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Albumin solution: Drug information

Copyright 1978-2020 Lexicomp, Inc. All rights reserved.
(For additional information see "Albumin solution: Patient drug information" and see "Albumin solution: Pediatric drug information")

For abbreviations and symbols that may be used in Lexicomp (show table)
Brand Names: US

 Albuked 25;
 Albuked 5;
 Albumin-ZLB;
 Albuminar-25 [DSC];
 Albuminar-5 [DSC];
 Albuminex;
 AlbuRx;
 Albutein;
 Buminate [DSC];
 Flexbumin;
 Human Albumin Grifols;
  Kedbumin;
 Plasbumin-25;
 Plasbumin-5

Brand Names: Canada

 Alburex-25;
 Alburex-5;
 Albutein;
 Octalbin;
 Plasbumin-25;
 Plasbumin-5

Pharmacologic Category

 Blood Product Derivative;

 Plasma Volume Expander, Colloid

Dosing: Adult

Note: Use 5% solution in hypovolemic patients or intravascularly depleted patients. Use 25% solution in patients in whom fluid and
sodium intake is restricted or to mobilize fluids.

Usual dose: IV: 25 g; initial dose may be repeated in 15 to 30 minutes if response is inadequate.

Adult respiratory distress syndrome: IV: 25 g over 30 minutes (in combination with furosemide); may repeat at 8 hours (if
necessary) for 3 days; titrate to fluid loss and normalization of serum total protein. Patients enrolled into the clinical trial had
hypoproteinemia (total protein <6 g/dL) (Martin 2005).

Hypovolemia: 5% albumin: IV: Initial: 12.5 to 25 g (250 to 500 mL); repeat after 15 to 30 minutes as needed (if hemodynamic
stability is not achieved). Note: May be considered after inadequate response to crystalloid therapy and when nonprotein colloids
are contraindicated. The volume administered and the rate of infusion should be adapted to individual response.
Large-volume paracentesis: IV:

25% albumin: 5 to 10 g for every liter removed (usual dose cited: 8 g for every liter removed) (Bernardi 2012; Moore 2003;
AASLD [Runyon 2012]) or 50 g total for paracentesis >5 L (ATS 2004). Note: Administer soon after the procedure to
avoid postprocedural complications (eg, hypovolemia, hyponatremia, renal impairment) (Moore, 2003).

Manufacturer's labeling: Dosing in the prescribing information may not reflect current clinical practice. 25% albumin: 8 g
for every liter removed.

Ovarian hyperstimulation syndrome (treatment): 25% albumin: IV: 50 to 100 g over 4 hours; repeat at 4 to 12 hours intervals as
needed.

Plasma exchange: 5% albumin: IV: Titrate dose to plasma volume removed during procedure.

Spontaneous bacterial peritonitis (treatment) (off-label use): 25% albumin: IV: Initial: 1.5 g/kg within 6 hours of diagnosis (in
conjunction with appropriate antimicrobial therapy), followed by 1 g/kg on day 3 (Abd 2012; AASLD [Runyon 2012]; Sort
1999). Note: Clinical trials used albumin 20%; the difference in concentration compared with 25% albumin is deemed to be
clinically inconsequential.

Dosing: Renal Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling; use with caution.

Dosing: Hepatic Impairment: Adult

There are no dosage adjustments provided in the manufacturer's labeling; use with caution.

Dosing: Pediatric

(For additional information see "Albumin solution: Pediatric drug information")

Note: Albumin 5% should be used in hypovolemic or intravascularly depleted patients; albumin 25% should be used in patients with
fluid or sodium restrictions (eg, patients with hypoproteinemia and generalized edema, or nephrotic syndrome). Dose depends on
condition of patient:

Ascites with hypoalbuminemia: Limited data available: Infants, Children, and Adolescents: 25% albumin: IV: 1 g/kg/dose over
2 to 3 hours; may repeat up to 3 times per day until albumin is >2.5 g/dL; maximum dose: 25 g/dose (Giefer 2011, Sabri
2003)

Hypovolemia, plasma volume expansion, including hypovolemic shock (SCCM [Dellinger 2013]): Infants, Children, and
Adolescents: 5% albumin: IV: 0.5 to 1 g/kg/dose (10 to 20 mL/kg/dose) over 5 to 10 minutes. Usual adult dose: 12.5 to 25
g/dose (250 to 500 mL/dose). May repeat after 30 minutes if response is not adequate (Kleigman 2007).

