Dextran

Identification

Name
Dextran
Accession Number
DB09255
Description

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

Associated Conditions
Associated Therapies
Contraindications & Blackbox Warnings
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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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Toxicity

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

Affected organisms
  • Humans and other mammals
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 Dextran which could result in a higher serum level.
AbciximabDextran may increase the anticoagulant activities of Abciximab.
AcarboseAcarbose may decrease the excretion rate of Dextran which could result in a higher serum level.
AceclofenacThe risk or severity of bleeding and hemorrhage can be increased when Aceclofenac is combined with Dextran.
AcemetacinThe risk or severity of bleeding and hemorrhage can be increased when Acemetacin is combined with Dextran.
AcenocoumarolThe risk or severity of bleeding can be increased when Acenocoumarol is combined with Dextran.
AcetaminophenAcetaminophen may decrease the excretion rate of Dextran which could result in a higher serum level.
AcetazolamideAcetazolamide may increase the excretion rate of Dextran which could result in a lower serum level and potentially a reduction in efficacy.
Acetylsalicylic acidAcetylsalicylic acid may increase the anticoagulant activities of Dextran.
AclidiniumAclidinium may decrease the excretion rate of Dextran which could result in a higher serum level.
Additional Data Available
  • Extended Description
    Extended Description
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    Extended description of the mechanism of action and particular properties of each drug interaction.

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  • Severity
    Severity
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    A severity rating for each drug interaction, from minor to major.

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  • Evidence Level
    Evidence Level
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    A rating for the strength of the evidence supporting each drug interaction.

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  • Action
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    An effect category for each drug interaction. Know how this interaction affects the subject drug.

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Food Interactions
  • 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

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Product Ingredients
IngredientUNIICASInChI Key
Dextran 40K3R6ZDH4DUNot AvailableNot applicable
Dextran 707SA290YK68Not AvailableNot applicable
Dextran 75JY83SHX053Not AvailableNot applicable
Brand Name Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
Dextran 75Injection, powder, lyophilized, for solution10 mg/1IntravenousAnazao Health Corporation2012-07-01Not applicableUS flag
Additional Data Available
  • Application Number
    Application Number
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    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code
    Product Code
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    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing EndRegionImage
LMD in DextroseInjection, solution10 g/100mLIntravenousHospira, Inc.2006-02-14Not applicableUS flag
LMD in Sodium ChlorideInjection, solution10 g/100mLIntravenousHospira, Inc.2005-08-12Not applicableUS flag
Additional Data Available
  • Application Number
    Application Number
    Available for Purchase

    A unique ID assigned by the FDA when a product is submitted for approval by the labeller.

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  • Product Code
    Product Code
    Available for Purchase

    A governmentally-recognized ID which uniquely identifies the product within its regulatory market.

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Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
10% Dextran 40 In 0.9% Sodium Chloride InjectionDextran 40 (10 %) + Sodium chloride (0.9 %)SolutionIntravenousB. Braun Medical Inc.1993-12-312018-12-12Canada flag
10% Dextran 40 In 5% Dextrose InjectionDextran 40 (10 %) + Dextrose, unspecified form (5 %)SolutionIntravenousB. Braun Medical Inc.1996-09-102018-12-12Canada flag
6% Dextran 70 In 0.9% Sodium Chloride InjectionDextran 70 (6 %) + Sodium chloride (0.9 %)SolutionIntravenousB. Braun Medical Inc.1996-09-102018-12-12Canada flag
Advance Relief Eye DropsDextran 70 (100 mg/100mL) + Polyethylene glycol 400 (1000 mg/100mL) + Povidone (1000 mg/100mL) + Tetrahydrozoline hydrochloride (50 mg/100mL)Solution / dropsOphthalmicWinCo Foods, LLC2015-01-09Not applicableUS flag
Advanced reliefDextran 70 (1 mg/1mL) + Polyethylene glycol 400 (10 mg/1mL) + Povidone (10 mg/1mL) + Tetrahydrozoline hydrochloride (0.5 mg/1mL)LiquidOphthalmicAmerican Sales Company2011-09-07Not applicableUS flag
Advanced reliefDextran 70 (1 mg/1mL) + Polyethylene glycol 400 (10 mg/1mL) + Povidone (10 mg/1mL) + Tetrahydrozoline hydrochloride (0.5 mg/1mL)LiquidOphthalmicSamchundang Pharm. Co., Ltd.2010-08-29Not applicableUS flag
Advanced ReliefDextran 70 (1 mg/1mL) + Polyethylene glycol 400 (10 mg/1mL) + Povidone (10 mg/1mL) + Tetrahydrozoline hydrochloride (0.5 mg/1mL)LiquidOphthalmicKareway Product, Inc.2018-05-30Not applicableUS flag
Advanced Relief Eye DropsDextran 70 (0.1 %) + Polyethylene glycol 400 (1 %) + Povidone (1 %) + Tetrahydrozoline hydrochloride (0.05 %)SolutionOphthalmicTEVA Canada Limited2010-08-30Not applicableCanada flag
Advanced Relief Eye DropsDextran 70 (0.1 %) + Polyethylene glycol 400 (1 %) + Povidone (1 %) + Tetrahydrozoline hydrochloride (0.05 %)SolutionOphthalmicKc Pharmaceuticals, Inc.Not applicableNot applicableCanada flag
Aquasite DpsDextran 70 (.1 %) + Polyethylene glycol (.2 %)Solution / dropsOphthalmicCiba Vision1993-12-312000-11-08Canada flag
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing EndRegionImage
Dextran 75Dextran 75 (10 mg/1)Injection, powder, lyophilized, for solutionIntravenousAnazao Health Corporation2012-07-01Not applicableUS flag

