Hetastarch (Hespan) – Side Effects, Interactions, Uses, Dosage, Warnings

Reviewed: June 23, 2020

Hetastarch (hydroxyethyl starch) is made from natural sources of starch. Hetastarch increases the volume of blood plasma that can be lost from bleeding or severe injury. Plasma is needed to circulate red blood cells that deliver oxygen throughout the body.

Hetastarch is used to treat or prevent hypovolemia (decreased blood plasma volume, also called “shock”) that may occur as a result of serious injury, surgery, severe blood loss, burns, or other trauma.

Hetastarch may also be used for purposes not listed in this medication guide.

uses

What is Hetastarch (Hespan) used for?

• Hypovolemia

warnings

What is the most important information I should know about Hetastarch (Hespan)?

You should not receive this medication if you are allergic to hetastarch, or if you have:

• a bleeding or blood clotting disorder;
• kidney disease;
• congestive heart failure; or
• urination problems not caused by hypovolemia (decreased blood plasma volume).

If possible before you receive hetastarch, tell your doctor if you have:

• liver disease;
• a history of heart disease; or
• if you are allergic to corn.

FDA pregnancy category C. It is not known whether hetastarch will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether hetastarch passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

In an emergency situation it may not be possible to tell your caregivers about your health conditions, or if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received this medicine.

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Side Effects

What are the side effects of Hetastarch (Hespan)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have:

• wheezing or gasping for breath, rapid breathing, sweating, and anxiety;
• a light-headed feeling, like you might pass out;
• weak pulse, slow breathing;
• chest pain, fever, chills, cough; or
• easy bruising, unusual bleeding, or any bleeding that will not stop.

Rare but serious side effects may include:

• severe headache, vision or speech problems, mental changes;
• drooping eyelids, loss of feeling in your face, tremors, trouble swallowing; or
• severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Hetastarch can harm your kidneys. Call your doctor at once if you have any of these symptoms of kidney damage: swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no urinating.

Common side effects may include:

• mild itching or skin rash;
• mild headache;
• muscle pain; or
• swollen glands, mild flu symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Pregnancy & Breastfeeding

Can I take Hetastarch (Hespan) if I’m pregnant or breastfeeding?

FDA pregnancy category C. It is not known whether hetastarch will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether hetastarch passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

Interactions

What drugs and food should I avoid while taking Hetastarch (Hespan)?

Follow your doctor’s instructions about any restrictions on food, beverages, or activity.

Dosage Guidelines & Tips

How to take Hetastarch (Hespan)?

Use Hetastarch (Hespan) exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

What should I do if I missed a dose of Hetastarch (Hespan)?

Because you will receive hetastarch in a clinical setting, you are not likely to miss a dose.

Overdose Signs

What happens if I overdose on Hetastarch (Hespan)?

Since hetastarch is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

If you think you or someone else may have overdosed on: Hetastarch (Hespan),  call your doctor or the Poison Control center

(800) 222-1222

If someone collapses or isn’t breathing after taking Hetastarch (Hespan), call 911

911

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Medical Disclaimer

Drugs A-Z provides drug information from Everyday Health and our partners, as well as ratings from our members, all in one place. Cerner Multum™ provides the data within some of the Overview, Uses, Warnings, Side Effects, Pregnancy, Interactions, Dosage, Overdose, and Images sections. The information within all other sections is proprietary to Everyday Health. 

Hetastarch Uses, Side Effects & Warnings

Generic name: hetastarch [ HET-a-starch ]
Brand names: Hespan, Hextend
Dosage form: intravenous solution (60 mg/mL-LR; 60 mg/mL-NaCl 0.9%)
Drug class: Plasma expanders

Medically reviewed by Drugs.com on Jul 19, 2022. Written by Cerner Multum.

What is hetastarch?

Hetastarch (hydroxyethyl starch) is made from natural sources of starch. Hetastarch increases the volume of blood plasma that can be lost from bleeding or severe injury. Plasma is needed to circulate red blood cells that deliver oxygen throughout the body.

