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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
6% Hetastarch In 0.9% Sodium Chloride
Brand Name
6% Hetastarch In 0.9% Sodium Chloride
Generic Name
6% Hetastarch In 0.9% Sodium Chloride
Active Ingredient
HetastarchCategory
Plasma Volume Expander [EPC]
Variants
1
Different strengths and dosage forms
| Strength | Form | Route | NDC |
|---|---|---|---|
| 6 g/100mL | INJECTION, SOLUTION | INTRAVENOUS | 51662-1317 |
Detailed information about 6% Hetastarch In 0.9% Sodium Chloride
References used for this content
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for 6% Hetastarch In 0.9% Sodium Chloride, you must consult a qualified healthcare professional.
Hetastarch is a synthetic colloid and plasma volume expander used to treat or prevent hypovolemia (low blood volume) and as an adjunct in leukapheresis procedures.
The dosage of Hetastarch is highly individualized and must be determined by a healthcare provider based on the patient's clinical status, heart rate, blood pressure, and central venous pressure.
The safety and effectiveness of Hetastarch in children have not been established through large-scale clinical trials. While it has been used in pediatric emergency settings, there are no standardized FDA-approved dosing guidelines for children. Healthcare providers usually calculate doses based on body weight (e.g., 10 mL/kg) and monitor the child extremely closely for signs of fluid overload or allergic reactions. Most clinicians prefer using albumin or crystalloids in pediatric patients unless those options are unavailable or ineffective.
Hetastarch is contraindicated (must not be used) in patients with severe renal failure or oliguria (low urine output) not related to low blood volume. In patients with mild to moderate kidney dysfunction, the dose must be reduced significantly, and the rate of infusion slowed. Because Hetastarch is partially cleared by the kidneys, accumulation can lead to further kidney damage.
While Hetastarch does not undergo significant hepatic metabolism, patients with severe liver disease (such as cirrhosis) are at high risk for fluid overload and coagulopathy (clotting disorders). Dosing should be conservative, and clotting factors must be monitored.
Elderly patients are at a higher risk for congestive heart failure and renal insufficiency. Healthcare providers typically start at the lower end of the dosing range and monitor heart and lung sounds frequently to prevent pulmonary edema (fluid in the lungs).
Hetastarch is never self-administered. It is given only by a healthcare professional (nurse or doctor) via an intravenous (IV) line.
Because Hetastarch is administered in a controlled clinical environment for acute conditions, missed doses are not applicable in the traditional sense. The infusion is continued until the patient's blood volume is stabilized.
An overdose of Hetastarch primarily manifests as fluid overload.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance. The clinical team will monitor your vital signs continuously during the infusion.
While Hetastarch is generally used in emergency settings, several side effects are frequently observed:
> Warning: Stop taking Hetastarch and call your doctor immediately if you experience any of these.
The primary long-term concern with Hetastarch is its persistence in body tissues. Because the large molecules are difficult for the body to break down, they can remain in the skin, liver, and spleen for months. This can lead to chronic itching (pruritus) or, in rare cases, long-term alterations in organ function. There is no known 'antidote' to remove stored Hetastarch from the tissues; the body must slowly degrade it over time.
Hetastarch carries a prominent FDA Black Box Warning regarding its use in critically ill patients.
Report any unusual symptoms to your healthcare provider. Even delayed symptoms like itching should be reported, as they may be linked to your prior Hetastarch treatment.
Hetastarch is a potent medical intervention that carries significant risks alongside its life-saving benefits. It should only be used when crystalloid solutions (like saline) are deemed insufficient for volume resuscitation. Patients with a history of heart failure or kidney disease must be evaluated with extreme caution. Because Hetastarch can affect blood clotting, it is not recommended for patients with known bleeding disorders or those undergoing major surgery where blood loss is already a significant concern.
Patients receiving Hetastarch require intensive monitoring, including:
Hetastarch is administered in acute care settings to patients who are typically too ill to drive or operate machinery. However, if a patient is discharged shortly after receiving Hetastarch, they should be aware that lingering dizziness or weakness from their underlying condition (or the volume expansion) may impair their ability to drive safely.
There is no direct chemical interaction between Hetastarch and alcohol. However, alcohol can cause dehydration and affect blood pressure, which may complicate the management of the condition for which Hetastarch was prescribed. Alcohol should be avoided until the patient is fully recovered and cleared by a physician.
Hetastarch does not require a tapering period. However, once the infusion is stopped, the healthcare team must continue to monitor the patient for 'rebound' dehydration or delayed kidney injury. If the drug is stopped due to an allergic reaction or kidney failure, alternative volume expanders like albumin or crystalloids will be used.
> Important: Discuss all your medical conditions with your healthcare provider before starting Hetastarch. Ensure they are aware of any history of kidney disease, heart failure, or bleeding disorders.
