Comparative Pharmacology
Head-to-head clinical analysis: EXTRANEAL versus INPERSOL LC LM W DEXTROSE 4 25 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXTRANEAL versus INPERSOL LC LM W DEXTROSE 4 25 IN PLASTIC CONTAINER.
EXTRANEAL vs INPERSOL-LC/LM W/ DEXTROSE 4.25% 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.
Removes uremic toxins and excess fluid via diffusion and ultrafiltration across the peritoneal membrane.
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: For continuous ambulatory peritoneal dialysis (CAPD), instill 2 liters of 4.25% dextrose solution into the peritoneal cavity four times daily (4 exchanges/day). For automated peritoneal dialysis (APD), use 2-3 liters per cycle with multiple cycles overnight. Adjust volume and frequency based on patient's fluid and electrolyte status.
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.
Dextrose: approximately 1-2 hours (terminal half-life of glucose in plasma); clinical context: continuous peritoneal dialysis (CAPD) maintains steady-state glucose levels.
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%).
Renal: 80-90% of dextrose metabolites (CO2 and H2O) are excreted via lungs and kidneys; electrolytes and water are eliminated renally. Biliary/fecal: minimal (<5%).
Category C
Category C
Peritoneal Dialysis Solution
Peritoneal Dialysis Solution