Identification
- Summary
Dextran is a low molecular weight dextran used as an adjunctive treatment of shock or impending shock due to hemorrhage, burns, surgery or other trauma, as well as the prophylaxis of venous thrombosis and pulmonary embolism during high-risk medical procedures.
- Brand Names
- Bion Tears, Colirio Ocusan, Genteal Tears, Genteal Tears Mild, Tears Naturale, Tears Renewed
- Generic Name
- Dextran
- DrugBank Accession Number
- DB09255
- Background
Dextran is a polysaccharide that differs from others in that its glucose units are joined together 1:6 glucoside links. The main chain of glucose has short branches at frequent intervals which are probably joined by 1:3 and 1:4 glucoside links. The chains can be composed of about 200,000 glucose units.2 Many bacteria, like Leuconostoc, can synthesize dextran from sucrose, and this activity is used commercially to obtain dextran.5
Dextran 40 is a sterile, nonpyrogenic preparation of low molecular weight dextran (average mol. wt. 40,000) in 5% Dextrose Injection or 0.9% Sodium Chloride Injection. It is administered by intravenous infusion.
Dextran 75 is a complex branched glucan with an average molecular weight 75000 Daltons. It is produced from certain bacteria that with α-1,6 glycosidic linkages between glucose molecules and α-1,3 linkages between branches. When labelled with technetium Tc99m, dextran 75 is intravenously administered as an imaging agent to detect and diagnose conditions in the vascular compartment such as pericardial effusion or ventricular aneurysm.
- Type
- Small Molecule
- Groups
- Approved, Investigational, Vet approved
- Synonyms
- Dextran
Pharmacology
- Indication
Dextran is used as the restoration of blood mass during surgical interventions if there is hypovolemia due to trauma or dehydration. It is as well used after the presence of hemorrhage in cases of blood loss to a level inferior to 15% of the blood mass, if compatibility test cannot be completed or when blood lots need to be tested for pathogen detection. Dextran is also used for the prevention of profound postoperative venous thrombosis.9
Dextran as well presents ophthalmic applications as solutions or ointments for the temporary relief of xerophthalmia or minor ocular irritations.10
Reduce drug development failure ratesBuild, train, & validate machine-learning modelswith evidence-based and structured datasets.Build, train, & validate predictive machine-learning models with structured datasets.- Associated Conditions
- Blood Circulation Disorder
- Capillary disorder
- Dry Eyes
- Ocular Irritation
- Pulmonary Embolism
- Pulmonary Embolism caused by procedures associated with a high incidence of thromboembolic complications
- Shock
- Thrombosis
- Venous Thrombosis (Disorder)
- Venous Thrombosis caused by procedures associated with a high incidence of thromboembolic complications
- Associated Therapies
- Contraindications & Blackbox Warnings
Avoid life-threatening adverse drug eventsImprove clinical decision support with information on contraindications & blackbox warnings, population restrictions, harmful risks, & more.Avoid life-threatening adverse drug events & improve clinical decision support.- Pharmacodynamics
It is reported that dextran presents an effect on the hemostatic system in particular by prolonging bleeding time. In the same trials, dextran is reported to reduce emboli, reduce platelet adhesiveness and produce hemodilution. These effects have been showed to be greater proportionally with the increase in the molecular weight of the dextran.3
- Mechanism of action
In preclinical studies, the mechanism of action is thought to be related to the blockage of the uptake of tissue plasminogen activator by mannose-binding receptors. This process has a direct effect by enhancing endogenous fibrinolysis.3
- Absorption
Dextran presents a very low oral bioavailability that is reduced as the chain gets longer. Thus, the bioavailability of dextran is inversely proportional to the length of the carbohydrate chain.5
- Volume of distribution
The reported volume of distribution of dextran suggested a distribution throughout the blood volume. This volume of distribution is reported to be of around 120 ml. The organ that presented a higher accumulation of dextran was the liver.11
- Protein binding
Dextran is highly retained in the vascular system by binding to plasma proteins including albumin.9
- Metabolism
Long chains of dextran such as dextran 60 are highly metabolized in the liver until formation of lower molecular weight products before being excreted from the body.5
- Route of elimination
The elimination of dextran will depend on the length of the carbohydrate chain, the administration route, and the molecular weight. For dextran 1, it is reported to be mainly secreted unchanged in the urine in a ratio of 80% of the administered dose when administered parentally. It is registered that the weight threshold for unrestricted glomerular filtration is about 15 kDa and if the dextran overpasses 50 kDa it will not be renally eliminated in any significant amount.5
- Half-life
The elimination half-life will depend on the length of the carbohydrate chain. The higher the molecular weight of the dextran the longer it will be the elimination half-life. The half-life will go from 1.9 hours from dextran 1 to 42 hours in the case of dextran 60.4,5
- Clearance
Not Available
- Adverse Effects
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Some reports have shown adverse effects when used in therapeutical doses and some teratogenic effects have been demonstrated when used in large doses. The current LD50 reported in rats is 10700 mg/kg.5
- 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.
