Accusol 35 solution for hemofiltration, hemodialysis and hemodiafiltration
SpainTable of Contents
- Package leaflet: Information for the user
- Introduction
- 1. What Accusol 35 is and what it is used for
- 2. What you need to know before Accusol 35 is administered to you
- 3. How Accusol 35 will be administered to you
- 4. Possible adverse effects
- 5. Storage of Accusol 35
- 6. Contents of the container and other information
Package leaflet: Information for the user
Introduction
Package leaflet: information for the user
Accusol 35, solution for haemofiltration, haemodialysis and haemodiafiltration
Read all of this leaflet carefully before you are given this medicine, because it contains important information for you.
- Keep this leaflet, as you may need to read it again.
- If you have any questions, ask your doctor.
- If you experience any side effects, talk to your doctor, even if it is a side effect not listed in this leaflet. See section 4.
Contents of this leaflet
- What Accusol 35 is and what it is used for
- What you need to know before you are given Accusol 35
- How Accusol 35 is given to you
- Possible side effects
- How to store Accusol 35
- Contents of the pack and other information
1. What Accusol 35 is and what it is used for
Accusol 35 is a solution for hemofiltration, hemodialysis, and hemodiafiltration.
Accusol 35 is indicated in patients with acute or chronic renal failure.
It removes waste products from the blood; corrects acidosis or alkalinity and abnormal levels of salts in the blood. As a replacement solution in hemodiafiltration and hemofiltration, it may also be used to supply salts and water for hydration.
Accusol 35 solutions are supplied in a dual-compartment (bicompartimental) bag that does not contain PVC. A long seal (inter-chamber seal) separates the two compartments. Prior to use, the solutions from the two chambers of Accusol 35 must first be mixed by opening the long seal (inter-chamber seal), followed by opening the short SafetyMoon seal located near the access port.
Accusol 35 is especially indicated when you have high levels of potassium.
Accusol 35 solutions must only be used under the supervision of a physician.
2. What you need to know before Accusol 35 is administered to you
The doctor will ensure that there is adequate access to the bloodstream to perform the procedure and that there is no risk of bleeding.
Accusol 35 solutions are available in different concentrations of potassium and glucose. Blood levels of potassium and glucose will be carefully checked to ensure that the most appropriate formulation of Accusol 35 is used.
Your doctor must not administer Accusol 35 if you:
- do not have adequate venous and/or arterial access
- are at high risk of bleeding
- have high blood bicarbonate levels
- have very low blood potassium levels, unless you are simultaneously receiving potassium supplementation
- have a medical condition in which blood acidity or alkalinity levels may worsen
- have a kidney disorder in which waste products cannot be removed from the blood by hemofiltration
Warnings and precautions
Accusol 35 must only be used by or under the supervision of a physician experienced in hemofiltration, hemodialysis, or hemodiafiltration techniques.
Your doctor will:
- measure the acidity, electrolyte levels, and waste product levels in your blood
- ensure that these levels are correct and monitor them closely during treatment
- ensure that your body's fluid balance is properly maintained
- closely monitor your blood glucose levels, especially if you are diabetic
- regularly measure the potassium level in your blood
- ensure, before use, that the contents of both chambers are mixed by opening the long seal (the seal between the chambers), followed by opening the short SafetyMoon seal located near the access port. If your doctor administers an unmixed solution, your blood bicarbonate level may rise. This could cause adverse effects such as nausea, drowsiness, headache, heart rhythm disturbances, and difficulty breathing.
Other medicines and Accusol 35
Inform your doctor if you are taking, have recently taken, or might need to take any other medicines.
The administration of Accusol 35 may affect the action of other medicines.
- If you are taking vitamin D or other medicines containing calcium, your blood calcium levels may be altered.
- If you are taking additional sodium bicarbonate, there is an increased risk of developing abnormal levels of salts and alkali (alkalosis) in your blood.
- If you are taking certain heart medications called cardiac glycosides, you may require potassium supplements. Your doctor will monitor you closely during treatment.
Pregnancy and breastfeeding
Inform your doctor if you are pregnant or breastfeeding. Your doctor must evaluate the benefits of using Accusol 35 against the potential risks.
3. How Accusol 35 will be administered to you
Depending on your treatment, your doctor will administer Accusol 35 through the tubing of the dialysis machine.
The hemofiltration, hemodialysis, or hemodiafiltration treatment you receive will depend on your clinical condition, physical examination, laboratory test results, and response to treatment.
Your doctor will determine the appropriate formulation and amount of Accusol 35 solution for your clinical condition.
