Friday, October 21, 2016

Plasmanate





Dosage Form: injection, solution
Plasma Protein Fraction (Human) 5%, USP

Plasmanate®

Plasmanate Description


This product has been prepared from large pools of human plasma. Each 100 mL of Plasma Protein Fraction (Human) 5%, USP—Plasmanate® contains 5 g selected plasma proteins buffered with sodium carbonate and stabilized with 0.004 M sodium caprylate and 0.004 M acetyltryptophan. The plasma proteins consist of approximately 88% normal human albumin, 12% alpha and beta globulins and not more than 1% gamma globulin as determined by electrophoresis.[1] The concentration of these proteins is such that this solution is iso-oncotic with normal human plasma and is isotonic. The approximate concentrations of the significant electrolytes in Plasmanate are: sodium 145 mEq/L, potassium 0.25 mEq/L, and chloride 100 mEq/L. Plasmanate must be administered intravenously.


This product is designed to bring to the medical profession a preparation derived from human blood and similar to human plasma. Each vial of Plasmanate is sterile and heat-treated at 60°C for 10 hours against the possibility of transmitting the hepatitis viruses.


The blood group agglutinins and agglutinogens A and B are at such a low level in Plasmanate solution that its use has no effect on routine blood typing procedures. No chemical or microscopic alterations of the urine have been observed with its use.


Additionally, the manufacturing process was investigated for its capacity to decrease the infectivity of an experimental agent of transmissible spongiform encephalopathy (TSE), considered as a model for the variant Creutzfeldt-Jakob disease (vCJD) and Creutzfeldt-Jakob disease (CJD) agents.[5-8] The production steps from Pooled Plasma to Effluent IV‑1 in the Plasmanate manufacturing process have been shown to decrease TSE infectivity of that experimental model agent (a total of ≥ 7.0 logs). These studies provide reasonable assurance that low levels of vCJD/CJD agent infectivity, if present in the starting material, would be removed.



Plasmanate - Clinical Pharmacology


In normal human volunteers, Plasmanate has resulted in an increased blood volume which has lasted up to 48 hours.[2] Clinical experience has indicated that it is an adequate replacement for human plasma in the treatment of shock and is a suitable means of providing human proteins for their osmotic effect.



Indications and Usage for Plasmanate


Treatment of Shock — Plasmanate is indicated in the treatment of shock due to burns, crushing injuries, abdominal emergencies, and any other cause where there is a predominant loss of plasma fluids and not red blood cells. It is also effective in the emergency treatment of shock due to hemorrhage.[3,4] Following the emergency phase of therapy, blood transfusions may be indicated depending on the severity of the blood loss.


In infants and small children, Plasmanate has been found to be very useful in the initial therapy of shock due to dehydration and infection.



Contraindications


Plasmanate is contraindicated for use in patients on cardiopulmonary bypass. Severe hypotension has been reported in such patients when given Plasma Protein Fraction.[4] 


Plasma Protein Fraction is contraindicated in patients with severe anemia, congestive heart failure, or increased blood volume.



Warnings


Plasmanate is made from human plasma. Products made from human plasma may contain infectious agents, such as viruses, and, theoretically, the Creutzfeldt-Jakob Disease (CJD) agent that can cause disease. The risk that such products will transmit an infectious agent has been reduced by screening plasma donors for prior exposure to certain viruses, by testing for the presence of certain current virus infections, and by inactivating and/or removing certain viruses. Despite these measures, such products can still potentially transmit disease. There is also the possibility that unknown infectious agents may be present in such products. Individuals who receive infusions of blood or plasma products may develop signs and/or symptoms of some viral infections, particularly hepatitis C. ALL infections thought by a physician possibly to have been transmitted by this product should be reported by the physician or other healthcare provider to Talecris Biotherapeutics, Inc. [1-800-520-2807].


The physician should discuss the risks and benefits of this product with the patient, before prescribing or administering it to the patient.


Solutions which are turbid or which have been frozen should not be used. Do not use if turbid. Do not begin administration more than 4 hours after the container has been entered. Partially used vials must be discarded. Vials which are cracked or which have been previously entered or damaged should not be used, as this may have allowed the entry of microorganisms. Plasmanate contains no preservative.



Precautions



General


Rapid infusion of Plasma Protein Fraction (Human) 5%, USP—Plasmanate® (greater than 10mL/minute) has produced hypotension in patients undergoing surgery or in the preoperative or postoperative period. Blood pressure should be monitored during use and infusion slowed or ceased if sudden hypotension occurs.


Plasmanate does not provide coagulation factors and therefore does not correct coagulation disorders.



Drug Interactions


Plasmanate is compatible with whole blood, packed red cells as well as the standard carbohydrate and electrolyte solutions intended for intravenous use. It should, however, not be mixed with protein hydrolysates or solutions containing alcohol.



Pregnancy Category C


Animal reproduction studies have not been conducted with Plasmanate. It is also not known if Plasmanate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Plasmanate should be given to a pregnant woman only if clearly needed.



Pediatric Use


Safety and effectiveness in the pediatric population have not been established.



Adverse Reactions


Hypotension may occur, particularly following rapid infusion or intraarterial administration to patients on cardiopulmonary bypass. The blood pressure may normalize spontaneously after the slowing or discontinuation of the infusion. Vasopressors will also correct the hypotension.


Flushing, urticaria, back pain, nausea and headache have been occasionally reported by conscious patients.



Plasmanate Dosage and Administration


Dosage is based almost entirely on the nature of the individual case and response to therapy. The usual minimum effective dose in adults is 250–500 mL. As with any plasma expander, the rate should be adjusted or slowed according to the clinical response and rising blood pressure.


