Dextran

Identification

Name
Dextran
Accession Number
DB09255
Type
Small Molecule
Groups
Approved, Investigational, Vet approved
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.

Synonyms
Not Available
Product Ingredients
IngredientUNIICASInChI Key
Dextran 40K3R6ZDH4DUNot AvailableNot applicable
Dextran 707SA290YK68Not AvailableNot applicable
Dextran 75JY83SHX053Not AvailableNot applicable
Generic Prescription Products
NameDosageStrengthRouteLabellerMarketing StartMarketing End
LMD in DextroseInjection, solution10 g/100mLIntravenousHospira, Inc.2006-02-14Not applicableUs
LMD in Sodium ChlorideInjection, solution10 g/100mLIntravenousHospira, Inc.2005-08-12Not applicableUs
Mixture Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
10% Dextran 40 In 0.9% Sodium Chloride InjectionDextran 40 (10 %) + Sodium Chloride (0.9 %)SolutionIntravenousB. Braun Medical Inc.1993-12-31Not applicableCanada
10% Dextran 40 In 5% Dextrose InjectionDextran 40 (10 %) + Dextrose, unspecified form (5 %)SolutionIntravenousB. Braun Medical Inc.1996-09-10Not applicableCanada
6% Dextran 70 In 0.9% Sodium Chloride InjectionDextran 70 (6 %) + Sodium Chloride (0.9 %)SolutionIntravenousB. Braun Medical Inc.1996-09-10Not applicableCanada
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
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
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.2011-08-11Not applicableUs
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
Advanced Relief Eye DropsDextran 70 (0.1 %) + Polyethylene glycol 400 (1 %) + Povidone (1 %) + Tetrahydrozoline hydrochloride (0.05 %)SolutionOphthalmicKc Pharmaceuticals, Inc.Not applicableNot applicableCanada
Advanced Relief Eye DropsDextran 70 (0.1 %) + Polyethylene glycol 400 (1 %) + Povidone (1 %) + Tetrahydrozoline hydrochloride (0.05 %)SolutionOphthalmicTeva2010-08-30Not applicableCanada
Aquasite DpsDextran 70 (.1 %) + Polyethylene glycol (.2 %)Solution / dropsOphthalmicCiba Vision1993-12-312000-11-08Canada
Unapproved/Other Products
NameIngredientsDosageRouteLabellerMarketing StartMarketing End
Dextran 75Dextran 75 (10 mg/1)Injection, powder, lyophilized, for solutionIntravenousAnazao Health Corporation2012-07-01Not applicableUs
Categories
UNII
Not Available
CAS number
9004-54-0
Weight
Not Available
Chemical Formula
Not Available
InChI Key
Not Available
InChI
Not Available
IUPAC Name
Not Available
SMILES
Not Available

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
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
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
DrugInteraction
(4R)-limonene(4R)-limonene may increase the anticoagulant activities of Dextran.
AbciximabDextran may increase the anticoagulant activities of Abciximab.
AceclofenacAceclofenac may increase the anticoagulant activities of Dextran.
AcemetacinThe risk or severity of bleeding can be increased when Dextran is combined with Acemetacin.
AcenocoumarolAcenocoumarol may increase the anticoagulant activities of Dextran.
AcetaminophenAcetaminophen may decrease the excretion rate of Dextran which could result in a higher serum level.
Acetylsalicylic acidThe risk or severity of bleeding can be increased when Dextran is combined with Acetylsalicylic acid.
AcyclovirAcyclovir may decrease the excretion rate of Dextran which could result in a higher serum level.
Adefovir DipivoxilAdefovir Dipivoxil may decrease the excretion rate of Dextran which could result in a higher serum level.
AlclofenacAlclofenac may increase the anticoagulant activities of Dextran.
Food Interactions
Not Available

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]
External Links
KEGG Drug
D00060
KEGG Compound
C00372
PubChem Substance
347910421
Wikipedia
Dextran
ATC Codes
B05AA05 — Dextran
MSDS
Download (39.4 KB)

Clinical Trials

Clinical Trials
PhaseStatusPurposeConditionsCount
1, 2RecruitingPreventionKeratolysis1
2CompletedTreatmentConjunctivitis, Seasonal Allergic1
2, 3CompletedTreatmentAKI / Liver Cirrhosis1
3Active Not RecruitingTreatmentCorneal Ectasia / Keratoconus1
3Active Not RecruitingTreatmentPhenylketonuria (PKU)1
3CompletedTreatmentConjunctivitis, Viral1
3CompletedTreatmentEye Dryness1
3Unknown StatusTreatmentAdenovirus / Conjunctivitis1
4CompletedTreatmentAnterior Uveitis (AU) / Cystoid Macular Edema1
4CompletedTreatmentConjunctivitis, Seasonal Allergic3
4TerminatedTreatmentSpontaneous Bacterial Peritonitis (SBP)1
4Unknown StatusDiagnosticEye Dryness1
4WithdrawnTreatmentDry Eye Syndrome (DES)1
Not AvailableCompletedPreventionEye Dryness1
Not AvailableCompletedTreatmentDry Eye Syndrome (DES)1
Not AvailableCompletedTreatmentEye Dryness1
Not AvailableCompletedTreatmentEye Dryness / Lipid Layer / Liposic / Tear Film / Tears Naturale Forte1
Not AvailableCompletedTreatmentIntraocular Pressure1
Not AvailableCompletedTreatmentMigraines1
Not AvailableRecruitingTreatmentAdenoviral Conjunctivitis / Conjunctivitis1
Not AvailableRecruitingTreatmentAge-related Cataract1
Not AvailableRecruitingTreatmentEye Dryness1
Not AvailableRecruitingTreatmentMeibomian Gland Dysfunction (MGD) / Sjögren's Syndrome2

Pharmacoeconomics

Manufacturers
Not Available
Packagers
Not Available
Dosage forms
FormRouteStrength
LiquidOphthalmic
SolutionOphthalmic
Injection, powder, lyophilized, for solutionIntravenous10 mg/1
SolutionIntravenous
Solution / dropsIntraocular
Injection, solutionIntravenous10 g/100mL
LiquidIntravenous
Kit
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

Taxonomy

Classification
Not classified

Drug created on October 26, 2015 10:05 / Updated on October 01, 2018 16:55