Comparative Pharmacology
Head-to-head clinical analysis: EXTRANEAL versus INPERSOL ZM W DEXTROSE 2 5 IN PLASTIC CONTAINER.
Peer-Reviewed Evidence
Head-to-head clinical analysis: EXTRANEAL versus INPERSOL ZM W DEXTROSE 2 5 IN PLASTIC CONTAINER.
EXTRANEAL vs INPERSOL-ZM 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.
Provides osmotic gradient for peritoneal dialysis via hyperosmolar dextrose solution; dextrose is absorbed and metabolized, driving ultrafiltration of excess fluid and solutes across 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 administration: 2 liters of 2.5% dextrose solution per exchange, 4 exchanges daily (8 liters total per day) for continuous ambulatory peritoneal dialysis (CAPD).
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.
Not applicable as a continuous dialysis solution; systemic glucose half-life ~1.5-2 hours in normal physiology, but prolonged in renal impairment.
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 (predominantly via dialysate effluent); peritoneal dialysis removes glucose and metabolites. Less than 5% metabolized; no significant biliary or fecal excretion.
Category C
Category C
Peritoneal Dialysis Solution
Peritoneal Dialysis Solution