Comparative Pharmacology
Head-to-head clinical analysis: DIANEAL 137 W DEXTROSE 2 5 IN PLASTIC CONTAINER versus EXTRANEAL.
Peer-Reviewed Evidence
Head-to-head clinical analysis: DIANEAL 137 W DEXTROSE 2 5 IN PLASTIC CONTAINER versus EXTRANEAL.
DIANEAL 137 W/ DEXTROSE 2.5% IN PLASTIC CONTAINER vs EXTRANEAL
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
Creates an osmotic gradient across the peritoneal membrane, facilitating ultrafiltration and diffusion of solutes (e.g., urea, creatinine, electrolytes) from blood into the dialysate, which is then drained.
Extraneal (icodextrin) is a glucose polymer that acts as an osmotic agent for peritoneal dialysis. It is absorbed from the peritoneal cavity into the bloodstream and metabolized to maltose and other oligosaccharides. Its primary mechanism is to create an osmotic gradient across the peritoneal membrane, facilitating ultrafiltration and removal of waste products.
Intraperitoneal (IP) administration: 2 liters per exchange, 4 exchanges daily, with dwell time of 4-6 hours. Dextrose concentration (2.5%) selected based on ultrafiltration needs.
7.5% solution: 2 L intraperitoneally, dwell time 4–8 hours, up to 4 exchanges per day. For automated peritoneal dialysis: 2 L per cycle, typically 3–5 cycles overnight.
None Documented
None Documented
Not applicable as a single entity; the dextrose component has a plasma half-life of approximately 15-20 minutes after absorption, reflecting rapid insulin-mediated clearance.
The terminal elimination half-life of icodextrin in plasma is approximately 19 hours (range 12-22 hours) following intraperitoneal administration for a dwell of 8-12 hours. This long half-life reflects slow metabolism and clearance, particularly relevant in patients with impaired renal function, leading to accumulation of maltose and other oligosaccharides.
Primarily excreted via peritoneal dialysis fluid removal; glucose is metabolized systemically. Renal excretion negligible as dialysis solution is not absorbed significantly. Fecal excretion minimal.
Icodextrin is metabolized to maltose, maltotriose, and other oligosaccharides. After intraperitoneal administration, approximately 40% of the administered dose is absorbed systemically; the absorbed icodextrin and its metabolites are primarily eliminated by renal excretion (via glomerular filtration). In patients with residual renal function, approximately 30-40% of the absorbed dose is excreted in urine over 14 days. Biliary/fecal excretion is negligible (<1%).
Category C
Category C
Peritoneal Dialysis Solution
Peritoneal Dialysis Solution