Drug Interaction Integrate drug-drug
interactions in your softwareAbacavir Abacavir may decrease the excretion rate of Dextran which could result in a higher serum level. Abciximab Dextran may increase the anticoagulant activities of Abciximab. Aceclofenac The risk or severity of bleeding and hemorrhage can be increased when Aceclofenac is combined with Dextran. Acemetacin The risk or severity of bleeding and hemorrhage can be increased when Dextran is combined with Acemetacin. Acenocoumarol The risk or severity of bleeding can be increased when Acenocoumarol is combined with Dextran. Acetaminophen Acetaminophen may decrease the excretion rate of Dextran which could result in a higher serum level. Acetazolamide Acetazolamide may increase the excretion rate of Dextran which could result in a lower serum level and potentially a reduction in efficacy. Acetylsalicylic acid Acetylsalicylic acid may increase the anticoagulant activities of Dextran. Aclidinium Aclidinium may decrease the excretion rate of Dextran which could result in a higher serum level. Acrivastine Dextran may decrease the excretion rate of Acrivastine which could result in a higher serum level. 
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- Avoid herbs and supplements with anticoagulant/antiplatelet activity. Dextran has antithrombotic activity, which may increase the bleeding risk if combined with antiplatelet/anticoagulant herbs. Examples include garlic, ginger, bilberry, danshen, piracetam, and ginkgo biloba.
Products
Drug product information from 10+ global regionsOur datasets provide approved product information including:dosage, form, labeller, route of administration, and marketing period.Access drug product information from over 10 global regions.- Product Ingredients
Ingredient UNII CAS InChI Key Dextran 40 K3R6ZDH4DU Not Available Not applicable Dextran 70 7SA290YK68 Not Available Not applicable Dextran 75 JY83SHX053 Not Available Not applicable Dextran sulfate Not Available 9042-14-2 Not applicable Dextran sulfate sodium Not Available 9011-18-1 Not applicable - Brand Name Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image Dextran 75 Injection, powder, lyophilized, for solution 10 mg/1 Intravenous Anazao Health Corporation 2012-07-01 Not applicable US 
- Generic Prescription Products
Name Dosage Strength Route Labeller Marketing Start Marketing End Region Image LMD in Dextrose Injection, solution 10 g/100mL Intravenous Hospira, Inc. 2006-02-14 Not applicable US LMD in Sodium Chloride Injection, solution 10 g/100mL Intravenous Hospira, Inc. 2005-08-12 Not applicable US - Mixture Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image 10% Dextran 40 In 0.9% Sodium Chloride Injection Dextran 40 (10 %) + Sodium chloride (0.9 %) Solution Intravenous B. Braun Medical Inc. 1993-12-31 2018-12-12 Canada 
10% Dextran 40 In 5% Dextrose Injection Dextran 40 (10 %) + Dextrose, unspecified form (5 %) Solution Intravenous B. Braun Medical Inc. 1996-09-10 2018-12-12 Canada 6% Dextran 70 In 0.9% Sodium Chloride Injection Dextran 70 (6 %) + Sodium chloride (0.9 %) Solution Intravenous B. Braun Medical Inc. 1996-09-10 2018-12-12 Canada Advance Relief Eye Drops Dextran 70 (100 mg/100mL) + Polyethylene glycol 400 (1000 mg/100mL) + Povidone (1000 mg/100mL) + Tetrahydrozoline hydrochloride (50 mg/100mL) Solution / drops Ophthalmic WinCo Foods, LLC 2015-01-09 Not applicable