Large volume paracentesis: Limited data available: Infants, Children, and Adolescents: 5% or 25% albumin: IV: 0.5 to 1 g/kg
over 1 to 2 hours after paracentesis (Giefer 2011, Kramer 2001)

Nephrotic syndrome edema, refractory: Infants, Children, and Adolescents: 25% albumin: IV: 0.5 to 1 g/kg/dose over 30 to 60
minutes followed by diuretic therapy (Gipson 2009; Kliegman 2011; Robinson 2003)

Dosing: Renal Impairment: Pediatric

There are no dosing adjustments provided in the manufacturer's labeling; use with caution.

Dosing: Hepatic Impairment: Pediatric

There are no dosing adjustments provided in the manufacturer's labeling.

Dosing: Geriatric

Refer to adult dosing.

Dosage Forms: US
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] =
Discontinued product

Solution, Intravenous:

Albumin-ZLB: 5% (250 mL, 500 mL); 25% (50 mL, 100 mL)

Albuminar-5: 5% (250 mL [DSC], 500 mL [DSC])

Albuminar-25: 25% (50 mL [DSC], 100 mL [DSC])

Albutein: 25% (50 mL, 100 mL)

Buminate: 5% (250 mL [DSC], 500 mL [DSC]); 25% (20 mL [DSC])

Plasbumin-5: 5% (50 mL [DSC], 250 mL [DSC])

Plasbumin-25: 25% (20 mL [DSC], 50 mL [DSC], 100 mL [DSC])

Generic: 25% (50 mL, 100 mL)

Solution, Intravenous [preservative free]:

Albuked 5: 5% (250 mL)

Albuked 25: 25% (50 mL, 100 mL)

Albuminex: 5% (250 mL, 500 mL); 25% (50 mL, 100 mL)

AlbuRx: 5% (250 mL, 500 mL)

Albutein: 5% (50 mL, 250 mL, 500 mL); 25% (20 mL, 50 mL, 100 mL)
 Flexbumin: 5% (250 mL); 25% (50 mL, 100 mL)

Human Albumin Grifols: 25% (50 mL, 100 mL)

Kedbumin: 25% (50 mL, 100 mL)

Plasbumin-5: 5% (50 mL, 250 mL)

Plasbumin-25: 25% (20 mL, 50 mL, 100 mL)

Generic: 5% (100 mL, 250 mL, 500 mL); 25% (50 mL, 100 mL)

Generic Equivalent Available: US

Yes

Dosage Forms: Canada

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous:

Alburex-5: 5% (100 mL, 250 mL, 500 mL)

Alburex-25: 25% (50 mL, 100 mL)

Albutein: 5% (250 mL); 25% (100 mL)

Plasbumin-5: 5% (50 mL, 250 mL, 500 mL)

Plasbumin-25: 25% (50 mL, 100 mL)

Generic: 5% (50 mL, 100 mL, 250 mL, 500 mL); 25% (50 mL, 100 ea, 100 mL)
Administration: Adult

For IV administration only. Infusion rate depends on indication and clinical situation. In emergencies, may administer as rapidly as
necessary to improve clinical condition. After initial volume replacement:

5%: Do not exceed 2 to 4 mL/minute in patients with normal plasma volume; 5 to 10 mL/minute in patients with
hypoproteinemia

25%: Do not exceed 1 mL/minute in patients with normal plasma volume; 2 to 3 mL/minute in patients with hypoproteinemia

Rapid infusion may cause vascular overload. Albumin 25% may be given undiluted or diluted in normal saline. May give in
combination or through the same administration set as saline or carbohydrates. Warm to room temperature before use if large
volumes are administered. Use within 4 hours after entering package; discard unused portion. Some products may require a filter;
refer to product labeling. Do not use with ethanol or protein hydrolysates (precipitation may form).

