100mLIntravenousTeva Parenteral Medicines, Inc.2009-01-132014-09-30US flag
Hetastarch in Sodium ChlorideInjection, solution6 g/100mLIntravenousHospira, Inc.2005-02-28Not applicableUS flag
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
HespanHydroxyethyl Starch (6 g/100mL) + Sodium chloride (0.9 g/100mL)Injection, solutionIntravenousCardinal Health1991-04-042016-03-31US flag
HespanHydroxyethyl Starch (6 g/100mL) + Sodium chloride (0.9 g/100mL)Injection, solutionIntravenousB. Braun Medical Inc.1991-04-04Not applicableUS flag
Hydroxyethyl Starch in Sodium ChlorideHydroxyethyl Starch (6 g/100mL) + Sodium chloride (900 mg/100mL)Injection, solutionIntravenousB. Braun Medical Inc.2015-01-09Not applicableUS flag
HYPERHAES INT. INF. ICIN COZELTIHydroxyethyl Starch (6 %) + Sodium chloride (7.2 %)SolutionIntravenousFRESENİUS KABİ İLAÇ SAN. VE TİC. LTD. ŞTİ.2020-08-142019-07-16Turkey flag
NEOHES %6 HES % 0.9 SODYUM KLORÜR İV İNFÜZYON İÇİN ÇÖZELTİ, 500 ML SETLİHydroxyethyl Starch (60 g/1000ml) + Sodium chloride (9 g/1000ml)Injection, solutionIntravenousTURKTIPSAN SAĞLIK TURİZM EĞİTİM VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
NEOHES %6 HES % 0.9 SODYUM KLORÜR İV İNFÜZYON İÇİN ÇÖZELTİ, 500 ML SETSİZHydroxyethyl Starch (60 g/1000ml) + Sodium chloride (9 g/1000ml)Injection, solutionIntravenousTURKTIPSAN SAĞLIK TURİZM EĞİTİM VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
PF POLIHES (HES 200/0,5) %6 IV INFZÜYON IÇIN ÇÖZELTI, 1000 ML SETLIHydroxyethyl Starch (6 %) + Sodium chloride (0.9 %)SolutionIntravenousPOLİFARMA İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
PF POLIHES (HES 200/0,5) %6 IV INFZÜYON IÇIN ÇÖZELTI, 1000 ML SETSIZHydroxyethyl Starch (6 %) + Sodium chloride (0.9 %)SolutionIntravenousPOLİFARMA İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
PF POLIHES (HES 200/0,5) %6 IV INFZÜYON IÇIN ÇÖZELTI, 500 ML SETLIHydroxyethyl Starch (6 %) + Sodium chloride (0.9 %)SolutionIntravenousPOLİFARMA İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
PF POLIHES (HES 200/0,5) %6 IV INFZÜYON IÇIN ÇÖZELTI, 500 ML SETSIZHydroxyethyl Starch (6 %) + Sodium chloride (0.9 %)SolutionIntravenousPOLİFARMA İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
BIOHES %10 INTRAVENOZ 500 ML SOLUSYON SETLI SISEHydroxyethyl Starch (10 %)SolutionIntravenousOSEL İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
BIOHES %10 INTRAVENOZ 500 ML SOLUSYON SETSIZ SISEHydroxyethyl Starch (10 %)SolutionIntravenousOSEL İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
BIOHES %6 INTRAVENOZ 500 ML SOLUSYON SETSIZ SISEHydroxyethyl Starch (6 %)SolutionIntravenousOSEL İLAÇ SAN. VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
ISOHES %6 (SETLI) 500 ML SOLUSYONHydroxyethyl Starch (6 %) + Sodium chloride (0.9 %)SolutionIntravenousECZACIBAŞI-BAXTER HASTANE ÜRÜNLERİ SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
ISOHES %6 (SETSIZ)500 ML SOLUSYONHydroxyethyl Starch (6 %) + Sodium chloride (0.9 %)SolutionIntravenousECZACIBAŞI-BAXTER HASTANE ÜRÜNLERİ SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
VARIHES %6 500 ML(SETLI)Hydroxyethyl Starch (6 %)SolutionIntravenousECZACIBAŞI-BAXTER HASTANE ÜRÜNLERİ SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
VARIHES %6 500 ML(SETSIZ)Hydroxyethyl Starch (6 %)SolutionIntravenousECZACIBAŞI-BAXTER HASTANE ÜRÜNLERİ SAN.VE TİC. A.Ş.2020-08-14Not applicableTurkey flag
VOLUVEN % 6 500 ML SOLUSYONHydroxyethyl Starch (6 %) + Sodium chloride (0.9 %)SolutionIntravenousFRESENİUS KABİ İLAÇ SAN. VE TİC. LTD. ŞTİ.2020-08-14Not applicableTurkey flag

Categories

ATC Codes
B05AA07 — Hydroxyethylstarch
Drug Categories
Classification
Not classified
Affected organisms
  • Humans and other mammals

Chemical Identifiers

UNII
875Y4127EA
CAS number
9005-27-0
InChI Key
Not Available
InChI
Not Available
IUPAC Name
Not Available
SMILES
Not Available

References

General References
  1. Mutter TC, Ruth CA, Dart AB: Hydroxyethyl starch (HES) versus other fluid therapies: effects on kidney function. Cochrane Database Syst Rev. 2013 Jul 23;(7):CD007594. doi: 10.1002/14651858.CD007594.pub3. [Article]
  2. MSDS [Link]
KEGG Drug
D03335
PubChem Substance
347910407
RxNav
5531
ChEMBL
CHEMBL2108448

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedDiagnosticProstate Cancer1
4CompletedPreventionHypotension1
4CompletedPreventionPostoperative Cardiorespiratory Failure1
4CompletedTreatmentAbdominal Compartment Syndrome / Abdominal Hypertension / Severe Trauma1
4CompletedTreatmentCardiopulmonarybypass / Surgery, Cardiac1
4CompletedTreatmentCoagulation Disorder1
4CompletedTreatmentCoronary Artery Bypass Grafting (CABG) / Valve Surgery1
4CompletedTreatmentCoronary Artery Disease (CAD) / Valvular Heart Disease1
4CompletedTreatmentCoronary Heart Disease (CHD)1
4CompletedTreatmentDelayed Bleeding / Post procedural complication / Post-Polypectomy Syndrome / Procedural haemorrhage1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
InjectionIntravenous
Injection, solutionIntravenous
InjectionIntravenous6 g/100mL
Injection, solutionIntravenous6 g/100mL
SolutionIntravenous6 g / 100 mL
Injection, solutionIntravenous
SolutionIntravenous
SolutionIntravenous
Solution
SolutionIntravenous6 %
SolutionParenteral
Injection, solutionIntravenous10 %
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
Not Available
Predicted Properties
Not Available
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available

Drug created on September 16, 2015 22:43 / Updated on September 19, 2021 19:53