Icodextrin (Intraperitoneal)

Overview

Icodextrin is a drug that is used as a peritoneal dialysis solution. This means it is used during the process of cleaning fluid and waste out of your body after your kidneys are not able to function properly. During the long (8 - 16 hour) dwell of automated peritoneal dialysis (APD) or continuous ambulatory peritoneal dialysis (CAPD), this drug is used as a single daily exchange. You can only obtain Icodextrin following a prescription from your doctor. This is because it has the potential to cause a number of side effects and lead to possible interactions with other drugs. It is therefore given to selected patients only.

Condition(s) treated

  • Automated peritoneal dialysis

Type of medicine

  • Colloid osmotic agent

Side effects

As well as having its intended uses, it is possible that Icodextrin could cause patients to experience other unwanted side effects. In some cases, these side effects are not very severe, but in other cases, they can be more worrying. Directly below is a list of the more severe side effects that could occur. If you experience any of these, you should contact your doctor immediately.

More common

  • Troubled breathing with exertion

Less common

  • Unexplained weight loss

Incidence not known

  • White spots, sores, or ulcers on the lips or in the mouth

As well as these more serious side effects, it is possible that you will experience less severe ones that require less urgent attention. Below is a list of such side effects. You may well find that, over time as your treatment progresses, these side effects will go away. This can occur as your body simply adjusts to the medicine. However, if you are experiencing any of the following, and you find them bothersome or lingering, then you can still contact your doctor. They may be able to alter your doses or advise other ways to help reduce the unwanted effects.

More common

  • Loss or lack of strength

Less common

  • Belching

Though these lists are extensive, they do not necessarily include all side effects that could occur. If you are experiencing side effects that are not listed here, then you can still contact your doctor. They can suggest ways to reduce them and can answer any other questions you may have.

Dosage

When receiving this drug, you will find a Medication Guide. You should read this carefully and address any questions you have to your doctor.

Your doctor can tell you exactly how much of this to take, and how frequently to do so. It is taken through a catheter, which is a special tube. You will need to undergo a minor operation to have this catheter inserted into your abdomen.

Your nurse, doctor, or other fully trained healthcare professional will tell you all about peritoneal dialysis and how it works exactly. You should be sure to fully understand this process and ask the medical professional any necessary questions you have. They will tell you exactly what steps to take, and you should follow these closely.

During peritoneal dialysis, this is not the only kind of fluid you will need, and your doctor will train you on how to use any others as well. Icodextrin is given for the long dwell exchange of your dialysis. This period lasts longer than 8 hours. During other exchanges, you will have other fluids to use. You should not use Icodextrin more than once in any 24-hour period unless you have been told to do so by a doctor.

Here is a guide to using this solution.

  • Before using, first look at the medicine in its container to see if there are any small specks floating in it or if it is cloudy. If this is the case, or if you see a leak in the container, do not use the medicine.

You will be given this medicine on a very fixed schedule. You should therefore never miss a dose, as it will harm the course of your treatment.However, if you do miss a dose for any reason, then call your pharmacist or doctor for advice.

Interactions

It is possible that Icodextrin will interact with other drugs you are currently taking. It is often the case that your doctor will want to avoid interactions, however, in other cases, they may be necessary. Either way, you should disclose to your doctor all drugs you are currently taking. This includes both prescription and nonprescription drugs. To avoid interactions, your doctor may wish to alter either one or both of the interacting drugs that you are taking. Alternatively, they may simply adjust one or both of the dosages that you receive. Directly below is a list of drugs with which it is usually not recommended you take at the same time as Icodextrin.

  • Eltrombopag

If you take Icodextrin at the same time as any of the following drugs, then you may be at an increased risk of experiencing certain side effects. However, it may be the case that taking both drugs is the best course of treatment for you. If this is so, then your doctor may wish to adjust the dosages you receive, or how frequently you take each medicine.