Hetastarch is used to treat or prevent hypovolemia (decreased blood plasma volume, also called “shock”) that may occur as a result of serious injury, surgery, severe blood loss, burns, or other trauma.

Hetastarch may also be used for purposes not listed in this medication guide.

Warnings

You should not receive this medication if you have a bleeding or blood clotting disorder, congestive heart failure, kidney disease, or urination problems not caused by hypovolemia (decreased blood plasma volume).

Hetastarch can harm your kidneys. Call your doctor at once if you have any of these symptoms of kidney damage: swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no urinating.

Before taking this medicine

You should not receive this medication if you are allergic to hetastarch, or if you have:

• a bleeding or blood clotting disorder;

• kidney disease;

• congestive heart failure; or

• urination problems not caused by hypovolemia (decreased blood plasma volume).

If possible before you receive hetastarch, tell your doctor if you have:

FDA pregnancy category C. It is not known whether hetastarch will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether hetastarch passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

In an emergency situation it may not be possible to tell your caregivers about your health conditions, or if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received hetastarch.

How is hetastarch given?

Hetastarch is injected into a vein through an IV. A healthcare provider will give you this injection.

Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will be watched closely while you are receiving hetastarch. Your blood will also need to be tested daily during treatment.

What happens if I miss a dose?

Because you will receive hetastarch in a clinical setting, you are not likely to miss a dose.

What happens if I overdose?

Since hetastarch is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

What should I avoid after receiving hetastarch?

Follow your doctor’s instructions about any restrictions on food, beverages, or activity.

Hetastarch side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have:

• wheezing or gasping for breath, rapid breathing, sweating, and anxiety;

• a light-headed feeling, like you might pass out;

• weak pulse, slow breathing;

• chest pain, fever, chills, cough; or

• easy bruising, unusual bleeding, or any bleeding that will not stop.

Rare but serious side effects may include:

• severe headache, vision or speech problems, mental changes;

• drooping eyelids, loss of feeling in your face, tremors, trouble swallowing; or

• severe skin reaction — fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Hetastarch can harm your kidneys. Call your doctor at once if you have any of these symptoms of kidney damage: swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no urinating.

Common side effects of hetastarch may include:

• mild itching or skin rash;

• mild headache;

• muscle pain; or

• swollen glands, mild flu symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Hetastarch dosing information

Usual Adult Dose for Hypovolemia:

Dosage for Acute Use in Plasma Volume Expansion: 500 to 1000 mL IV
Maintenance dose: Total dosage and rate of infusion depends on the amount of blood or plasma lost and the resultant hemoconcentration.
Maximum dose: Doses more than 1500 mL per day (approximately 20 mL per kg of body weight) are usually not required although higher doses have been used in postoperative and trauma patients with severe blood loss.

Dosage in Leukapheresis: 250 to 700 mL to which citrate anticoagulant has been added and administered to the input line of the centrifugation apparatus at a ratio of 1:8 to 1:13 to venous whole blood.

Comments:
-Hetastarch and citrate should be thoroughly mixed to assure effective anticoagulation.
-Hetastarch admixtures of 500 to 560 mL with citrate concentrations up to 2.5% are compatible for 24 hours at room temperature.

Uses:
-For treatment of hypovolemia when plasma volume expansion is desired
-This drug in leukapheresis improves the harvesting and increasing the yield of granulocytes by centrifugal means

What other drugs will affect hetastarch?

Other drugs may interact with hetastarch, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

More about hetastarch

• Compare alternatives
• Pricing & coupons
• Side effects
• Dosage information
• During pregnancy
• Drug class: plasma expanders
• En español

Patient resources

• Advanced Reading
• Hetastarch/sodium chloride (Advanced Reading)

Other brands

Hextend, Hespan

Professional resources

• Prescribing Information

Related treatment guides

• Blood Disorders
• Hypovolemia

Further information

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Medical Disclaimer

Copyright 1996-2023 Cerner Multum, Inc. Version: 2.02.