Categories

ATC Codes
B05AA05 — Dextran
Drug Categories
Classification
Not classified

Chemical Identifiers

UNII
Not Available
CAS number
9004-54-0

References

General References
  1. Klotz U, Kroemer H: Clinical pharmacokinetic considerations in the use of plasma expanders. Clin Pharmacokinet. 1987 Feb;12(2):123-35. [PubMed:2435442]
  2. RICKETTS CR: Chemistry of dextran and its derivatives. Proc R Soc Med. 1951 Jul;44(7):558-9. [PubMed:14864546]
  3. 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. [PubMed:18572351]
  4. Gray A., Wright J., Goodey V. and Bruce L. (2011). Injectable drugs guide. Royal pharmaceutical society .
  5. Collins P. (2006). Dictionary of carbohydrates (2nd ed.). Taylor and Francis.
  6. Dailymed [Link]
  7. Drugs.com [Link]
  8. ChemIDplus [Link]
  9. WHO [Link]
  10. Tears naturale monograph [Link]
  11. Military trauma research [Link]
KEGG Drug
D00060
KEGG Compound
C00372
PubChem Substance
347910421
RxNav
42635
Wikipedia
Dextran
MSDS
Download (39.4 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
4CompletedPreventionChronic Allergic Conjunctivitis1
4CompletedPreventionConjunctivitis, Seasonal Allergic1
4CompletedTreatmentAnterior Uveitis (AU) / Cystoid Macular Edema1
4CompletedTreatmentConjunctivitis allergic / Conjunctivitis, Seasonal Allergic2
4TerminatedTreatmentSpontaneous Bacterial Peritonitis (SBP)1
3Active Not RecruitingTreatmentCorneal Ectasia / Keratoconus1
3CompletedTreatmentPhenylketonuria (PKU)1
3CompletedTreatmentTraumatic Brain Injury (TBI)1
3TerminatedTreatmentBrain Injuries,Traumatic1
3TerminatedTreatmentTraumatic Shock1

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage Forms
FormRouteStrength
LiquidOphthalmic
SolutionIntravenous10 g/100ml
SolutionIntravenous10 g/L
SolutionIntravenous6 g/100ml
Solution / dropsOphthalmic0.3 %
Injection, powder, lyophilized, for solutionIntravenous10 mg/1
SolutionIntramuscular400 mg
SolutionIntravenous
Solution / dropsIntraocular
SolutionConjunctival; Ophthalmic1 mg
Injection, solutionIntravenous6 g/100mL
Injection, solutionIntravenous10 g/100mL
Injection, solutionIntravenous10 %
Injection, solutionIntravenous30 g/500ml
Injection, solutionIntravenous50 g/500ml
SolutionIntravenous500 ML
SolutionIntravenous1 %
SolutionIntravenous6 %
SolutionParenteral6 %
LiquidIntravenous
Solution / dropsOphthalmic1 mg/ml
Solution / dropsOphthalmic100 mg/100mL
SolutionOphthalmic
Solution / dropsOphthalmic
Prices
Not Available
Patents
Not Available

Properties

State
Solid
Experimental Properties
PropertyValueSource
melting point (°C)>254ºC'MSDS'
water solubilitySoluble 'MSDS'
logP0Loftsson T. Essential pharmacokinetics. (2015)
Predicted Properties
Not Available
Predicted ADMET Features
Not Available

Spectra

Mass Spec (NIST)
Not Available
Spectra
Not Available

Drug created on October 26, 2015 10:05 / Updated on July 10, 2020 21:43

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