  • Strontium Ranelate

As well as interacting with drugs, it is possible that Icodextrin will interact with certain parts of your dietary intake. This includes things you drink, eat, and smoke. To avoid such interactions, your doctor may ask you to make certain lifestyle or dietary adjustments. For example, this may mean smoking less tobacco or drinking less alcohol.

Finally, other medical problems you have could cause an interaction to occur with this medicine. You should inform your doctor of your complete medical history so that they can decide whether this drug is indeed suitable. Below is a list of medical problems which are known to interact more severely with Icodextrin.

  • Recent heart surgery (aortic graft surgery)

Warnings

Before prescribing you with this medicine, your doctor will need to examine you to decide whether it is indeed safe and suitable for your specific treatment. As a part of this examination, they will need to understand any and all allergies you currently have. You should inform them of any allergies you have to dyes, preservatives, food, and animals.

As of writing, no efficacy and safety have been established for the use of Icodextrin in pediatric patients. This is because no appropriate studies have been performed on how Icodextrin affects younger patients. Your doctor will need to advise you of any increased risks your child faces.

The studies that have taken place in older patients using this medicine have not highlighted any geriatric-specific problems that would make this drug less useful.

As of writing, it is unclear as to whether Icodextrin is a suitable drug for pregnant women to receive. This is because it is unclear as to whether any studies have taken place, or if any studies have highlighted problems. Your doctor is best placed to inform you of any increased risks, and then weigh them against the benefits of using this medicine. If you get pregnant whilst taking this drug, inform your doctor straight away.

Similarly, there are no suitable studies on the effects this drug has on patients who are breastfeeding. If there are any increased risks to either you or your infant, then your doctor can advise you of these.

Whilst receiving this medicine, your doctor will need to see you at regular appointments. This is so they can decide whether your treatment is going as expected, and to check for any unwanted effects. To check for these, your doctor may need to carry out blood tests.

If you need to measure your blood sugar levels, then be aware that Icodextrin can cause false high blood sugar readings for those using certain test strips and monitors. You should only use glucose-specific test strips and monitors. To help you choose the right equipment, you should discuss this with your nurse or doctor. They may decide that you should carry around a wallet card which explains your specific needs for a certain set of test strips or monitor.

You could experience peritonitis whilst using this medicine. This is an infection that occurs in your peritoneal cavity. This can be fairly common in patients undergoing peritoneal dialysis. If you experience redness, a fever, pain, or cloudy drained fluid at any time, then contact your doctor straight away.

Whilst taking Icodextrin, you could experience severe allergic reactions, such as anaphylaxis. Anaphylaxis is very dangerous and requires immediate medical attention as it can cause death. If you experience any of the following symptoms, then you should contact your doctor immediately or seek other immediate medical attention.

  • Trouble swallowing

Whilst undergoing treatment, you will need to keep track of how much fluid is in your body. Your caregiver can inform you on how to go about doing this. They can also tell you what to do if you ever have too much or too little fluid. One way to do this is to weigh yourself at regular intervals and track this number.

You should inform your doctor of all drugs you are using at the same time as Icodextrin. This drug may remove other medicines that you are taking, so your doctor may have to alter the doses of other medicines. However, you should not alter any doses you are currently taking unless you have been told to do so by your doctor.

Storage

You should store this medicine in a sealed container, and keep it at room temperature at all times. Never allow it to freeze, and do not expose it to moisture, direct light, or heat. It can be harmful to children so should be stored somewhere safe. Once you have finished your treatment, or if any medicine goes out of date, then you should dispose of any remaining Icodextrin in a safe and sensible manner. If you need advice on how to do this, you can speak to your pharmacist or doctor.

Summary

If you need to undergo peritoneal dialysis, then Icodextrin is just one solution that will be necessary for your treatment. You should be careful in following any instructions and guidance your doctor gives you for using this medicine. It must be taken on a very strict schedule, and you should never take it for longer than you have been told to do so. If you have any questions about how to properly take this medicine, you should address them to your doctor. Above you can find details regarding the possible side effects that may occur whilst using this medicine. If you experience any of the more serious ones at any time, then you should contact your doctor.