Administration should be by vein and preferably through an area of skin at some distance from any site of infection or trauma. Plasmanate is compatible with the usual carbohydrate and electrolyte solutions.


We recommend the following procedure: First swab the stopper with Iodine Tincture, USP followed by a sterile antiseptic swab.


Parenteral drug products should be inspected visually for particulate matter and discol­oration prior to administration, whenever solution and container permit.


Only 16 gauge needles or dispensing pins should be used with 20 mL vial sizes and larger. Needles or dispensing pins should only be inserted within the stopper area delineated by the raised ring. The stopper should be penetrated perpendicular to the plane of the stopper within the ring.


A number of factors beyond our control could reduce the efficacy of this product or even result in an ill effect following its use. These include improper storage and handling of the product after it leaves our hands, diagnosis, dosage, method of administration, and biological differences in individual patients. Because of these factors, it is important that this product be stored properly and that the directions be followed carefully during use.



How is Plasmanate Supplied


Plasmanate is available in 50 mL pediatric size, 250 mL and 500 mL rubber-stoppered vials. Each single dose vial contains plasma protein in the following approximate amounts:














NDC NumberSizeGrams Protein
13533-613-2050 mL2.5
13533-613-25250 mL12.5
13533-613-27500 mL25.0

STORAGE


Store at room temperature not exceeding 30°C (86°F). Solution that has been frozen should not be used. Do not use after expiration date.



CAUTION


Rx only


U.S. federal law prohibits dispensing without prescription.



REFERENCES


  1. Hink JH Jr, Hidalgo J, Seeberg VP, et al: Preparation and properties of a heat-treated human plasma protein fraction. Vox Sang 2:174–86, 1957.

  2. Bertrand JJ, Feichtmeir TV, Kolomeyer N, et al: Clinical investigations with a heat-treated plasma protein fraction—Plasmanate®Vox Sang 4:385–402, 1959.

  3. Tullis JL: Albumin. 1. Background and use. 2. Guidelines for clinical use. JAMA 237:355–60; 460–3, 1977.

  4. Bland JHL, Laver MB, Lowenstein E: Vasodilator effect of commercial 5% plasma protein fraction solutions. JAMA 224:1721 –4, 1973.

  5. Stenland CJ, Lee DC, Brown P, et al: Partitioning of human and sheep forms of the pathogenic prion protein during the purification of therapeutic proteins from human plasma. Transfusion 2002. 42(11):1497-500.

  6. Lee DC, Stenland CJ, Miller JL, et al: A direct relationship between the partitioning of the pathogenic prion protein and transmissible spongiform encephalopathy infectivity during the purification of plasma proteins. Transfusion 2001. 41(4):449-55.

  7. Lee DC, Stenland CJ, Hartwell RC, et al: Monitoring plasma processing steps with a sensitive Western blot assay for the detection of the prion protein. J Virol Methods 2000. 84(1):77-89.

  8. Cai K, Miller JL, Stenland CJ, et al: Solvent-dependent precipitation of prion protein. Biochim Biophys Acta 2002. 1597(1):28-35.

08940018 (Rev. April 2010)




Talecris Biotherapeutics, Inc.

Research Triangle Park, NC27709USA

U.S. License No. 1716



PACKAGE LABEL



Plasma Protein

Fraction (Human)

5%, USP


Plasmanate®


Heated 60°C 10 hours


For Intravenous Use Only


Each 100 mL contains 5 g selected plasma proteins buffered with sodium carbonate and stabilized with 0.004 M sodium caprylate and 0.004 M acetyltryptophan. No preservative. Volumne for volumn, osmotically equivalent to plasma.


DO NOT USE IF TURBID. DO NOT BEGIN ADMINISTRATION MORE THAN 4 HOURS AFTER THE CONTAINER HAS BEEN ENTERED.


50 mL


Talecris Biotherapeutics


NDC 13533-613-20


The patient and physician should discuss the risks and benefits of this product.


Dosage and Administration: Read enclosed package insert.


Store at room temperature not exceeding 30°C (86°F). Do not freeze.


Single Dose Vial


Discard any unused contents.


Approximate significant electrolytes per liter: 


Sodium 145 mEq

Potassium 0.25 mEq

Chloride 100 mEq


If the shrink band is absent or shows any sign of tampering, do not use the product and notify Talecris Biotherapeutics, Inc. immediately.


Not returnable for credit or exchange


CAUTION: U.S. federal law prohibits dispensing without prescription.


Rx only


08908608


Talecris Biotherapeutics, Inc.

Research Triangle Park,

NC 27709 USA

U.S. License No. 1716









Plasmanate  
plasma protein fraction (human)  solution










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)13533-613
Route of AdministrationINTRAVENOUSDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
Albumin (human) (Albumin (human))Albumin (human)2.5 g  in 50 mL





Inactive Ingredients
Ingredient NameStrength
No Inactive Ingredients Found


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      






























Packaging
#NDCPackage DescriptionMultilevel Packaging
113533-613-201 VIAL In 1 CARTONcontains a VIAL
150 mL In 1 VIALThis package is contained within the CARTON (13533-613-20)
213533-613-251 VIAL In 1 CARTONcontains a VIAL
2250 mL In 1 VIALThis package is contained within the CARTON (13533-613-25)
313533-613-271 VIAL In 1 CARTONcontains a VIAL
3500 mL In 1 VIALThis package is contained within the CARTON (13533-613-27)










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
BLABLA10114010/02/1958


Labeler - TALECRIS BIOTHERAPEUTICS, INC. (839731507)









Establishment
NameAddressID/FEIOperations
TALECRIS BIOTHERAPEUTICS HOLDINGS CORP611019113MANUFACTURE
Revised: 04/2010TALECRIS BIOTHERAPEUTICS, INC.

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