Hetastarch: side effects, dosages, treatments, interactions, warnings

Getastarkh

Checked on 01/13/2020

• What is
  • What is Hetastarch used for and how does it work?
• Side effects
  • What side effects are associated with the use of Hetastarch?
• Drug interactions
  • What other drugs interact with Hetastarch?
• Warning and precautions
  • What are the warnings and precautions for Hetastarch?

Brand Name and Other Names: Hespan, Hextend

Generic Name: Hetastarch

Drug Class: Volume Expanders

What is Hetastarch used for and how does it work?

can i take benadryl and claritin

Hetastarch is used to treat low blood volume (hypovolemia) and to remove white blood cells from a blood draw (leukapheresis).

Hetastarch is available under the following brand names: Hespan and Hextend.

Hetastarch dosages:

Dosage forms and strengths

Injection solution

• 6% hydroxyethyl starch in 0.9% NaCl (Hespan)
• 6% hydroxyethyl starch in lactate electrolyte solution (Hextend )

Dosage recommendations – to be considered as follows:

Hypovolemia, adults and geriatrics

• 500-1000 ml (30-60 g) iv
• Not more than 1500 ml/day (20 ml/kg )
• Monitor: complete blood count with differential, Hgb, Hct, PT, PTT

Hypovolemia, pediatrics (off label)

• 10 ml/kg/dose
• Max. 20 ml / kg

Leukapheresis for adults and the elderly

• 250-700 ml Hespan with added citrate anticoagulant
• Ratio 1:8 to 1:13 to venous whole blood
• Monitor: complete blood count with differential, Hgb, Hct, PT, PTT 90 012

Leukapheresis , pediatric (off label)

• 250-700 ml Horse
• Infused at a ratio of 1:8 to 1:13 to venous whole blood
• Monitor: complete blood count with differentials, Hgb, Hct, PT, PTT

Renal failure

• CrCl less than 10 ml/min: After the usual initial dose, reduce subsequent doses by 20-50% of normal.

What side effects are associated with the use of Hetastarch?

Common side effects of Hetastarch include:

• Anaphylaxis (swelling around the eyes, urticaria, wheezing, mild fever)
• Chills
• Flu-like symptoms
• Muscle pain
• Swelling of extremities
• Headache
• Itching
• Vomiting
• Salivary gland enlargement

This document does not contain all possible side effects that may occur. For more information about side effects, please consult your doctor.

What other drugs interact with Hetastarch?

If your doctor has advised you to use this medicine, your doctor or pharmacist may already be aware of any possible drug interactions and can monitor you for them. Do not start, stop, or change the dosage of any medicine without talking to your doctor, health care provider, or pharmacist.

Hetastarch does not have any serious drug interactions listed.

Hetastarch does not have any serious drug interactions listed.

Hetastarch does not have listed mild drug interactions.

Hetastarch does not have listed mild interactions with other drugs.

What are the warnings and precautions for Hetastarch?

Precautions

This medicine contains hetastarchat. Do not take Hespan or Hextend if you are allergic to hetastarch or any of the ingredients in this medicine.

Black box warnings

• Avoid use in patients with pre-existing renal dysfunction.
• Stop use at first sign of kidney damage.
• Renal replacement therapy has been reported up to 90 days after administration; continue to monitor renal function for at least 90 days in all patients
• Avoid use in patients undergoing open heart surgery combined with cardiopulmonary bypass due to excessive bleeding.
• Stop at the first sign of coagulopathy

Contraindications.

• Hypersensitivity to hetastarch.
• Severe bleeding disorders, severe congestive heart failure, severe renal failure.

Consequences of drug abuse

• No information available.

Short-term effects

• See “What side effects are associated with the use of Hetastarch?”

Long-term effects

• See “What side effects are associated with the use of Hetastarch?”