Administration: Pediatric

Parenteral: IV: Too rapid infusion may result in vascular overload. Rate of infusion dependent upon use. In emergencies, may
administer as rapidly as necessary to improve clinical condition. After initial volume replacement:

5%: Do not exceed 2 to 4 mL/minute in patients with normal plasma volume; 5 to 10 mL/minute in patients with
hypoproteinemia

25%: Do not exceed 1 mL/minute in patients with normal plasma volume; 2 to 3 mL/minute in patients with hypoproteinemia

Product-specific details:

Albuminar: May administer via the administration set provided (in-line 60 micron filter) or via any administration set; use of
filter is optional; size of filter may vary according to institutional policy. Method of filter sterilization used by
manufacturer includes 0.2 micron filter; however, aggregates may form under storage, shipping, and handling.
Administration via very small filter will not damage product, but will slow flow rate.
 Albutein: May administer via the administration set provided (in-line 50 micron filter) or via any administration set; use of
filter is optional; size of filter may vary according to institutional policy. Method of production includes passage
through 0.22 micron filter. May administer via filter as small as 0.22 microns.

Buminate: Administer via the administration set provided (in-line 15 micron filter) or via any filtered administration set; use
≥5 micron filter to ensure adequate flow rate

Plasbumin: May administer with or without an IV filter; filter as small as 0.22 microns may be used

Use: Labeled Indications

Acute respiratory distress syndrome (25% solution only): To correct interstitial pulmonary edema and hypoproteinemia associated
with acute respiratory distress syndrome in conjunction with diuretics.

Cirrhotic ascites, adjunct treatment: To maintain intravascular volume following removal of large-volume paracentesis in cirrhotic
patients.

Erythrocyte resuspension: To avoid excessive hypoproteinemia, during certain types of exchange transfusion, or with the use of very
large volumes or previously frozen or washed red cells.

Hypovolemia: Plasma volume expansion and maintenance of intravascular volume in the emergency treatment of hypovolemia (with
or without shock).

Neonatal hemolytic disease: Binds and detoxifies unconjugated bilirubin in severe hemolytic disease of the newborn during
exchange transfusion.

Nephrosis (acute), adjunct: Treatment of edema in patients with acute nephrosis in combination with diuretics.

Ovarian hyperstimulation syndrome, treatment (25% solution only): As a plasma volume expander in fluid management for the
treatment of severe ovarian hyperstimulation syndrome.

Use: Off-Label: Adult

Cirrhosis (in combination with diuretics to facilitate diuresis); Spontaneous bacterial peritonitis (treatment); Volume expansion in
dehydrated, mildly hypotensive patients with cirrhosis

Medication Safety Issues

Sound-alike/look-alike issues:

Albuminar-25 (albumin) may be confused with Privigen (immune globulin) due to similar packaging

Albutein may be confused with albuterol

Buminate may be confused with bumetanide

Adverse Reactions

Frequency not defined.

Cardiovascular: Cardiac failure (precipitation), edema, hypertension, hypotension, tachycardia

Central nervous system: Chills, headache

Dermatologic: Pruritus, skin rash, urticaria

Endocrine & metabolic: Hypervolemia

Gastrointestinal: Nausea, vomiting

Hypersensitivity: Anaphylaxis

Respiratory: Bronchospasm, pulmonary edema

Miscellaneous: Fever

Contraindications
Hypersensitivity to albumin or any component of the formulation; severe anemia, heart failure; patients at risk of volume overload (eg,
patients with renal insufficiency, severe anemia, stabilized chronic anemia, or heart failure); dilution with sterile water for injection
(may cause hemolysis or acute renal failure)

Warnings/Precautions

Concerns related to adverse effects:

• Hypersensitivity: Severe allergic or anaphylactic reaction may occur. Discontinue immediately and manage appropriately if
allergic or anaphylactic reactions are suspected.

