Hydroxyethyl Starch


Hydroxyethyl Starch
Accession Number
Small Molecule

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.

  • HAES
  • HES
  • Hetastarch
  • Hydroxyethylstarch
Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
HextendInjection, solution6 g/100mLIntravenousHospira, Inc.2005-02-02Not applicableUs
HextendSolution6 gIntravenousBiotime Inc2003-12-112013-07-12Canada
VolulyteSolution6 %IntravenousFresenius Kabi2011-05-16Not applicableCanada
VoluvenInjection, solution6 g/100mLIntravenousHospira, Inc.2010-06-25Not applicableUs
VoluvenSolution6 %IntravenousFresenius Kabi2006-09-18Not applicableCanada
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
6% Hetastarch In 0.9% Sodium ChlorideInjection, solution6 g/100mLIntravenousHF Acquisition Co LLC, DBA HealthFirst2018-11-26Not applicableUs
HetastarchInjection6 g/100mLIntravenousTeva Parenteral Medicines, Inc.2009-01-132014-09-30Us
Hetastarch in Sodium ChlorideInjection, solution6 g/100mLIntravenousHospira, Inc.2005-02-28Not applicableUs
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
HespanHydroxyethyl Starch (6 g/100mL) + Sodium chloride (0.9 g/100mL)Injection, solutionIntravenousCardinal Health1991-04-042016-03-31Us
HespanHydroxyethyl Starch (6 g/100mL) + Sodium chloride (0.9 g/100mL)Injection, solutionIntravenousB. Braun Medical Inc.1991-04-04Not applicableUs
Hydroxyethyl Starch in Sodium ChlorideHydroxyethyl Starch (6 g/100mL) + Sodium chloride (900 mg/100mL)Injection, solutionIntravenousB. Braun Medical Inc.2015-01-09Not applicableUs
CAS number
Not Available
Chemical Formula
Not Available
InChI Key
Not Available
Not Available
Not Available
Not Available



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

Associated Conditions
Associated Therapies

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.


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

Volume of distribution

5.9 L.

Protein binding

Data not found.


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.


31.4 mL/min


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

Affected organisms
  • Humans and other mammals
Not Available
Pharmacogenomic Effects/ADRs
Not Available


Drug Interactions
AbacavirAbacavir may decrease the excretion rate of Hydroxyethyl Starch which could result in a higher serum level.
AcarboseAcarbose 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.
Food Interactions
Not Available


General References
  1. MSDS [Link]
  2. Article [Link]
External Links
PubChem Substance
ATC Codes
B05AA07 — Hydroxyethylstarch
AHFS Codes
  • 40:12.00 — Replacement Preparations

