sodium chloride + succinylated gelatin: clinical use

Prescribing considerations

• Use only when hypovolaemia cannot be treated adequately with crystalloids alone.
• Assess gelatin, alpha-Gal, red-meat and offal allergy before administration.
• Exercise caution in allergic disease, including asthma, and observe closely for hypersensitivity.
• Avoid circulatory overload, particularly with cardiac, pulmonary or renal impairment.
• Paediatric efficacy and safety evidence is limited.
• Where practical, obtain relevant blood and urine samples before infusion because some laboratory results may be affected.

Contraindications and cautions

• Hypersensitivity to gelatin-containing solutions or an excipient.
• Alpha-Gal hypersensitivity or known allergy to mammalian meat or offal.
• Hypervolaemia or hyperhydration.
• Acute congestive cardiac failure.

Monitoring

• Haemodynamic status and signs of circulatory or pulmonary overload.
• Serum electrolytes, acid–base status and fluid balance.
• Renal function, particularly with severe impairment or reduced urine output.
• Haematocrit, plasma proteins and coagulation where clinically relevant.
• Early signs of anaphylactic or anaphylactoid reaction.
• Interpret affected laboratory tests cautiously, including erythrocyte sedimentation rate, urine specific gravity and some protein assays.

Clinical pharmacology

Succinylation adds negative charges that expand the gelatin molecules, supporting colloid-osmotic activity within the intravascular compartment. Modified gelatin is eliminated mainly through the kidneys; larger molecules undergo proteolytic degradation before renal excretion.

Formulation and product differences

• The selected product is a clear, colourless or slightly yellow aqueous solution for infusion supplied in non-PVC bags.
• It contains no preservative. Use only clear solution from an intact container, commence infusion after connection and discard unused or partially used contents.
• Excipients are water for injections and sodium hydroxide for pH adjustment.