• Coagulation abnormality: Large replacement volumes may result in coagulation abnormality. Monitor and replete with blood
constituents if indicated.

• Electrolyte imbalance: Large replacement volumes may result in electrolyte imbalance. Monitor electrolytes and replace or
maintain as indicated.

• Hemodynamic effects: Cardiac or respiratory failure, renal failure, or increasing intracranial pressure can occur; closely monitor
hemodynamic parameters in all patients.

• Hypervolemia/hemodilution: Use with caution in conditions where hypervolemia and its consequences or hemodilution may
increase the risk of adverse effects (eg, heart failure, pulmonary edema, hypertension, hemorrhagic diathesis, esophageal
varices). Adjust rate of administration per hemodynamic status and solution concentration; monitor closely with rapid
infusions. Avoid rapid infusions in patients with a history of cardiovascular disease (may cause circulatory overload and
pulmonary edema). Discontinue at the first signs of cardiovascular overload (eg, headache, dyspnea, jugular venous
distention, rales, abnormal elevations in systemic or central venous blood pressure). All patients should be observed for
signs of hypervolemia, such as pulmonary edema. Monitor blood pressure.

Disease-related concerns:

• Critical illness: In patients with increased microvascular permeability (eg, sepsis, trauma, burn), the translocation of fluid from
the interstitial compartment to the intravascular compartment may decrease due to increased albumin in the interstitial space.
Furthermore, in extreme microvascular permeability states, administration of albumin (or other colloids) may increase the
 net flux of fluid into the interstitial space reducing intravascular volume and precipitating edematous states (eg, pulmonary
edema) (Roberts, 1998).

• Hepatic impairment: Use with caution in patients with hepatic impairment; protein load may exacerbate or precipitate
encephalopathy.

• Renal impairment: Use with caution in patients with renal impairment; protein load may precipitate azotemia. Patients with
chronic renal insufficiency receiving albumin solution may be at risk for accumulation of aluminum and potential toxicities
(eg, hypercalcemia, vitamin D refractory osteodystrophy, anemia, severe progressive encephalopathy).

Special populations:

• Sodium restricted patients: Use with caution in those patients for whom sodium restriction is necessary. Albumin 5% and 25%
solutions contain 130 to 160 mEq/L sodium and are considered isotonic with plasma.

Dosage form specific issues:

• Aluminum: The parenteral product may contain aluminum (Kelly, 1989); toxic aluminum concentrations may be seen with high
doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and
aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with
CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register 2002). See manufacturer's labeling.

• Dilution: Do not dilute 5% albumin with sterile water for injection (may result in hemolysis and/or renal failure).

• Human plasma: Product of human plasma; may potentially contain infectious agents which could transmit disease. Screening of
donors, as well as testing and/or inactivation or removal of certain viruses, reduces the risk. Infections thought to be
transmitted by this product should be reported to the manufacturer.

• Latex: Packaging may contain natural latex rubber.

Warnings: Additional Pediatric Considerations

In neonates, use the 25% concentration with extreme caution due to risk of intraventricular hemorrhage (from rapid expansion of the
intravascular volume); infuse slowly.

Due to the occasional shortage of 5% human albumin, 5% solutions may at times be prepared by diluting 25% human albumin with
NS or with D5W (if sodium load is a concern); however, do not use sterile water to dilute albumin solutions, as this may result in
hypotonic-associated hemolysis which can be fatal.

Metabolism/Transport Effects

None known.

Drug Interactions
(For additional information: Launch drug interactions program)

There are no known significant interactions.

