PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER (PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER).
PrismaSol BGK 0/2.5 is a sterile, nonpyrogenic, multi-electrolyte solution used in continuous renal replacement therapy (CRRT) to replace fluid and electrolytes removed during hemofiltration or hemodiafiltration. It provides a balanced electrolyte composition designed to correct metabolic acidosis and maintain acid-base balance.
| Metabolism | Not metabolized; components are excreted via renal replacement therapy or as electrolytes. |
| Excretion | PRISMASOL BGK 0/2.5 is a dialysis solution; its components (electrolytes and glucose) are dialyzed and not metabolized. Excretion is via the hemodialysis circuit, with no significant renal or fecal elimination of the intact solution. Electrolytes are distributed and excreted primarily through the dialysate effluent. Glucose is metabolized or taken up by cells, with any excess handled by endogenous mechanisms. |
| Half-life | Not applicable; as a dialysis solution, the half-life of its components is determined by dialysis session parameters. The half-life of glucose during dialysis is approximately 2-3 hours due to continuous removal by dialysate. |
| Protein binding | Minimal; electrolytes (sodium, potassium, calcium, magnesium) and bicarbonate are not significantly protein-bound (<10%). Glucose has negligible protein binding. |
| Volume of Distribution | Distributes throughout the extracellular fluid volume (~0.2 L/kg for sodium and chloride); glucose distributes in total body water (~0.6 L/kg). |
| Bioavailability | 100% via intravascular administration during hemodialysis; not applicable via oral route. |
| Onset of Action | Immediate upon initiation of hemodialysis; correction of electrolyte imbalances and acid-base status begins within minutes. |
| Duration of Action | Duration corresponds to the dialysis session (typically 3-5 hours). Clinical effects (electrolyte and acid-base normalization) persist post-dialysis until next session. |
PRISMASOL BGK 0/2.5 is a hemodialysis solution for continuous renal replacement therapy (CRRT). The typical dose is infused into the extracorporeal circuit at a rate of 20-40 mL/kg/h, adjusted to achieve the desired solute clearance and fluid balance. Route: intravenous via CRRT circuit. Frequency: continuous infusion.
| Dosage form | INJECTABLE |
| Renal impairment | This solution is indicated for patients with acute kidney injury requiring CRRT. No dose adjustment is needed as the drug itself is not renally cleared; however, electrolyte concentrations (e.g., potassium, phosphate) must be monitored and customized based on GFR and clinical status. |
| Liver impairment | No specific Child-Pugh based adjustments are required. However, hepatic impairment may affect acid-base and electrolyte balance; monitor lactate and bicarbonate levels, and adjust solution composition accordingly. |
| Pediatric use | For pediatric patients, the CRRT dose should be weight-based: typically 2000-3000 mL/1.73 m²/h or 20-40 mL/kg/h, with careful monitoring of electrolytes and fluid balance. Use pediatric-specific formulations if available. |
| Geriatric use | Elderly patients may have reduced vascular access flow and increased risk of hypotension. Start at lower end of standard dosing (e.g., 20 mL/kg/h) and titrate based on hemodynamic tolerance and electrolyte monitoring. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER (PRISMASOL BGK 0/2.5 IN PLASTIC CONTAINER).
| Breastfeeding | Not studied in breastfeeding women. PRISMASOL components (electrolytes, glucose) are endogenous substances and are considered compatible with breastfeeding. The milk-to-plasma ratio is not established. Infusion of large volumes may theoretically affect maternal fluid/electrolyte balance and thus milk composition, but significant infant exposure via milk is unlikely. The manufacturer recommends caution due to lack of data; however, the benefit of continued breastfeeding likely outweighs theoretical risks. |
| Teratogenic Risk | PRISMASOL BGK 0/2.5 is a sterile hemofiltration solution containing electrolytes and glucose, used in continuous renal replacement therapy (CRRT). There are no adequate and well-controlled studies in pregnant women. Animal reproduction studies have not been conducted. As a supportive therapy in acute kidney injury, the solution components are typically not associated with direct teratogenic risk. However, maternal electrolyte imbalances or acidosis may pose indirect fetal risks. Use during pregnancy only if clearly needed, with benefit-risk assessment by the clinician. In the first trimester, theoretical risks from maternal metabolic disturbances; second and third trimesters, similar concerns plus potential for fetal exposure to any additives. PRISMASOL is not known to cause structural anomalies, but careful monitoring of maternal-fetal status is recommended. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hypersensitivity to any component","Severe metabolic alkalosis","Uncorrected hyperkalemia","Severe hypercalcemia","Patients not suitable for CRRT"]
| Precautions | ["Must be used under physician supervision","Monitor serum electrolytes, fluid balance, and acid-base status","Risk of electrolyte disturbances (hypo/hyperkalemia, hypomagnesemia, hypercalcemia)","Risk of fluid overload or dehydration","Use only in patients receiving CRRT"] |
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| Fetal Monitoring | Monitor maternal vital signs, fluid balance, serum electrolytes (sodium, potassium, calcium, magnesium, chloride, bicarbonate), blood glucose, acid-base status, and renal function. Assess for signs of fluid overload or deficiency. For fetal surveillance: regular fetal heart rate monitoring and assessment of uterine activity; consider serial ultrasound to monitor fetal growth and amniotic fluid volume. In cases of maternal electrolyte or acid-base disturbances, fetal assessment should be increased. |
| Fertility Effects | No studies on fertility have been conducted with PRISMASOL. Based on the composition (electrolytes, glucose, and water), no direct adverse effects on fertility are anticipated. However, the underlying condition requiring CRRT (e.g., acute kidney injury, severe electrolyte imbalances) may impair fertility. No specific human data are available. |