Clinical Trials

Clinical Trials
0CompletedPreventionComplications Associated With Artificial Fertilization / Disorder of Endocrine Ovary1
0Not Yet RecruitingPreventionHypotension Drug-Induced1
2CompletedPreventionCoagulation Defect; Bleeding1
2CompletedTreatmentAngina Pectoris / Myocardial Infarction / Unstable Angina Pectoris1
2CompletedTreatmentCritical Lower Limb Ischemia / Vascular Diseases1
2TerminatedTreatmentPeripheral Vascular Disease (PVD)1
3Active Not RecruitingTreatmentPostoperative Kidney Injury1
3CompletedPreventionPostoperative Hemorrhages1
3CompletedSupportive CarePancreatoduodenectomy1
3CompletedTreatmentArterial Hypotension / Transient ischemia attacks2
3CompletedTreatmentCirculation, Extracorporeal / Surgery, Cardiac1
3CompletedTreatmentColon Polyps / Colorectal Polyps / Crohn's Disease (CD) / Diverticulitis / Malignant Neoplasm of Colon / Rectal Carcinoma / Ulcerative Colitis (UC)1
3CompletedTreatmentHemorrhage / Hypovolaemia1
3CompletedTreatmentIntensive Care1
3CompletedTreatmentRenal Failure / Survival1
3CompletedTreatmentSevere Sepsis / Shock, Septic2
3RecruitingTreatmentCardiopulmonary Bypass / Surgery, Cardiac1
3TerminatedTreatmentHip Fractures1
3TerminatedTreatmentLung Injury, Acute (ALI) / Respiratory Distress Syndrome, Acute (ARDS)1
4Active Not RecruitingTreatmentDelayed Bleeding / Post procedural complication / Post-Polypectomy Syndrome / Postoperative Hemorrhages1
4CompletedDiagnosticProstate Cancer1
4CompletedPreventionArterial Hypotension1
4CompletedPreventionSurgical Side Infections After Breast Reduction1
4CompletedTreatmentAbdominal Compartment Syndrome / Abdominal Hypertension / Severe Trauma1
4CompletedTreatmentArthroplasties, Hip Replacement1
4CompletedTreatmentCardiopulmonary Bypass / Surgery, Cardiac1
4CompletedTreatmentCoronary Artery Bypass Graft Surgery Patients / Valve Surgery1
4CompletedTreatmentCoronary Artery Disease / Valvular Heart Disease1
4CompletedTreatmentCoronary Heart Disease (CHD)1
4CompletedTreatmentDisorders of Coagulation1
4CompletedTreatmentFluid Volume Disorder1
4CompletedTreatmentGeneral Surgery / Major Abdominal Surgery by Laparotomy1
4CompletedTreatmentHeart; Dysfunction Postoperative, Cardiac Surgery1
4CompletedTreatmentOsteoarthritis (OA)1
4CompletedTreatmentPlasma Volume Replacement / Surgery of the Pancreatic Head1
4CompletedTreatmentPostoperative Complications1
4CompletedTreatmentSepsis / Severe Sepsis / Shock, Septic1
4CompletedTreatmentSubarachnoid Hemorrhage1
4RecruitingTreatmentHypovolaemia Due to Acute Blood Loss1
4TerminatedTreatmentAnaesthesia therapy1
4TerminatedTreatmentIntraoperative Complications1
4TerminatedTreatmentRenal Cancers1
4TerminatedTreatmentMinor burns1
4Unknown StatusNot AvailableUrologic Surgical Procedures1
4Unknown StatusTreatmentArterial Hypotension / Cesarean Section / Fluid Therapy / Obstetric Anesthesia / Spinal Anaesthesia1
4WithdrawnTreatmentSevere Sepsis1
Not AvailableActive Not RecruitingSupportive CareAnesthesia Morbidity1
Not AvailableCompletedNot AvailableAcute Kidney Injury After Adult Cardiac Surgery1
Not AvailableCompletedNot AvailableMitral Valve Insufficiency / Mitral Valve Stenosis / Tricuspid valve incompetence1
Not AvailableCompletedNot AvailableTotal Fluid Volume Increased1
Not AvailableCompletedBasic SciencePerfusions1
Not AvailableCompletedDiagnosticFluid Responsiveness Predictability1
Not AvailableCompletedPreventionImpaired Renal Function1
Not AvailableCompletedSupportive CareCesarean Section2
Not AvailableCompletedSupportive CareMitral Valve Insufficiency / Mitral Valve Stenosis / Tricuspid valve incompetence1
Not AvailableCompletedTreatmentCesarean Section2
Not AvailableCompletedTreatmentCoagulation, Blood / Volumes, Blood1
Not AvailableCompletedTreatmentIntracranial Hypotension1
Not AvailableCompletedTreatmentMicrovascular Reactivity / Tissue Oxygen Saturation1
Not AvailableCompletedTreatmentMitral Valvular Heart Disease1
Not AvailableCompletedTreatmentPatients Undergoing Cardiac Surgery With Cardiopulmonary Bypass1
Not AvailableCompletedTreatmentPostoperative Complications2
Not AvailableCompletedTreatmentShock, Septic1
Not AvailableCompletedTreatmentStroke Patients Presenting Within 24 Hrs of Onset of Symptoms1
Not AvailableCompletedTreatmentSurgery, Cardiac1
Not AvailableNot Yet RecruitingNot AvailableCardiac Surgical Procedures1
Not AvailableNot Yet RecruitingTreatmentCerebral Aneurysms1
Not AvailableNot Yet RecruitingTreatmentCoronary Artery Bypass Graft Surgery Patients1
Not AvailableNot Yet RecruitingTreatmentSurgery, Cardiac1
Not AvailableNot Yet RecruitingTreatmentSurgery, Colon1
Not AvailableRecruitingOtherEndothelial Dysfunction1
Not AvailableTerminatedSupportive CareGoal-oriented Fluid Therapy / Surgery, Colorectal1
Not AvailableTerminatedTreatmentHip Arthroplasty1
Not AvailableUnknown StatusTreatmentCoronary Artery Bypass Graft Surgery Patients1


Not Available
Not Available
Dosage forms
InjectionIntravenous6 g/100mL
SolutionIntravenous6 g
Injection, solutionIntravenous
Injection, solutionIntravenous6 g/100mL
SolutionIntravenous6 %
Not Available
Not Available


Experimental Properties
Not Available
Predicted Properties
Not Available
Predicted ADMET features
Not Available


Mass Spec (NIST)
Not Available
Not Available


Not classified

Drug created on September 16, 2015 16:43 / Updated on March 23, 2019 04:21