US Advanced relief Dextran 70 (1 mg/1mL) + Polyethylene glycol 400 (10 mg/1mL) + Povidone (10 mg/1mL) + Tetrahydrozoline hydrochloride (0.5 mg/1mL) Liquid Ophthalmic Samchundang Pharm. Co., Ltd. 2010-08-29 Not applicable US Advanced Relief Dextran 70 (1 mg/1mL) + Polyethylene glycol 400 (10 mg/1mL) + Povidone (10 mg/1mL) + Tetrahydrozoline hydrochloride (0.5 mg/1mL) Liquid Ophthalmic Kareway Product, Inc. 2018-05-30 Not applicable US Advanced relief Dextran 70 (1 mg/1mL) + Polyethylene glycol 400 (10 mg/1mL) + Povidone (10 mg/1mL) + Tetrahydrozoline hydrochloride (0.5 mg/1mL) Liquid Ophthalmic American Sales Company 2011-09-07 Not applicable US Advanced Relief Eye Drops Dextran 70 (0.1 % w/v) + Polyethylene glycol 400 (1 % w/v) + Povidone (1 % w/v) + Tetrahydrozoline hydrochloride (0.05 % w/v) Solution Ophthalmic Kc Pharmaceuticals, Inc. Not applicable Not applicable Canada Advanced Relief Eye Drops Dextran 70 (0.1 % w/v) + Polyethylene glycol 400 (1 % w/v) + Povidone (1 % w/v) + Tetrahydrozoline hydrochloride (0.05 % w/v) Solution Ophthalmic TEVA Canada Limited 2010-08-30 Not applicable Canada Aquasite Dps Dextran 70 (.1 %) + Polyethylene glycol (.2 %) Solution / drops Ophthalmic Ciba Vision 1993-12-31 2000-11-08 Canada - Unapproved/Other Products
Name Ingredients Dosage Route Labeller Marketing Start Marketing End Region Image BIOFLEKS DEKSTRAN 40 %5 DEKSTROZ SOL (PVC TORBA) 500 ML SETLI Dextran 40 (10 g/100ml) + D-glucose monohydrate (5 g/100ml) Solution Intravenous OSEL İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey 
BIOFLEKS DEKSTRAN 40 %5 DEKSTROZ SOL (PVC TORBA) 500 ML SETSIZ Dextran 40 (10 g/100ml) + D-glucose monohydrate (5 g/100ml) Solution Intravenous OSEL İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey DEKSTRAN-40 IZO.%09 500 ML SOLUSYON (PVC TORBA) SETSIZ Dextran 40 (10 g/100ml) Solution Intravenous OSEL İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey DEKSTRAN-70 IZO.%09 500 ML SOLUSYON SETSIZ Dextran 70 (6 g/100ml) Solution Intravenous OSEL İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey DEKSTRAN-70 IZOTONIK SODYUM KLORUR SOL 500 ML SETLI SISE Dextran 70 (6 g/100ml) Solution Intravenous OSEL İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey Dextran 75 Dextran 75 (10 mg/1) Injection, powder, lyophilized, for solution Intravenous Anazao Health Corporation 2012-07-01 Not applicable US POLIFLEKS 100 MG/ML DEKSTRAN 40 9 MG/ML İZOTONİK SODYUM KLORÜR IV İNFÜZYON İÇİN ÇÖZELTİ, 100 ML SETLİ(PVC) Dextran 40 (1 %) + Sodium chloride (0.9 %) Solution Intravenous POLİFARMA İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey POLIFLEKS 100 MG/ML DEKSTRAN 40 9 MG/ML İZOTONİK SODYUM KLORÜR IV İNFÜZYON İÇİN ÇÖZELTİ, 100 ML SETSİZ(PVC) Dextran 40 (1 %) + Sodium chloride (0.9 %) Solution Intravenous POLİFARMA İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey POLIFLEKS 100 MG/ML DEKSTRAN 40 9 MG/ML İZOTONİK SODYUM KLORÜR IV İNFÜZYON İÇİN ÇÖZELTİ, 1000 ML SETLİ(PVC) Dextran 40 (1 %) + Sodium chloride (0.9 %) Solution Intravenous POLİFARMA İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey POLIFLEKS 100 MG/ML DEKSTRAN 40 9 MG/ML İZOTONİK SODYUM KLORÜR IV İNFÜZYON İÇİN ÇÖZELTİ, 1000 ML SETSİZ(PVC) Dextran 40 (1 %) + Sodium chloride (0.9 %) Solution Intravenous POLİFARMA İLAÇ SAN. VE TİC. A.Ş. 2020-08-14 Not applicable Turkey
Categories
- ATC Codes
- B05AA05 — Dextran
- Drug Categories