Dosage and frequency
Your doctor will decide and adjust the volume and rate of administration of the solution to be infused.
The amount of fluid required will depend on how Accusol is used.
If you are an adult or elderly patient and
- you are being treated with Accusol 35 as a replacement solution due to chronic renal failure, you should be administered 7 to 35 ml/kg/h or more
- you are being treated with Accusol 35 as a replacement solution due to acute renal failure, you should be administered 20 to 35 ml/kg/h or more
- you are being treated with Accusol 35 as a dialysis solution due to chronic or acute renal failure, the amount of solution should be determined according to the frequency and duration of treatment.
4. Possible adverse effects
Like all medicines, this medicine can cause adverse effects, although not everyone experiences them.
Rare possible adverse effects of Accusol 35 Potassium 4 mmol/l (occurring in less than 1 in 1,000 patients) include:
??Low blood glucose levels (hypoglycaemia).
You may experience other adverse effects. These adverse effects may not all be due to the solutions or treatment. Possible adverse effects that may occur include:
??Decrease (hypovolaemia) or increase (hypervolaemia) in body fluid volume
??Decrease (hypotension) or increase (hypertension) in blood pressure
??Very low levels of phosphate in the blood (hypophosphataemia)
??Alterations in blood alkali levels (alkalosis)
??Dizziness
??Vomiting
??Muscle cramps
??Bleeding disorder
??Infection
??Difficulty breathing, irregular breathing (caused by air bubbles in the bloodstream)
??Changes in levels of different blood electrolytes (e.g. changes in sodium, potassium, calcium in blood)
??Increased blood coagulation
Reporting of adverse effects
If you experience any adverse effects, consult your doctor, even if they are possible adverse effects not listed in this leaflet. You may also report them directly via the Spanish Pharmacovigilance System for Human Medicinal Products:
www.notificaRAM.es
5. Storage of Accusol 35
Keep this medicine out of sight and reach of children.
Do not refrigerate or freeze.
Do not use this medicine after the expiry date stated on the label and on the packaging after EXP. The expiry date refers to the last day of the month indicated.
Your doctor will not use Accusol 35 if the solution is not clear or if the container is damaged.
Medicines must not be disposed of via wastewater drains or household waste. Dispose of unused medicines and their containers at the SIGRE Point in your pharmacy. If you are unsure, ask your pharmacist how to dispose of medicines and containers you no longer need. This will help protect the environment.
6. Contents of the container and other information
Name of the medicine
Accusol 35, solution for hemofiltration, hemodialysis, and hemodiafiltration.
Composition of Accusol 35 solution:
Composition | Per 1000 ml Accusol 35 |
Large chamber 'A' | |
Calcium chloride dihydrate | 0.343 g |
Magnesium chloride hexahydrate | 0.136 g |
Sodium chloride | 7.52 g |
Large chamber 'B' | |
Sodium bicarbonate | 13.4 g |
The final 5000 ml solution results from mixing 3750 ml of solution 'A' with 1250 ml of solution 'B'.
Ionic composition of the final solution:
Per 1000 ml Accusol 35 | |
Calcium (Calcium++) | 1.75 mmol |
Magnesium (Mg++) | 0.5 mmol |
Sodium (Na+) | 140 mmol |
Chloride (Cl-) | 109.3 mmol |
Bicarbonate (HCO3-) | 35 mmol |
Theoretical osmolarity | 287 mOsm/L |
The other components are: water for injections, hydrochloric acid, sodium hydroxide and disodium phosphate dihydrate.
Appearance of Accusol 35 and contents of the pack
Accusol 35 is supplied in a cardboard box containing two 5-litre dual-chamber bags that do not contain PVC.
Each bag is wrapped in an overpouch.
The solution in the bag is clear and colourless.
Marketing Authorization Holder:
Nikkiso Belgium
Industriepark 6
3300 Tienen
Belgium
Local Representative:
Palex Medical S.A.
Jesus Serra Santamans, 5
08174 Sant Cugat del Valles
Spain
Manufacturer:
Baxter Healthcare S.A.
Moneen Road
Castlebar
County Mayo – Ireland
or
Serumwerk Bernburg AG
Hallesche Landstrasse 105b
06406 Bernburg
Germany
Date of the most recent review of this leaflet: 07/2018
Detailed and up-to-date information on this medicinal product is available on the website of the Spanish Agency of Medicines and Medical Devices (AEMPS) http://www.aemps.gob.es/
Accusol is a registered trademark of Nikkiso International Inc.