Warnings

• Corn allergy, liver disease, kidney failure, thrombocytopenia
• Risk of pulmonary edema or congestive heart failure
• Possibility of circulatory overload
• Hetastarch in varnish tatny solution contains potassium and sodium.
• Hextend should not be used in leukapheresis or lactic acidosis.

Pregnancy and lactation

Hetastarch should be used with caution during pregnancy if the benefits outweigh the risks. Animal studies show a risk and no human studies are available or studies in animals or humans have not been conducted.

It is not known if hetastarch passes into breast milk. Avoid using hetastarch while breastfeeding.

Recommendations https://reference.medscape.com/drug/hespan-hextend-hetastarch-342427

Hespan, hextend (hetastarch) side effects, interactions, uses and drug imprint

Brand names: Hespan, Hextend

Generic name: hetastarch

What is hetastarch (Hespan, Hextend)?

Hetastarch (hydroxyethyl starch) is made from natural starch sources. Hetastarch increases the volume of blood plasma that can be lost due to bleeding or serious injury. Plasma is essential for the circulation of red blood cells, which deliver oxygen throughout the body.

Hetastarch is used to treat or prevent hypovolemia (decreased blood plasma volume, also called “shock”) that can occur as a result of serious injury, surgery, severe blood loss, burns, or other trauma.

Hetastarch may also be used for purposes not listed in this medication guide.

What are the possible side effects of hetastarch (Hespan, Hextend)?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; labored breathing; swelling of the face, lips, tongue, or throat.

Tell your caregivers right away if you have:

• shortness of breath or trouble breathing, fast breathing, sweating and restlessness;
• light-headed feeling, as if you might pass out;
• weak pulse, slow breathing;
• chest pain, fever, chills, cough; or
• easy bruising, unusual bleeding, or any bleeding that won’t stop.

Rare but serious side effects may include:

• severe headache, problems with vision or speech, mental changes;
• drooping eyelids, facial numbness, trembling, trouble swallowing; or
• serious skin reaction – fever, sore throat, swelling of the face or tongue, burning eyes, skin pain accompanied by a red or purple skin rash that spreads (especially on the face or upper body) and causes blistering and peeling.

Hetastarch may harm your kidneys. Call your doctor right away if you have any of these symptoms of kidney damage : swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no lack of urination.

Common side effects may include:

• mild itching or skin rash;
• mild headache;
• muscle pain; or
• swollen glands, mild flu symptoms.

This is not a complete list of side effects and others may occur. Ask your doctor about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

What is the most important information I should know about hetastarch (Hespan, Hextend)?

You should not receive this medicine if you have bleeding or a bleeding disorder, congestive heart failure, kidney disease, or urinary problems not caused by hypovolemia (decreased blood plasma volume).

Hetastarch may harm your kidneys. Call your doctor right away if you have any of these symptoms of kidney damage: swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no urination .

What should I discuss with my doctor before I receive hetastarch (Hespan, Hextend)?

You should not receive this drug if you are allergic to hetastarch or if you have:

• a bleeding or blood clotting disorder;
• Kidney disease;
• chronic heart failure; or
• urinary problems not caused by hypovolemia (decreased plasma volume).

If possible, before you receive hetastarch, tell your doctor if you have:

• liver disease;
• history of heart disease; or
• If you are allergic to corn.

FDA pregnancy category C. It is not known whether hetastarch will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medicine.

It is not known whether hetastarch passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breastfeeding a baby.

In an emergency, it may not be possible to tell your caregivers about your health and whether you are pregnant or breastfeeding. Make sure any doctor who cares about your pregnancy or your child knows you have received this medicine

How is hetastarch (Hespan, Hextend) given?

Hetastarch is injected into a vein through an IV. The health worker will give you this injection.

Your breathing, blood pressure, oxygen levels, kidney function and other vital signs will be monitored closely while you are taking hetastarch. Your blood will also need to be checked daily during treatment.

What happens if I miss a dose (Hespan, Hextend)?

Since you will be receiving hetastarch in a clinical setting, you are unlikely to miss a dose.