- Anticoagulants
- Biopolymers
- Blood and Blood Forming Organs
- Blood and Related Products
- Blood Substitutes
- Blood Substitutes and Perfusion Solutions
- Blood Substitutes and Plasma Protein Fractions
- Carbohydrates
- Compounds used in a research, industrial, or household setting
- Dextrans
- Drugs that are Mainly Renally Excreted
- Glucans
- Hematologic Agents
- Increased Intravascular Volume
- Macromolecular Substances
- Osmotic Activity
- Plasma Substitutes
- Polymers
- Polysaccharides
- Classification
- Not classified
- Affected organisms
- Humans and other mammals
Chemical Identifiers
- UNII
- Not Available
- CAS number
- 9004-54-0
References
- General References
- Klotz U, Kroemer H: Clinical pharmacokinetic considerations in the use of plasma expanders. Clin Pharmacokinet. 1987 Feb;12(2):123-35. [Article]
- RICKETTS CR: Chemistry of dextran and its derivatives. Proc R Soc Med. 1951 Jul;44(7):558-9. [Article]
- Jones CI, Payne DA, Hayes PD, Naylor AR, Bell PR, Thompson MM, Goodall AH: The antithrombotic effect of dextran-40 in man is due to enhanced fibrinolysis in vivo. J Vasc Surg. 2008 Sep;48(3):715-22. doi: 10.1016/j.jvs.2008.04.008. Epub 2008 Jun 24. [Article]
- Gray A., Wright J., Goodey V. and Bruce L. (2011). Injectable drugs guide. Royal pharmaceutical society .
- Collins P. (2006). Dictionary of carbohydrates (2nd ed.). Taylor and Francis.
- Dailymed [Link]
- Drugs.com [Link]
- ChemIDplus [Link]
- WHO [Link]
- Tears naturale monograph [Link]
- Military trauma research [Link]
- External Links
- MSDS
- Download (39.4 KB)
Clinical Trials
- Clinical Trials
Phase Status Purpose Conditions Count 4 Completed Prevention Allergic Conjunctivitis (AC) 1 4 Completed Prevention Chronic Allergic Conjunctivitis 1 4 Completed Treatment Allergic Conjunctivitis (AC) 2 4 Completed Treatment Anterior Uveitis (AU) / Macular Edema, Cystoid 1 4 Terminated Treatment Spontaneous Bacterial Peritonitis (SBP) 1 3 Active Not Recruiting Treatment Ectasia Corneal / Keratoconus 1 3 Completed Treatment Phenylketonuria (PKU) 1 3 Completed Treatment Traumatic Brain Injury (TBI) 1 3 Terminated Treatment Traumatic Brain Injury (TBI) 1 3 Terminated Treatment Traumatic Shock 1
Pharmacoeconomics
- Manufacturers
- Not Available
- Packagers
- Not Available
- Dosage Forms
Form Route Strength Liquid Ophthalmic Solution Intravenous 10 g/100ml Solution Parenteral Injection, powder, lyophilized, for solution Intravenous 10 mg/1 Solution Intramuscular Solution Intravenous Injection, solution Intravenous 10 g/100mL Solution Conjunctival; Ophthalmic 1 mg Injection, solution Intravenous Solution Intravenous 6 g/100ml Injection, solution Intravenous 30 g/500ml Injection, solution Intravenous 50 g/500ml Solution Intravenous 500 ML Solution Parenteral 6 % Liquid Intravenous Solution Conjunctival; Ophthalmic Kit; solution / drops Ophthalmic Solution Ophthalmic 0.500 mg Solution Ophthalmic Solution / drops Ophthalmic - Prices
- Not Available
- Patents
- Not Available
Properties
- State
- Solid
- Experimental Properties
Property Value Source melting point (°C) >254ºC 'MSDS' water solubility Soluble 'MSDS' logP 0 Loftsson T. Essential pharmacokinetics. (2015) - Predicted Properties
- Not Available
- Predicted ADMET Features
- Not Available
Spectra
- Mass Spec (NIST)
- Not Available
- Spectra
- Not Available
Drug created at October 26, 2015 16:05 / Updated at May 04, 2023 06:06