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Details for: EXTRANEAL

Company: BAXTER CORPORATION

DIN DIN name Active Ingredient(s) Strength Dosage Form Route of Administration
02240806EXTRANEALSODIUM CHLORIDE; SODIUM LACTATE; CALCIUM CHLORIDE; MAGNESIUM CHLORIDE; ICODEXTRIN5.35 G / L; 4.48 G / L; 257 MG / L; 51 MG / L; 75 G / LSOLUTIONDIALYSIS
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Consumer Information

This information was provided by the drug’s manufacturer when this drug product was approved for sale in Canada. It is designed for consumers and care givers. It is a summary of information about the drug and will not tell you everything about the drug. Contact your doctor or pharmacist if you have any questions about the drug.

What the medication is used for

  • EXTRANEAL solution is a sterile peritoneal dialysis solution used in patients whose kidneys are not working properly. It removes waste products and water from the blood. EXTRANEAL solution can be used up to 12 hours for continuous peritoneal dialysis in mobile patients or 14 and up to 16 hours for automated peritoneal dialysis procedures.
What it does

EXTRANEAL solution contains icodextrin, which is made from cornstarch. It draws fluid and wastes from your blood stream into your peritoneal cavity (the space inside your abdomen). The fluids and wastes are removed from your body when the EXTRANEAL solution solution is drained.

When it should not be used

Do not use EXTRANEAL solution:

  • If you have been treated for acute renal failure
  • If a doctor has ever told you that you have a glycogen storage disease
  • If you are allergic to cornstarch or have had an allergic reaction to icodextrin
  • If you have maltose or isomaltose intolerance
  • If a doctor has told you that you have pre-existing severe lactic acidosis
  • If you have had abdominal surgery within the last month
  • If you are allergic to any of the nonmedicinal ingredients (see What the nonmedicinal ingredients are:)
  • If you have impaired respiratory function or potassium deficiency
  • If you are told having a surgically uncorrectable problem affecting your abdominal wall or cavity or uncorrectable problem that increases risk of abdominal infections such as abdominal fistulae, tumors, open wounds, herniae or other conditions until healing is complete
  • If you have documented loss of peritoneal function due to severe peritoneal scarring
  • If you are pregnant or plan to become pregnant
  • If you are breastfeeding
What the medicinal ingredient is

Icodextrin
Sodium Chloride
Sodium Lactate
Calcium Chloride
Magnesium Chloride

What the non-medicinal ingredients are

Hydrochloric acid (For pH adjustment)
Sodium Hydroxide (For pH adjustment)
Water for Injection

What dosage form it comes in

EXTRANEAL solution is available in Viaflex® Single or TwinBag containers holding 2000 mL or 2500 mL.

Warnings and precautions

If you monitor your blood glucose, you must use a glucose specific monitor and test strips. If your glucose monitor or test strips use a GDH-PQQ*GDO**or GDH-FAD***- based method, using EXTRANEAL solution may cause a falsely high glucose reading or may mask a very low actual glucose reading. A false high blood glucose reading could cause you to give more insulin than you need. Getting more insulin than you need can cause serious reaction including loss of consciousness, coma, neurological damage and death. If you have true low blood sugar but are using a monitor that is not specific, you may inadvertently delay taking appropriate measure to correct the low blood sugar. A false elevated reading may be measured up to two weeks following the discontinuance of EXTRANEAL solution.

*GDH-PQQ: glucose dehydrogenase pyrroloquinolinequinone
**GDO: glucose-dye-oxidoreductase
***GDH-FAD: glucose dehydrogenase flavin-adenine dinucleotide

If you are ever hospitalized or admitted to the emergency room, notify the hospital staff that you are using EXTRANEAL solution and that icodextrin and maltose may give a false high glucose reading with some types of glucose monitors or test strips.

Tell your doctor if you:

  • Use cardiac glycosides, such as digoxin. Your doctor may need to monitor your blood levels of calcium, potassium and magnesium
  • Have recently had surgery to repair a weakness in an abdominal artery
  • Suspect you are having an allergic reaction to EXTRANEAL solution or any ingredient in EXTRANEAL solution

Patients on EXTRANEAL solution may experience high or low levels of potassium, calcium, or magnesium in their blood. Your doctor will monitor your blood test results.

Tell your doctor about any other conditions you have that may affect the inside, outside or the wall of your abdomen.

If you are allergic to corn or corn products, undesirable allergic reactions, including development of rash, hives, throat and/or facial swelling, wheezing, shortness of breath, low blood pressure, and other anaphylactic/anaphylactoid reactions, may occur. Stop the infusion immediately and drain the solution from the peritoneal cavity if any signs or symptoms of a suspected allergic reaction develop and contact your doctor immediately.

Interactions with this medication

Tell your doctor or pharmacist all the medications you are taking including all prescription, non-prescription and natural health products.

The blood concentration of drugs that can be removed from the body using dialysis may be reduced by peritoneal dialysis.

Talk with your doctor about any drugs prescribed as an additive to EXTRANEAL solution.

Tell your doctor about all the medicines you take, including insulin and blood pressure medicines. Your dose of these medicines may need to be changed when you use EXTRANEAL solution.

