Magnesium Chloride, Dextrose Anhydrous, Lactic Acid, Sodium Chloride, Sodium Bicarbonate, And Potassium Chloride
FDA Drug Information • Also known as: Prismasol B22Gk4/0, Prismasol Bgk2/0, Prismasol Bgk4/0/1.2
- Brand Names
- Prismasol B22Gk4/0, Prismasol Bgk2/0, Prismasol Bgk4/0/1.2
- Route
- INTRAVENOUS
- Dosage Form
- INJECTION
- Product Type
- HUMAN PRESCRIPTION DRUG
Description
11 DESCRIPTION PRISMASOL and PHOXILLUM solutions are clear, sterile, free of bacterial endotoxins and contain no bacteriostatic or antimicrobial agents. These solutions are used in Continuous Renal Replacement Therapies (CRRT) as a replacement solution in hemofiltration and hemodiafiltration. Depending on the product (see Table 2 ), the two compartments contain: Calcium chloride, USP, is chemically designated calcium chloride dihydrate (CaCl 2
What Is Magnesium Chloride, Dextrose Anhydrous, Lactic Acid, Sodium Chloride, Sodium Bicarbonate, And Potassium Chloride Used For?
1 INDICATIONS AND USAGE PRISMASOL and PHOXILLUM solutions are indicated in pediatric and adult patients for use as a replacement solution in Continuous Renal Replacement Therapy (CRRT) to replace plasma volume removed by ultrafiltration and to correct electrolyte and acid-base imbalances. They may also be used in case of drug poisoning when CRRT is used to remove dialyzable substances. PRISMASOL and PHOXILLUM solutions are indicated: As a replacement solution in Continuous Renal Replacement Therapy (CRRT) and in case of drug poisoning when CRRT is used to remove dialyzable substances ( 1 )
Dosage and Administration
2 DOSAGE AND ADMINISTRATION Therapy must be individualized based on the patient's clinical condition, fluid, electrolyte, acid-base and glucose balance ( 2.2 ) Solution must be mixed prior to use ( 2.2 ) Use only with extracorporeal dialysis equipment appropriate for CRRT ( 2.3 ) 2.1 Administration Instructions Visually inspect PRISMASOL and PHOXILLUM for particulate matter and discoloration prior to administration. Administration should only be under the direction of a physician competent in intensive care treatment including CRRT. Use only with extracorporeal dialysis equipment appropriate for CRRT. The prepared solution is for single patient use only. Aseptic technique should be used throughout administration to the patient. Discard any unused solution. 2.2 Dosing Considerations PRISMASOL replacement solutions contain 4 different combinations of active ingredients (7 different products with varying ingredient amounts). PHOXILLUM replacement solutions contain 2 different combinations of active ingredients (2 different products with varying ingredient amounts). PRISMASOL and PHOXILLUM are supplied in a two-compartment bag that must be mixed immediately prior to use [see Dosage and Administration (2.3) ]: Small compartment A (250 mL) containing an electrolyte solution, and Large compartment B (4750 mL) containing the buffer solution. See Table 1 for the concentrations of the active ingredients (after mixing) in these 9 different replacement solutions (total volume is 5 Liters). Table 1: Concentrations of Active Ingredients in the 7 PRISMASOL and 2 PHOXILLUM Replacement Solutions after Mixing Ca 2+ mEq/L HCO 3 - mEq/L K + mEq/L Mg 2+ mEq/L Na + mEq/L HPO 4 2- mmol/L Cl - mEq/L Lactate mEq/L Dextrose mg/dL Osmolarity mOsm/L Ca 2+ = calcium, HCO 3 - = bicarbonate, K + = potassium, Mg 2+ = magnesium, Na + = sodium, HPO 4 2- = phosphate, Cl- = chloride; osmolarity is estimated PRISMASOL Replacement Solutions BGK0/2.5 2.5 32 0 1.5 140 0 109 3 100 292 BGK4/2.5 2.5 32 4 1.5 140 0 113 3 100 300 BGK2/3.5 3.5 32 2 1 140 0 111.5 3 100 296 BGK2/0 0 32 2 1 140 0 108 3 100 291 B22GK4/0 0 22 4 1.5 140 0 120.5 3 100 296 BGK4/0/1.2 0 32 4 1.2 140 0 110.2 3 100 295 BK0/0/1.2 0 32 0 1.2 140 0 106.2 3 0 282 PHOXILLUM Replacement Solutions BK4/2.5 2.5 32 4 1.5 140 1 114.5 0 0 294 B22K4/0 0 22 4 1.5 140 1 122 0 0 290 The mode of therapy, solute formulation, flow rates, and length of PRISMASOL and PHOXILLUM replacement therapy in CRRT should be established by a physician based on the patient’s clinical condition, blood concentration of phosphate and other electrolytes, acid-base and glucose balance. Administer either PRISMASOL or PHOXILLUM into the extracorporeal circuit: Before (pre-dilution) the hemofilter or hemodiafilter, After (post-dilution) the hemofilter or hemodiafilter, or Before and after the hemofilter or hemodiafilter. 2.3 Preparing the Solution Use only if the overwrap is not damaged, all seals are intact, peel seal is not broken, and the solution is...
