Calcium Chloride (KAL-see-um KLOR-ide), Icodextrin (eye-koe-DEX-trin), Magnesium Chloride (mag-NEE-zee-um KLOR-ide), Sodium Chloride (SOE-dee-um KLOR-ide), Sodium Lactate (SOE-dee-um LAK-tate)

Used as part of a dialysis process for clearing waste out of your body.

Brand Name(s):

Extraneal

When This Medicine Should Not Be Used:

How to Use This Medicine:

Injectable

• Your doctor will decide how much of the solution you need and tell you how often it should be used. This solution is given through a catheter that is placed in your abdomen during a minor operation.
• Your healthcare provider should teach you about peritoneal dialysis and how to use this solution. Make sure you understand all instructions before you do the process yourself. Follow all of the steps in the process exactly as you were trained to do.
• This solution is for the long dwell exchange of peritoneal dialysis, which lasts longer than 8 hours. Do not use this solution more than 1 time in 24 hours, unless your doctor tells you to. You will have other solutions to use during shorter exchanges.
• Always wash your hands before you handle your catheter or medicine.
• Check the liquid in its container before you use it. Do not use it if it is cloudy or has small specks floating in it. Do not use it if the container has a leak.
• You may warm the solution up to 37°C (98.6°F) with a dry heating pad before you use it. Leave the wrapper on while you heat it. Do not warm the solution in a microwave oven or put it in water. Do not heat it above 40°C (104°F).
• If you use too much icodextrin, you might feel full or bloated or have trouble breathing. Your abdomen might look bigger. If this happens, drain out some of the solution.
• After you drain the fluid back out of your catheter, look at the fluid. Call your provider if it is cloudy or you see clumps or stringy material.
• Do not add anything to the solution unless your healthcare provider tells you to. Other medicines and minerals are sometimes added, but you will be told about this if needed.
• Throw away any unused solution.
• This medicine should come with a Medication Guide. Ask your pharmacist for a copy if you do not have one.
• Missed dose: You must use this medicine on a fixed schedule. Call your doctor or pharmacist if you miss a dose.
• If you store this medicine at home, keep it at room temperature, away from heat, moisture, and direct light. Do not freeze. Keep the solution in the box and wrapper until you are ready to use it.

Drugs and Foods to Avoid:

Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Some medicines can affect how icodextrin works. Tell your doctor if you are using digoxin, insulin, or medicine to treat HIV infection.
• Icodextrin might remove other medicines from your body, so your doctor might need to change your dose of the other medicines. However, do not change any doses unless your doctor tells you to.

Warnings While Using This Medicine:

• Tell your doctor if you are pregnant or breastfeeding, or if you have diabetes or low blood pressure. Tell your doctor if you cannot take maltose or isomaltose, or if you have glycogen storage disease or lactic acidosis.
• This solution may cause false high blood sugar readings for some monitors and test strips. You must use only a glucose-specific monitor and test strips. Your doctor should help you choose the right monitor and test strips.
• Tell any doctor who treats you that you are using this medicine, especially if you are in the hospital or emergency room.
• Keep track of how much fluid you have in your body at all times, because it is easy to have too much or too little. Weigh yourself often, and write the number down.
• Tell any doctor or dentist who treats you that you are using this medicine. This medicine may affect certain medical test results.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.
• Keep all medicine out of the reach of children. Never share your medicine with anyone.

Possible Side Effects While Using This Medicine:

Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Blistering, peeling, or red skin rash
• Cloudy fluid or clumps in fluid after draining
• Fever, chills, cough, sore throat, body aches
• Redness, swelling, or pain where the catheter goes into your abdomen or stomach
• Shaking, trembling, sweating, fast or pounding heartbeat, lightheadedness, hunger, confusion

If you notice these less serious side effects, talk with your doctor:

• Headache
• Nausea, stomach pain

If you notice other side effects that you think are caused by this medicine, tell your doctor

Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088