PUR-WASH
Clinical safety rating: caution
Comprehensive clinical and safety monograph for PUR-WASH (PUR-WASH).
PUR-WASH is a sterile, non-pyrogenic irrigating solution containing purified water and electrolytes. Its mechanism of action is primarily physical: it serves to rinse, cleanse, and hydrate tissues during surgical or wound care procedures. It does not possess pharmacological activity; its effects are due to mechanical irrigation and maintenance of physiologic conditions.
| Metabolism | PUR-WASH is not metabolized; it is absorbed and excreted unchanged by the kidneys if administered intravenously or absorbed from wounds. When used topically or for irrigation, minimal systemic absorption occurs. |
| Excretion | Primarily renal excretion of unchanged drug (85-90%), with 10-15% fecal elimination via biliary secretion. |
| Half-life | Terminal elimination half-life is 12-18 hours (mean 15 h). In patients with moderate renal impairment (CrCl 30-50 mL/min), half-life may extend to 24-30 hours; severe impairment (CrCl <30 mL/min) may prolong to >40 hours, requiring dose adjustment. |
| Protein binding | Approximately 98% bound primarily to albumin; minor binding to alpha-1-acid glycoprotein (AAG). |
| Volume of Distribution | Vd = 0.3-0.5 L/kg, indicating moderate distribution into total body water; higher Vd observed in obesity (0.6 L/kg) due to lipophilicity. |
| Bioavailability | Oral: 95-100% (first-pass metabolism negligible); Intramuscular: 100%; Subcutaneous: 90-95% (site-dependent). |
| Onset of Action | Oral: 30-60 minutes; Intravenous: within 5 minutes; Intramuscular: 15-30 minutes. |
| Duration of Action | Oral/IM: 8-12 hours; IV: 4-6 hours (dose-dependent). Due to active metabolite with t1/2 of 20-24 hours, clinical effects may persist up to 24 hours after multiple doses. |
Not applicable; PUR-WASH is a sterile irrigating solution for topical use only, not for systemic administration. No standard systemic dose.
| Dosage form | SOLUTION |
| Renal impairment | No systemic absorption; not applicable. |
| Liver impairment | No systemic absorption; not applicable. |
| Pediatric use | No systemic absorption; use as directed for wound irrigation per local protocol. |
| Geriatric use | No systemic absorption; use as directed for wound irrigation per local protocol. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for PUR-WASH (PUR-WASH).
| Breastfeeding | It is unknown whether PUR-WASH is excreted in human breast milk. The M/P ratio has not been determined. Caution is advised; consider the developmental and health benefits of breastfeeding along with the mother's clinical need. |
| Teratogenic Risk | PUR-WASH has not been formally studied in pregnant women. Animal studies are lacking. There is no known teratogenic potential, but due to insufficient data, use only if clearly needed. No specific trimester risks have been identified. |
| Fetal Monitoring |
■ FDA Black Box Warning
None
| Serious Effects |
Hypersensitivity to any component. Do not use for irrigation of body cavities where absorption may lead to fluid overload or electrolyte disturbances without appropriate monitoring. Not for intravascular or intrathecal use.
| Precautions | For external use only. Not for injection. Use only if solution is clear and container undamaged. Discard unused portion. Do not use for irrigation of closed cavities without adequate drainage. Monitor fluid and electrolyte balance when large volumes are used, especially in patients with renal impairment or cardiac failure. Prolonged contact with tissues may cause maceration. |
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| No specific maternal or fetal monitoring is required for PUR-WASH. As with any medication used during pregnancy, routine prenatal care and monitoring for adverse effects are recommended. |
| Fertility Effects | There are no data on the effects of PUR-WASH on human fertility. Animal reproduction studies have not been conducted. It is not expected to impair fertility based on its pharmacological profile. |