Albumin

Albumin IV is a prescription medication used to treat Acute Liver Failure, Adult Respiratory Distress Syndrome, Burns, Cardiopulmonary Bypass, Hypoalbuminemia, Hemodialysis, Hypovolemia, Ovarian Hyperstimulation Syndrome. 

• Albumin IV is available under the following different brand names: Aluminar, Alba, Albuked, Albutein, Flexbumin, Kedbumin, Plasbumin, Albuminex

Adult and pediatric dosage

Injectable solution

• 50mg/mL (5%)
• 250mg/mL 25%)

Acute Liver Failure

Adult dosage

• 6-8 g IV for every 100 mL of ascitic fluid removed

Adult Respiratory Distress Syndrome

Adult dosage

• 25g IV over 30 minutes; repeat every 8 hours as needed

Burns

Adult dosage

• Indicated after 24 hours post burn if severe albumin depletion in order to favor edema reabsorption
• Amount of albumin required to achieve adequate plasma volume and protein content should be determined by direct observation of vital signs or measurement of either plasma oncotic pressure or protein content. 

Cardiopulmonary Bypass

Adult dosage

• Indicated for procedures as part of the priming fluids for bypass machines. 
• Required dose can be estimated from the difference between the desired and actual total serum protein concentration multiplied by the estimated plasma volume (`40 mL/kg) times 2 (to account for extravascular deficit, which absorbs about half of the administered dose)

Hypoalbuminemia

Adult dosage

• Indicated for restoration and maintenance of circulating blood volume deficiency caused by illness or active bleeding; when albumin deficiency results from excessive protein loss, the effect of albumin administration will be temporary unless the underlying disorder is reversed. 

Hemodialysis

Adult dosage

• 25 g IV

Hypovolemia

Adult dosage

• Initial 25 g IV; adjust according to volume requirements

Pediatric dosage

• 5% albumin: 0.5-1 g/kg/dose IV infused over 1 hour; may infuse more rapidly for hypovolemic shock

Ovarian Hyperstimulation Syndrome

Adult dosage

• 50-100 g IV infused over 4 hours; repeat every 4-12 hours as needed

Ascites with Hypoalbuminemia

Pediatric dosage

• 25% albumin: 1g/kg/dose IV infused over 2-3 hours; may repeat every 8 hours until serum albumin above 2.5 g/dL

Hemolytic Disease of the Newborn

Pediatric dosage

• 25% albumin: 1g/kg/dose IV administered before or during plasma exchange
• Use 25% concentration with extreme caution in neonates, owing to risk of intraventricular hemorrhage from rapid expansion of intravascular volume

Dosage Considerations – Should be Given as Follows: 

• See "Dosages."

Common side effects of Albumin IV include:

• nausea, 
• vomiting, 
• fever, 
• chills, 
• fast heart rate, 
• mild rash, and
• flushing (warmth, redness, or tingly feeling)

Serious side effects of Albumin IV include:

• hives, 
• cough, 
• difficulty breathing, 
• swelling of the face, lips, tongue, or throat, 
• lightheadedness, 
• weak or shallow breathing, 
• throbbing headache, 
• blurred vision, 
• buzzing in your ears, 
• anxiety, 
• confusion, 
• sweating, 
• pale skin, 
• severe shortness of breath, 
• wheezing, 
• gasping for breath, 
• cough with foamy mucus, 
• chest pain, and
• fast and uneven heart rate

Rare side effects of Albumin IV include:

• none 

This is not a complete list of side effects and other serious side effects or health problems may occur as a result of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

• Albumin IV has severe interactions with no other drugs. 
• Albumin IV has serious interactions with no other drugs. 
• Albumin IV has moderate interactions with no other drugs. 
• Albumin IV has minor interactions with no other drugs. 

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this drug, tell your doctor or pharmacist of all the drugs you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Contraindications

• Hypersensitivity to commercially available albumin products; suspected hypersensitivity to perflutren, blood, blood products or albumin
• Severe anemia, heart failure.

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Albumin IV?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Albumin IV?”

Cautions

• Hypersensitivity reactions reported; monitor patient during infusion in facility that can respond to anaphylaxis
• Caution in conditions where hypervolemia and its consequences or hemodilution could represent a special risk (e.g., heart failure, arterial hypertension, esophageal varices, pulmonary edema, hemorrhagic diathesis, severe anemia, renal and postrenal anuria)
• Do not dilute with sterile water for injection as this may cause hemolysis; use D5W or 0.9% NaCl for dilution
• When replacing large volumes of albumin, control of coagulation and hematocrit is essential; ensure adequate substitution of other blood constituents (e.g., coagulation factors, electrolytes, platelets, erythrocytes)
• Colloid osmotic effect is ~4 times that of human blood; therefore, when concentrated albumin is administered, ensure adequate hydration of the patient; carefully monitor to guard against circulatory overload by assessing arterial blood pressure and pulse rate, central venous pressure, pulmonary artery occlusion pressure, urine output, electrolyte levels, and hematocrit/hemoglobin
• Albumin is a blood product; extremely remote risk for transmission of viral diseases and variant Creutzfeldt-Jakob disease (vCJD)

Pregnancy and Lactation

• No human or animal data are available to indicate the presence or absence of drug-associated risk. 
• Unknown if excreted in human milk.