Icodextrin, Peritoneal eye-koh-DEKS-trin

What are other names for this medicine?

Type of medicine: peritoneal dialysis solution

Generic and brand names: icodextrin, peritoneal; Extraneal

What is this medicine used for?

This medicine is used for the long dwell exchange (8 to 16 hours) in peritoneal dialysis.

What should my healthcare provider know before I take this medicine?

Before taking this medicine, tell your healthcare provider if you have any other medical conditions such as:

• an allergic reaction to any medicine or to cornstarch
• a condition that restricts normal nutrition (you do not eat well)
• breathing problems or lung disorders such as asthma or COPD
• diabetes
• glycogen storage disease
• high levels of calcium in the blood
• low levels of magnesium or potassium in the blood
• unable to tolerate maltose or isomaltose

Tell your provider if you have recently had heart or abdominal surgery, or any problems with your abdomen (such as infection, open wounds, tumors, or a hernia).

Females of childbearing age: Tell your healthcare provider if you are pregnant or plan to become pregnant. It is not known whether this medicine will harm an unborn baby. Do not breast-feed while receiving this medicine without your healthcare provider's approval.

How do I use it?

Read the Medication Guide that comes with this medicine before you start treatment and each time you get a new carton of medicine.

Use this medicine for your long dwell (8 to 16 hours) peritoneal dialysis exchange only, and not more than 1 exchange in 24 hours. Follow the steps learned in your peritoneal dialysis training. Clean all surfaces and connections to avoid serious infection. Do not add any other medicines to this medicine without your healthcare provider's approval. If you need help or have any questions, contact your dialysis center.

• Before use, always check to make sure the bags are not leaking and that the solution is clear and does not contain particles. Do not use bags that are cloudy, leaking, or that contain particles.
• Make sure the date for using the solution (expiration date) has not passed. Do not use this medicine after the expiration date.
• To make using this medicine more comfortable, you can warm it 98.6°F (37°C) before use. Use a heating pad. Do not use hot water or a microwave to heat the bags. You can damage the solution if it gets hotter than 104°F (40°C).
• If you use a manual method of peritoneal dialysis (CAPD), this medicine should be infused over 10 to 20 minutes at a rate that is comfortable for you. When draining the fluid after the dwell, always check the drained fluid for cloudiness or fibrin. Fibrin looks like clumps or stringy material in the drained solution. Cloudy drained fluid or fibrin may mean you have an infection. Call your healthcare provider if your drained fluid is cloudy or contains fibrin.
• Carefully monitor your fluid balance and weight. Keep an accurate fluid record.

What if I miss a dose?

This medicine is given on a regular schedule. Do not miss a dose. Keep all appointments. If you are not sure of what to do if you miss a dose or appointment, contact your healthcare provider.

What if I overdose?

Symptoms of an acute overdose have not been reported.

What should I watch out for?

You will need to have lab tests regularly to see how this medicine affects you. Keep all appointments for these tests.

If you need emergency care, surgery, or dental work, tell the healthcare provider or dentist you are taking this medicine.

Diabetics: You may have incorrect blood glucose results when using certain blood glucose monitors and test strips while receiving this medicine. DO NOT use monitors or test strips that use GDH-PQQ or GDO to measure blood glucose. You must use a glucose specific monitor and test strips to check your blood sugar. Contact the manufacturer of the monitor and test strips you use to make sure that this medicine will not interfere with the test results. Also, this medicine may affect your blood sugar level and change the amount of insulin you may need. Talk to your healthcare provider before you change your diet or dosage of diabetes medicine.

What are the possible side effects?

Along with its needed effects, your medicine may cause some unwanted side effects. Some side effects may be very serious. Some side effects may go away as your body adjusts to the medicine. Tell your healthcare provider if you have any side effects that continue or get worse.

Life-threatening (Report these to your healthcare provider right away). If you cannot reach your healthcare provider right away, get emergency medical care or call 911 for help): Allergic reaction (hives; itching; rash; trouble breathing; chest pain or tightness in your chest; swelling of your lips, tongue, and throat).

Serious (report these to your healthcare provider right away): Pain, redness, fever, chills, or cloudy drained fluid; severe nausea or vomiting; increased cough; trouble breathing; severe headache; stomach pain or swelling; chest pain; rapid weight gain; unusual swelling in your hands, ankles, or feet; severe rash; severe dizziness or fainting; increased blood pressure or blood sugar.

Other: Mild rash, mild headache, nausea.

What products might interact with this medicine?

When you take this medicine with other medicines, it can change the way this or any of the other medicines work. Nonprescription medicines, vitamins, natural remedies, and certain foods may also interact. Using these products together might cause harmful side effects. Talk to your healthcare provider if you are taking:

• diabetes medicines such as insulin, glipizide (Glucotrol), glyburide (DiaBeta), metformin (Glucophage), pioglitazone (Actos), repaglinide (Prandin), and rosiglitazone (Avandia)
• digoxin (Lanoxin)

If you are not sure if your medicines might interact, ask your pharmacist or healthcare provider. Keep a list of all your medicines with you. List all the prescription medicines, nonprescription medicines, supplements, natural remedies, and vitamins that you take. Be sure that you tell all healthcare providers who treat you about all the products you are taking.

How should I store this medicine?

Store this medicine at room temperature. Do not let it freeze. Keep the container tightly closed. Protect it from heat, high humidity, and bright light. Keep the medicine in the original box until ready for use.

Throw away any unused medicine. Do not use your medicine more than one time.

This advisory includes selected information only and may not include all side effects of this medicine or interactions with other medicines. Ask your healthcare provider or pharmacist for more information or if you have any questions.

Keep all medicines out of the reach of children.

Do not share medicines with other people.