Anaphylactoid reactions (mild influenza-like symptoms, bradycardia, tachycardia, bronchospasm, non-cardiac pulmonary edema) occur with solutions containing hydroxyethyl starch. If a hypersensitivity reaction occurs, administration of the drug should be discontinued immediately and the appropriate treatment and supportive measures should be undertaken until symptoms have resolved.
Fluid Equilibrium: Avoid fluid overload; adjust dosage in patients with cardiac or renal dysfunction
Fluid status and rate of infusion should be assessed regularly during treatment, especially in patients with cardiac insufficiency or severe kidney dysfunction.
In cases of severe dehydration, a crystalloid solution should be given first. Generally, sufficient fluid should be administered in order to avoid dehydration.
Monitoring: Laboratory Tests: Clinical evaluation and periodic laboratory determinations are necessary to monitor fluid balance, serum electrolyte concentrations, kidney function, acid-base balance, and coagulation parameters during prolonged parenteral therapy or whenever the patient's condition warrants such evaluation. Monitor liver function in patients receiving Hydroxyethyl starch
Interference with Laboratory Tests: Elevated serum amylase levels may be observed temporarily following administration of the HES and can interfere with the diagnosis of pancreatitis.
At high dosages, the dilutional effects may result in decreased levels of coagulation factors and other plasma proteins and a decrease in hematocrit.