Side Effects (Adverse Reactions)
6 ADVERSE REACTIONS The following adverse reactions have been identified during postapproval use with these or other similar products and therefore may occur with use of PHOXILLUM or PRISMASOL. Because these reactions are reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure. Metabolic acidosis Hypotension Acid-base disorders Electrolyte imbalance including calcium ionized increased (reported in PRISMASOL solutions containing calcium), hyperphosphatemia, and hypophosphatemia Fluid imbalance
Drug Interactions
7 DRUG INTERACTIONS As with the use of other replacement solutions, blood concentrations of dialyzable drugs may be reduced by CRRT due to their removal by the hemofilter or hemodiafilter. The blood concentrations of certain drugs may need to be monitored and appropriate therapy implemented to correct for removal during treatment. 7.1 Citrate When used as an anticoagulant, citrate contributes to the overall buffer load and can reduce plasma calcium levels. Select the PRISMASOL/PHOXILLUM formulation(s) accordingly.
Contraindications
4 CONTRAINDICATIONS PHOXILLUM and PRISMASOL replacement solutions are contraindicated in patients with known hypersensitivities to these products. Known hypersensitivities to PRISMASOL and PHOXILLUM solutions ( 4 )
Pregnancy and Breastfeeding
8.1 Pregnancy Risk Summary PRISMASOL and PHOXILLUM are pharmacologically inactive solutions. While there are no adequate and well controlled studies in pregnant women, appropriate administration of PRISMASOL and PHOXILLUM solutions with monitoring of fluid, electrolyte, acid-base and glucose balance, is not expected to cause fetal harm. Animal reproduction studies have not been conducted with PRISMASOL and PHOXILLUM solutions. The estimated background risk of major birth defects and miscarriage for the indicated population are unknown. All pregnancies have a background risk of birth defect, loss or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively. Clinical Considerations Maintenance of normal acid-base balance is important for fetal well-being.
How Supplied
16 HOW SUPPLIED/STORAGE AND HANDLING PRISMASOL and PHOXILLUM solutions are supplied in a two-compartment bag made of polyolefin. The 5000 mL bag is composed of a small compartment (250 mL) and a large compartment (4750 mL). The two compartments are separated by a peel seal. The bag is overwrapped with a transparent overwrap. See Table 2 for the concentrations of the active ingredients in each compartment for each product [see Description (11) ]. Container Fill Volume NDC PRISMASOL Solutions PRISMASOL BGK0/2.5 5000 mL 24571-108-06 PRISMASOL BGK4/2.5 5000 mL 24571-105-06 PRISMASOL BGK2/3.5 5000 mL 24571-103-06 PRISMASOL BGK2/0 5000 mL 24571-102-06 PRISMASOL B22GK4/0 5000 mL 24571-111-06 PRISMASOL BK0/0/1.2 5000 mL 24571-113-06 PRISMASOL BGK4/0/1.2 5000 mL 24571-114-06 PHOXILLUM Solutions PHOXILLUM BK4/2.5 5000 mL 24571-116-06 PHOXILLUM B22K4/0 5000 mL 24571-117-06 Not all formulations may be marketed. Storage conditions Store at 20°C to 25°C (68°F to 77°F); excursions permitted to 15ºC to 30ºC (59ºF to 86ºF). [See USP Controlled Room Temperature] Do not freeze or expose to excessive heat. Do not use if precipitate has formed or if container seals have been damaged. Manufactured for: Vantive US Healthcare LLC One Baxter Parkway Deerfield, Illinois 60015 07-19-00-8247 Vantive, Phoxillum and PrismaSol are trademarks of Vantive Health Inc., or its subsidiaries
About This Information
This drug information is sourced from FDA-approved labeling via the openFDA database. It is intended for educational and reference purposes only. This is not medical advice. Always consult your healthcare provider before making decisions about medication. Drug information may be updated by the FDA; check with your pharmacist for the most current information.
What are side effects?
Side effects are unwanted reactions that can occur when taking a medication. They range from mild (headache, nausea) to severe (allergic reactions, organ damage). Not everyone experiences side effects, and severity varies. Report any concerning side effects to your doctor.
What are drug interactions?
Drug interactions occur when a medication is affected by another drug, food, or supplement. Interactions can make medications less effective or cause dangerous side effects. Always tell your doctor about all medications and supplements you take.