Pregnancy Considerations

Albumin is an endogenous substance; products are prepared from pooled human plasma. Available data are insufficient to recommend
use of albumin to reduce the risk of ovarian hyperstimulation syndrome (Practice Committee 2016). Use for other indications may be
considered in pregnant women when contraindications to nonprotein colloids exist (Liumbruno 2009).

Breast-Feeding Considerations

Endogenous albumin is present in breast milk.

According to the manufacturer, the decision to breastfeed during therapy should consider the risk of infant exposure, the benefits of
breastfeeding to the infant, and benefits of treatment to the mother.

Dietary Considerations

Some products may contain potassium and/or sodium.

Monitoring Parameters

Monitor electrolytes, hemoglobin/hematocrit, and urine output regularly; monitor hemodynamic parameters, blood pressure, heart rate,
central venous pressure, pulmonary artery occlusion pressure.

Mechanism of Action

Provides increase in intravascular oncotic pressure and causes mobilization of fluids from interstitial into intravascular space

Pharmacodynamics and Pharmacokinetics

Half-life: 15 to 20 days

Pricing: US

Solution (Albuked 25 Intravenous)

25% (per mL): $1.15

Solution (Albuked 5 Intravenous)

5% (per mL): $0.23

Solution (Albumin Human Intravenous)

5% (per mL): $0.33

25% (per mL): $1.38 - $2.16

Solution (Albuminex Intravenous)

5% (per mL): $0.34

 25% (per mL): $1.68

Solution (Albutein Intravenous)

5% (per mL): $0.22

25% (per mL): $1.10

Solution (Flexbumin Intravenous)

5% (per mL): $0.28

25% (per mL): $1.39

Solution (Human Albumin Grifols Intravenous)

25% (per mL): $2.16

Solution (Plasbumin-25 Intravenous)

25% (per mL): $1.18

Solution (Plasbumin-5 Intravenous)

5% (per mL): $0.78

Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is
provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to
determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or
adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or
manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no
liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for
special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Brand Names: International

 Acebumin (PE);
 Alba (IN);
 Albapure (ID, TW);
 Albiomin (TH);
 Albotein (IT);
 Albuman (IS, MT);
 Albumar (MX);
 Albumax (PH);
 Albumer (BF, BJ, CI, ET, GH, GM, GN, KE, LR, MA, ML, MR, MU, MW, NE, NG, SC, SD, SL, SN, TN, TZ, UG, ZM,
ZW);
 Albumex (AU, NZ);
 Albumex 20 (HK);
 Albumin 5% (CH);
 Albumin 5% Human (DE);
 Albumin Human Salzarm 25% (DE);
 Albumina Humana (BR, CU);
 Albuminar (BR, ID, PH, VN);
 Albuminar 25 (TH);
 Albuminativ (AT, SE);
 Albuminative (QA, SA);
 Albumine-LFB (HK);
 Albunate (MX);
 Albunorm (BG, HR, HU, IE, LU, LV, MY, NL, NO, PH, RO, SI, UA);
 Alburel (PH, ZW);
 Alburex (CO, CY);
 Alburx (CN, VN);
 Albusol (ZA);
 Albutein (AE, BH, EG, HR, LB, LK, PH, SA, VN);
 Albutein 25% (BR, CN, HK);
 Biseko (PL);
  Buminate (SA);
 Buminate 25% (HK, PH);
 Cealb (AE);
 Flexbumin (CZ, IE, LV, SK, VN);
 Human Albumin 25% (DE);
 Human Albumin 5% (DE);
 Kedrialb (PH);
 Octalbin (CR, DK, DO, ES, FI, GT, HN, ID, MX, PA, SV);
 Plasbumin (AE, ID, KW, LB, SG);
 Seralbumin (PY);
 SRK (CH);
 Uman Albumin (IL);
 Vialebex (FR);
 Vialebex -Wilson (HK);
 Volumin (IN);
 Zenalb (GR, IL, MT, SG, TH, VN);
 Zenalb 20 (CO)

For country abbreviations used in Lexicomp (show table)

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