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What should I discuss with my healthcare provider before using icodextrin (LVP solution) (Extraneal)?

You should not use this medication if you are allergic to icodextrin or cornstarch, or if you have:

• maltose or isomaltose intolerance;
• severe lactic acidosis; or
• a glycogen storage disease (an inherited metabolic disorder).

If you have diabetes and you test your blood sugar using a glucose monitor and test strips, ask a doctor or pharmacist about the best type to use. Certain glucose monitors and test strips must not be used while you are being treated with icodextrin. Tell any doctor who treats you that you are using icodextrin.

Before using icodextrin, tell your doctor if any of the following conditions have recently affected your stomach area: surgery, tumors, hernia, infection, or open wounds.

To make sure you can safely use icodextrin, tell your doctor if you have any of these other conditions:

• a breathing disorder;
• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood;)
• high levels of calcium in your blood;
• high blood pressure, congestive heart failure;
• a stomach or intestinal condition such as inflammatory bowel disease, diverticulitis, or if you have a colostomy or ileostomy;
• if you are malnourished or cannot eat; or
• if you have recently had aortic graft surgery.

FDA pregnancy category C. It is not known whether icodextrin 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 icodextrin passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How is icodextrin (LVP solution) given (Extraneal)?

Icodextrin is used in peritoneal dialysis during the long dwell exchange (8 to 16 hours). Icodextrin is given during the night-time exchange if you are on continuous peritoneal dialysis. Icodextrin is given during the daytime exchange if you are using automated peritoneal dialysis (a cycler).

This medication comes with patient instructions for safe and effective use. Follow these directions carefully. Ask your doctor or pharmacist if you have any questions.

Prepare your dose only when you are ready to give the medicine.

You may warm the medication with a heating pad to make it more comfortable to use during dialysis. Do not heat icodextrin with hot water or in a microwave. High heat can ruin the medicine.

Do not use the medication if it looks cloudy or has particles in it. Call your doctor for a new prescription.

Drink plenty of liquids while you are using icodextrin. Follow your doctor's instructions about the type and amount of liquids you should drink. In some cases, drinking too much liquid can be as unsafe as not drinking enough.

You will need regular medical tests to be sure this medication is not causing harmful effects. Visit your doctor regularly.

Store at room temperature away from moisture and heat. Do not freeze. Keep the medicine in its moisture-proof pouch until you are ready to prepare your dose.

Throw away any unused icodextrin after the expiration date on the label has passed.

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