There are no absolute drug-drug contraindications where Hetastarch and another drug create a lethal chemical reaction. However, Hetastarch is absolutely contraindicated in patients with certain clinical conditions (like sepsis), regardless of other medications being used. Using Hetastarch in a patient with sepsis who is also on nephrotoxic drugs (drugs that damage the kidneys) is considered a critical safety violation.
There are no known interactions between Hetastarch and specific foods, as the medication is administered intravenously. However, general nutritional status is important for recovery from the conditions requiring Hetastarch.
Patients should inform their doctors if they are taking herbal supplements that affect bleeding, such as:
These may exacerbate the coagulopathy (bleeding risk) associated with Hetastarch infusions.
Hetastarch can significantly interfere with certain laboratory tests:
For each major interaction, the management strategy involves clinical vigilance, dose adjustment of the secondary medication, or the selection of an alternative volume expander like albumin.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, especially those that affect your kidneys or your blood's ability to clot.
Hetastarch must NEVER be used in the following circumstances:
Conditions requiring careful risk-benefit analysis include:
Patients who have had allergic reactions to other starches (such as those used in other medical products or even certain food-grade starches in rare cases) may be at a higher risk for a reaction to Hetastarch. There is also a potential for cross-reactivity with other hydroxyethyl starch brands like Voluven or Hextend.
> Important: Your healthcare provider will evaluate your complete medical history, including your kidney function and heart health, before prescribing Hetastarch.
Hetastarch is classified as FDA Pregnancy Category C. This means that animal reproduction studies have shown an adverse effect on the fetus, or there are no adequate and well-controlled studies in humans. In animal studies, high doses of Hetastarch were associated with restricted fetal growth and skeletal variations.
In pregnant women, Hetastarch should only be used if the potential benefit justifies the potential risk to the fetus. It is generally reserved for life-threatening emergencies where other volume expanders are unavailable. There is a specific risk of anaphylactoid reactions in the mother, which could cause fetal distress due to maternal hypotension (low blood pressure).
It is not known whether Hetastarch is excreted in human milk. Because many drugs are excreted in human milk and because of the potential for serious adverse reactions in nursing infants, a decision should be made whether to discontinue nursing or to forgo the drug, taking into account the importance of the drug to the mother. Given that Hetastarch is typically used in acute, emergency settings, breastfeeding is usually paused until the mother is stable and the drug has cleared her system.
Hetastarch is not FDA-approved for use in the pediatric population. While it has been used 'off-label' in children, clinical data is insufficient to establish safety. Children are at a higher risk for fluid overload and electrolyte imbalances. If used, dosing must be strictly calculated based on weight, and the child must be monitored in an intensive care setting. Most pediatricians prefer using 5% Albumin or isotonic crystalloids for volume expansion in children.
Clinical studies of Hetastarch did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. However, elderly patients are more likely to have decreased renal, hepatic, or cardiac function and concomitant diseases. The risk of fluid overload and congestive heart failure is significantly higher in this group. Dose selection should be cautious, usually starting at the low end of the dosing range, and kidney function must be monitored closely.
Hetastarch is primarily eliminated by the kidneys. In patients with impaired renal function, the risk of toxic accumulation and further kidney injury (osmotic nephrosis) is greatly increased.
Patients with hepatic impairment are at increased risk for bleeding and fluid retention. Hetastarch does not treat the underlying protein deficiency (hypoalbuminemia) often found in liver disease. Use should be limited to acute volume expansion where no other options exist, with careful monitoring of coagulation parameters.
> Important: Special populations require individualized medical assessment and constant monitoring during and after Hetastarch administration.
Hetastarch is a large, complex polysaccharide molecule. Its primary mechanism is the exertional of colloid osmotic pressure. When injected into the vein, these large molecules cannot pass through the capillary pores. This creates an osmotic gradient that draws water from the interstitial space into the intravascular space.
Chemically, Hetastarch is a hydroxyethyl starch. The addition of hydroxyethyl groups to the glucose units of the starch molecule serves two purposes: it increases the solubility of the starch and, more importantly, it slows down the degradation of the molecule by the enzyme alpha-amylase. By 'shielding' the starch from enzymatic breakdown, the hydroxyethyl groups allow the molecule to remain in the blood for a duration sufficient to provide sustained volume expansion.
| Parameter | Value |
|---|---|
| Bioavailability | 100% (Intravenous) |
| Protein Binding | Negligible |
| Half-life | Biphasic: Initial 17 hours; Terminal >48 hours |
| Tmax | Immediate (End of infusion) |
| Metabolism | Plasma Alpha-Amylase (Hydrolysis) |
| Excretion | Renal (approx. 40% in 24h), Fecal (trace) |
Hetastarch is a Plasma Volume Expander and a Synthetic Colloid. It is grouped with other hydroxyethyl starches (HES) and is often compared to other colloids like human albumin or dextran. Unlike crystalloids (e.g., Normal Saline), which are simple salt solutions, Hetastarch provides 'oncotic' support to keep fluid within the circulatory system.
