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| AHFS/Drugs.com | International Drug Names |
| Routes of administration | Intraperitoneal |
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| Pharmacokinetic data | |
| Bioavailability | 40% in 12 hours |
| Metabolism | Alpha-amylase |
| Excretion | Renal |
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| Chemical and physical data | |
| Formula | (C6H10O5)n |
| Molar mass | 13–19 kg/mol |
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Icodextrin (INN,USAN) is acolloidosmotic agent, derived frommaltodextrin,[1] used in form of anaqueous solution forperitoneal dialysis under the trade nameExtraneal,[2] and after gynecologicallaparoscopic surgery for the reduction of post-surgicaladhesions (fibrous bands that form between tissues and organs) under the trade nameAdept.[3]
Icodextrin is astarch-derived, branched, water-solubleglucosepolymer linked by α-(1→4) and less than 10% α-(1→6)glycosidic bonds, making it a type ofdextrin. Its weight-average molecular weight is between 13,000 and 19,000daltons and its number-average molecular weight between 5,000 and 6,500 daltons. The substance is a white to off-white solid, and the solution is clear and colourless to pale yellow.[3]
The osmotic activity of icodextrin keeps the solution inside theperitoneum for three to four days, separating tissues and thus reducing adhesion between them whenfibrin is formed after a surgery. In other words, the tissues are kept from gluing together.[3]
When used for peritoneal dialysis, the icodextrin solution absorbs waste products from the blood, and is removed from the peritoneum after a few hours together with the waste.[4]
Icodextrin is not significantly metabolised inside the peritoneum. Instead, it is absorbed slowly (40% after 12 hours) into the bloodstream via thelymph vessels. There it is broken down intooligosaccharides by the enzymealpha-amylase. In patients with intact kidney function, both icodextrin and its fragments are excreted via the kidney byglomerular filtration.[2][3]
Icodextrin is contraindicated in patients with cornstarch allergy,maltose orisomaltose intolerance,glycogen storage disease, or severelactic acidosis.[5]
Adverse effects includeperitonitis,respiratory infection,hypertension (high blood pressure),rashes, and headache. Of these side effects, only hypertension and rashes occurred significantly more often than under glucose solution; the other events seem to be related to peritoneal dialysis in general.[5]
Icodextrin can mimic increasedblood glucose levels, depending on the used testing system. Specifically, glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) or glucose-dye-oxidoreductase (GDO) based tests can erroneously show high blood glucose in patients that have been treated with icodextrin.[5]
