Comparative Pharmacology
Head-to-head clinical analysis: EXTRANEAL versus INPERSOL LC LM W DEXTROSE 2 5 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXTRANEAL versus INPERSOL LC LM W DEXTROSE 2 5 IN PLASTIC CONTAINER.
EXTRANEAL vs INPERSOL-LC/LM W/ DEXTROSE 2.5% IN PLASTIC CONTAINER
Comparing the clinical profiles, pharmacokinetic behaviors, and safety indices of these two therapeutic agents.
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.
The mechanism of action of INPERSOL-LC/LM W/ DEXTROSE 2.5% is based on peritoneal dialysis. Dextrose creates an osmotic gradient across the peritoneal membrane, facilitating the removal of waste products (e.g., urea, creatinine) and excess fluid from the blood into the dialysate. Lactate or low magnesium buffer corrects metabolic acidosis by providing bicarbonate precursors.
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.
Intraperitoneal administration: 2 liters of 2.5% dextrose solution per exchange, typically 4-5 exchanges per day, as part of continuous ambulatory peritoneal dialysis (CAPD). For automated peritoneal dialysis (APD): 2 liters per cycle, 4-6 cycles per night, with a daytime dwell as prescribed.
None Documented
None Documented
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.
Intraperitoneal dextrose has a terminal elimination half-life of approximately 1-2 hours, reflecting rapid absorption from the peritoneal cavity followed by systemic metabolism and distribution.
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%).
Primarily renal elimination through peritoneal dialysis; approximately 60-80% of dextrose absorbed is metabolized to CO2 and water, with the remainder eliminated via the kidneys. Non-dextrose components are removed via peritoneal dialysis outflow.
Category C
Category C
Peritoneal Dialysis Solution
Peritoneal Dialysis Solution