Common questions about 6% Hetastarch In 0.9% Sodium Chloride
Hetastarch is primarily used as a plasma volume expander to treat patients suffering from hypovolemia, which is a condition where the blood volume is dangerously low. This often occurs during major surgery, after severe trauma, or in cases of significant blood loss. By increasing the volume of fluid in the blood vessels, Hetastarch helps maintain blood pressure and ensures that vital organs receive enough oxygen and nutrients. It is also used during a procedure called leukapheresis to help separate white blood cells from the rest of the blood. It is important to note that it is only used when other simpler fluids like saline are not effective enough.
The most frequently reported side effect of Hetastarch is severe itching, known as pruritus, which can sometimes be delayed and occur weeks after the treatment. Other common side effects include a temporary thinning of the blood (hemodilution), which can lower the concentration of red blood cells. Some patients may also experience headaches, dizziness, or mild flu-like symptoms such as chills and fever shortly after the infusion. Swelling of the salivary glands, often called 'starch mumps,' is another unique but less common side effect. Because it expands blood volume, it can also lead to temporary swelling in the limbs or high blood pressure.
Alcohol should be avoided if you have recently received Hetastarch. While there is no direct chemical reaction between the two, alcohol is a diuretic that can cause dehydration and interfere with blood pressure regulation. Since Hetastarch is used to stabilize blood volume and pressure in critically ill or post-surgical patients, consuming alcohol can complicate the recovery process and mask signs of fluid imbalance. Furthermore, alcohol can affect blood clotting, which may add to the bleeding risks already associated with Hetastarch. Always wait until your doctor confirms that your blood volume and kidney function have fully stabilized before consuming alcohol.
Hetastarch is generally not recommended during pregnancy unless it is a life-threatening emergency where no other options are available. It is classified as Pregnancy Category C, meaning animal studies have shown potential harm to the fetus, but human data is limited. There are concerns that it could restrict fetal growth or cause skeletal issues if used in high doses. Additionally, if the mother has an allergic reaction to the drug, it could cause a sudden drop in blood pressure that deprives the baby of oxygen. Doctors will almost always prefer using safer alternatives like albumin or simple saline solutions for pregnant patients.
Hetastarch begins working almost immediately as it is infused directly into the bloodstream. As soon as the molecules enter the circulation, they begin pulling fluid from the surrounding tissues into the blood vessels through osmosis. Most patients will show an improvement in blood pressure and heart rate within minutes of starting the infusion. The maximum effect on blood volume is usually reached by the time the infusion is completed. This effect is sustained for quite a long time, typically lasting between 24 and 36 hours, which gives the body time to recover or for other treatments to take effect.
Hetastarch is given as a single or series of infusions in a hospital setting, so the concept of 'stopping' it like a daily pill doesn't apply. Once the desired blood volume is reached, the healthcare provider will simply stop the IV infusion. There is no physical withdrawal or need to taper the medication. However, after the infusion stops, medical staff will continue to monitor you closely for several hours or days. This is to ensure that your blood volume stays stable and that your kidneys are functioning correctly, as some side effects like kidney injury can appear after the drug has been stopped.
Because Hetastarch is administered by healthcare professionals in a clinical or emergency environment, it is virtually impossible for a patient to 'miss a dose.' The timing and amount of the infusion are carefully controlled by doctors and nurses based on real-time monitoring of your vital signs. If an infusion is delayed for some reason, the medical team will adjust the treatment plan accordingly to ensure your blood volume remains at a safe level. You do not need to worry about scheduling this medication yourself, as it is only used during acute medical situations.
Hetastarch can cause a temporary increase in weight due to fluid retention. Because the drug is designed to pull fluid into and hold it within the blood vessels, it increases the total amount of water in your body. In some cases, this fluid can leak into the tissues, causing visible swelling (edema) in the legs, ankles, or hands, which will reflect as an increase on the scale. This is not a gain in body fat, but rather 'water weight.' This usually resolves on its own as the kidneys gradually filter the starch and excess fluid out of your system over the days following the treatment.
Hetastarch can interact with several other medications, so it is vital that your doctor knows your full medication history. It is particularly risky when combined with blood thinners like aspirin, warfarin, or heparin, as it can further increase the risk of bleeding. It also poses a danger when used with other drugs that can stress the kidneys, such as certain antibiotics or high-dose anti-inflammatory drugs. While it is often used alongside life-saving medications like blood pressure supports (vasopressors), these combinations require very careful monitoring by hospital staff to prevent complications like heart strain or fluid overload.
Yes, Hetastarch is available as a generic injection. While it was originally known by brand names like Hespan, several manufacturers now produce generic versions of 6% Hetastarch in 0.9% Sodium Chloride. The generic versions are bioequivalent, meaning they work the same way and carry the same risks and benefits as the brand-name versions. Regardless of whether a brand or generic is used, the medication remains restricted to hospital and clinical use and is subject to the same strict FDA Black Box Warnings regarding its use in critically ill patients.
Other drugs with the same active ingredient (Hetastarch)