EXTRANEAL IS INDICATED FOR A SINGLE DAILY EXCHANGE FOR THE LONG (8- TO 16- HOUR) DWELL DURING CONTINUOUS AMBULATORY PERITONEAL DIALYSIS (CAPD) OR AUTOMATED PERITONEAL DIALYSIS (APD) FOR THE MANAGEMENT OF END-STAGE RENAL DISEASE. EXTRANEAL IS ALSO INDICATED TO IMPROVE (COMPARED TO 4.25% DEXTROSE) LONG-DWELL ULTRAFILTRATION AND CLEARANCE OF CREATININE AND UREA NITROGEN IN PATIENTS WITH HIGH AVERAGE OR GREATER TRANSPORT CHARACTERISTICS, AS DEFINED USING THE PERITONEAL EQUILIBRATION TEST (PET).
PATIENTS SHOULD BE CAREFULLY MONITORED TO AVOID UNDER- OR OVER-HYDRATION. AN ACCURATE FLUID BALANCE RECORD MUST BE KEPT AND THE PATIENT'S BODY WEIGHT MONITORED TO AVOID POTENTIALLY SEVERE CONSEQUENCES INCLUDING CONGESTIVE HEART FAILURE, VOLUME DEPLETION, AND HYPOVOLEMIC SHOCK.
TO REDUCE POSSIBLE DISCOMFORT DURING ADMINISTRATION, SOLUTIONS MAY BE WARMED PRIOR TO USE. SHOULD BE ADMINISTERED OVER A PERIOD OF 10-20 MINUTES AT A RATE THAT IS COMFORTABLE FOR THE PATIENT.
FOLLOWING USE, THE DRAINED FLUID SHOULD BE INSPECTED FOR THE PRESENCE OF FIBRIN OR CLOUDINESS, WHICH MAY INDICATE THE PRESENCE OF PERITONITIS.
SIGNIFICANT LOSSES OF PROTEIN, AMINO ACIDS, WATER-SOLUBLE VITAMINS AND OTHER MEDICINES MAY OCCUR DURING PERITONEAL DIALYSIS. THE PATIENT'S NUTRITIONAL STATUS SHOULD BE MONITORED AND REPLACEMENT THERAPY SHOULD BE PROVIDED AS NECESSARY.