hetastarch

Generic Name: hetastarch (HET a starch)Brand Names: Hespan, Hextend

What is hetastarch?

Hetastarch (hydroxyethyl) is a plasma volume expander derived from natural sources of starch. It works by restoring blood plasma lost through severe bleeding.

Severe blood loss can decrease oxygen levels, which can lead to organ failure, brain damage, coma, and possibly death. Plasma is needed to circulate red blood cells that deliver oxygen throughout the body.

Hetastarch is used to treat hypovolemia (a decrease in the volume of circulating blood plasma), that can result from severe blood loss after surgery, injury, or other causes of bleeding.

Hetastarch also contains electrolytes (sodium, calcium potassium, magnesium) which are minerals essential for many functions in the body, including the brain and nervous system, heartbeat, and fluid balance.

Hetastarch may also be used for other purposes not listed in this medication guide.

What is the most important information I should know about hetastarch?

You should not be given this medication if you are allergic to hetastarch, or if you have a bleeding or blood clotting disorder, congestive heart failure, urination problems not caused by hypovolemia, or lactic acidosis.

Before you receive hetastarch, tell your doctor if you have kidney or liver disease, heart disease, congestive heart failure, diabetes, or an electrolyte imbalance.

Tell your doctor about all other medications you use, especially a blood thinner such as warfarin (Coumadin), steroid medications, digoxin (digitalis, Lanoxin), or a diuretic (water pill).

Tell your caregivers at once if you have a serious side effect such as chest pain, fast or slow heart rate, wheezing or gasping for breath, feeling like you might pass out, weak pulse, slow breathing (breathing may stop), pale skin, easy bruising, blood in your urine or stools, swelling in your hands or feet, unusual bleeding, or any bleeding that will not stop.

Rare but serious side effects may include unusual headache, vision or speech problems, mental changes, drooping eyelids, loss of feeling in your face, tremors, or trouble swallowing, or fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

What should I discuss with my health care provider before I receive hetastarch?

You should not be given this medication if you are allergic to hetastarch, or have certain conditions. Be sure your doctor knows if you have:

• a bleeding or blood clotting disorder;

• congestive heart failure;

• urination problems not caused by hypovolemia; or

• lactic acidosis.

Before you receive hetastarch, tell your doctor if you are allergic to any drugs, or if you have:

• kidney disease;

• liver disease;

• heart disease;

• congestive heart failure;

• diabetes;

• high potassium levels in your blood (hyperkalemia), or any other electrolyte imbalance; or

• if you are allergic to corn.

If you have any of these conditions, you may need a dose adjustment or special tests to safely receive hetastarch.

FDA pregnancy category C. This medication may be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether hetastarch passes into breast milk or if it could harm a nursing baby. Do not receive this medication without telling your doctor if you are breast-feeding a baby.

How is hetastarch given?

Hetastarch is given as an injection through a needle placed into a vein. You will receive this injection in a clinic or hospital setting. A doctor, nurse, or other healthcare professional will give you this medication.

To be sure hetastarch is helping your condition, your blood will need to be tested often. This will help your doctor determine how long to treat you with hetastarch.

What happens if I miss a dose?

Since hetastarch is given as needed by a healthcare professional, it is not likely that you will miss a dose.

What happens if I overdose?

Seek emergency medical attention if you think you have received too much of this medicine.

An overdose of hetastarch is not expected to produce life-threatening symptoms.

What should I avoid while receiving hetastarch?

Follow your doctor's instructions about any restrictions on food, beverages, or activity while you are receiving hetastarch.

Hetastarch side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat. Tell your caregivers at once if you have a serious side effect such as:

• chest pain, fast or slow heart rate;

• wheezing or gasping for breath, sweating, and anxiety;

• feeling like you might pass out;

• weak pulse, slow breathing (breathing may stop);

• pale skin, easy bruising, weakness, blood in your urine or stools;

• unusual bleeding, or any bleeding that will not stop;

• unusual headache, vision or speech problems, mental changes, drooping eyelids, loss of feeling in your face, tremors, or trouble swallowing;

• swelling in your hands or feet; or

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

Rare but serious side effects may include:

• unusual headache, vision or speech problems, mental changes;

• drooping eyelids, loss of feeling in your face, tremors, or trouble swallowing; or

• fever, sore throat, and headache with a severe blistering, peeling, and red skin rash.

Less serious side effects may include:

• mild itching or skin rash;

• cough or sneezing;

• warmth, redness, or tingly feeling under your skin;

• vomiting;

• swollen glands;

• headache;

• muscle pain; or

• flu symptoms.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect hetastarch?

Before you receive hetastarch, tell your doctor if you are also using:

• a blood thinner such as warfarin (Coumadin);

• steroids (prednisolone and others);

• corticotropin (Acthar, ACTH);

• digoxin (digitalis, Lanoxin); or

• a diuretic (water pill) such as amiloride (Midamor, Moduretic), spironolactone (Aldactone, Aldactazide), or triamterene (Dyrenium, Dyazide, Maxzide).

This list is not complete and there may be other drugs that can interact with hetastarch. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

• Your doctor or pharmacist can provide more information about hetastarch.

• Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2006 Cerner Multum, Inc. Version: 1.02. Revision Date: 4/12/2009 4:39:59 PM.