Products
Hydroxyethyl starch is commercially available as an infusion solution (HAES-sterile, HyperHAES, Venofundin, Voluven). It has been approved in many countries since 1983. Pharmaceutically, HES is also known as O-(hydroxyethyl)-amylopectini hydrolysatum.
Structure and properties
Hydroxyethyl starch is a hydroxyethylated starch derivative prepared from plant amylopectin. Amylopectin is the name given to a highly branched starch that resembles the body’s glycogen. Starch is itself a polymer of glucose. Why the addition of the hydroxylethyl groups? They increase water solubility, reduce degradation by amylases, and increase residence time in plasma.
Effects
Hydroxyethyl starch (ATC B05AA07) is a colloidal volume replacement agent that leads to an increase in plasma volume.
Indications
For prevention and treatment of volume deficiency (hypovolemia) and shock and for therapeutic blood thinning.
Dosage
According to the SmPC. Hydroxyethyl starch is administered as an intravenous infusion.
Contraindications
Hydroxyethyl starch is contraindicated in hypersensitivity, severe dehydration, renal failure, severe hypernatremia, severe hyperchloremia, dialysis treatment, severe congestive heart failure, hyperhydration, severe blood clotting disorders, and intracranial hemorrhage. For complete precautions, see the drug label.
Interactions
There are no known drug-drug interactions to date.
Adverse effects
Possible adverse effects include hypersensitivity reactions (including severe), refractory pruritus, pain in the renal area, and dilution of blood components (e.g., with clotting disorders).