Proper use of this medication

Usual Dose

    Usual dose
  • EXTRANEAL solution is used for the long dwell exchange, up to 12 hours, in CAPD. EXTRANEAL solution is used for the long dwell exchange (14 to 16 hours) in APD. Do not perform more than one exchange in 24 hours.
  • To do your EXTRANEAL solution exchange, it is very important that you follow the steps shown to you in your peritoneal dialysis training. All surfaces and connecting parts must be clean to avoid serious infection. If you need more help or have any questions you should contact your dialysis center or doctor.
  • Before use, always check to make sure the bags are not leaking and the date for using the solution (expiration date) has not passed. Do not use EXTRANEAL solution after the expiration date shown on the carton and product label.
  • Make sure the solution is clear and does not contain particles. Do not use bags that are cloudy, leaking or that contain particles.
  • EXTRANEAL solution is for single use only. Discard any unused remaining solution.
  • EXTRANEAL solution is only for intraperitoneal administration.
  • Sometimes, too much EXTRANEAL solution can get into your peritoneal cavity. If you experience abdominal distention, feeling of fullness and, or shortness of breath, contact your doctor or peritoneal dialysis unit.
  • To make using EXTRANEAL solution more comfortable, you can warm it to 37oC (98.6o F) before use. This should only be done using dry heat, such as a heating pad.
  • To avoid increased risk of infection, do not place EXTRANEAL solution in water to heat the bags.
  • Do not microwave EXTRANEAL solution.
  • EXTRANEAL solution should be infused based on your need for adequate dialysis, as determined by your doctor. When draining the fluid after the dwell, always check your drained fluid for cloudiness or fibrin. Fibrin looks like clumps or stringy material in the drained solution. Cloudy drained fluid or fibrin may mean you have an infection. Call your doctor if your drained fluid is cloudy or contains fibrin.
  • Carefully monitor your fluid balance. Keep an accurate fluid record. Carefully monitor your body weight to avoid too much or too little fluid in your body (over or under hydration) which may have serious effects.
  • Talk to your doctor before adding any other medicines to EXTRANEAL solution.

Overdose

There is no information available on the effects of overdosage. Only one exchange is recommended in a 24-hour period. Contact your doctor if a suspected overdosage has been administered.

In case of a suspected drug overdose, contact a health care practitioner, hospital emergency department or regional Poison Control Centre immediately, even if there are no symptoms.

Side effects and what to do about them

Rash is the most common side effect of EXTRANEAL solution. It usually appears during the first 3 weeks of treatment and goes away when treatment stops.

Serious side effects and what to do about them
Symptom / effect Talk to your healthcare professional Only if severe Talk to your healthcare professional In all cases Stop taking drug and get immediate medical help
Common
Allergic Reactions: swelling of the face, throat, lips, difficulty swallowing or breathing, skin peeling, itching, hives or rash  
Dehydration: dizziness, weakness or fainting, low or drop in blood pressure, thirst, dry mouth, constipation    
Ringing in your ears    
Headache    
Swelling in different parts of the body such as the hands, feet, face and abdomen    
Decreased urine production    
High blood pressure    
Uncommon
Peritonitis (an infection in the peritoneal cavity): cloudy or bloody drained fluid, abdominal pain, fever, redness, nausea, upset stomach, vomiting, lack of appetite, weight loss, constipation)    
High / low blood sugar    
Shortness of breath, chest pain    
Flu-like symptoms, cold, cough    

This is not a complete list of side effects. For any unexpected effects while taking EXTRANEAL solution, contact your doctor or pharmacist.

How to store

Store at room temperature (15 - 25°C). Do not store below 4°C. Do not use unless the solution is clear and the container undamaged. Any unused portion of the solution should be discarded.

Keep out of reach and sight of children.

Reporting side effects

You can help improve the safe use of health products for Canadians by reporting serious and unexpected side effects to Health Canada. Your report may help to identify new side effects and change the product safety information.

3 ways to report:

  • Online at MedEffect MedEffect (www.healthcanada.gc.ca/medeffect);
  • By calling 1-866-234-2345 (toll-free);
  • By completing a Consumer Side Effect Reporting Form and sending it by:
    • Fax to 1-866-678-6789 (toll-free), or
    • Mail to: Canada Vigilance Program
      Health Canada, Postal Locator 1908C
      Ottawa, ON
      K1A 0K9

Postage paid labels and the Consumer Side Effect Reporting Form are available at MedEffect.

NOTE: Contact your health professional if you need information about how to manage your side effects. The Canada Vigilance Program does not provide medical advice.

More information

If you want more information about EXTRANEAL solution:

  • Talk to your healthcare professional
  • Find the full product monograph that is prepared for healthcare professionals and includes this Patient Medication Information by visiting the Health Canada website (http://hc-sc-gc.ca/index-eng.php); Baxter Corporation’s website (http://www.baxter.ca), or by contacting the sponsor, BAXTER CORPORATION, at:1-800-387-8399

This leaflet was prepared by Baxter Corporation Mississauga, Ontario, Canada L5N 0C2

Baxter, Extraneal and Viaflex are trademarks of Baxter International Inc.

Last revised: September 27, 2016

Date modified: