Anaphylactoid Reactions: Anaphylactoid reactions (mild influenza-like symptoms, bradycardia, tachycardia, bronchospasm, non-cardiac pulmonary edema) have been reported 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.Renal Dysfunction: Avoid use in patients with pre-existing renal dysfunction. Discontinue use of Expansol at the first sign of renal injury. Continue to monitor renal function in hospitalized patients for at least 90 days.Coagulopathy: Monitor the coagulation status of patients undergoing open heart surgery in association with cardiopulmonary bypass as excess bleeding has been reported with Hydroxyethyl Starch solutions in this population. Discontinue use of Expansol at the first sign of coagulopathy.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. Monitor liver function in patients receiving Hydroxyethyl Starch products.
