Reconstitution of Hematin for Intravenous Infusion

Letters4 April 2006Reconstitution of Hematin for Intravenous InfusionKarl E. Anderson, MD, Herbert L. Bonkovsky, MD, Joseph R. Bloomer, MD, and Steven I. Shedlofsky, MDKarl E. Anderson, MDFrom University of Texas Medical Branch, Galveston, TX 77555-1109; University of Connecticut Health Center, Farmington, CT 06030; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Kentucky, Lexington, KY 40506., Herbert L. Bonkovsky, MDFrom University of Texas Medical Branch, Galveston, TX 77555-1109; University of Connecticut Health Center, Farmington, CT 06030; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Kentucky, Lexington, KY 40506., Joseph R. Bloomer, MDFrom University of Texas Medical Branch, Galveston, TX 77555-1109; University of Connecticut Health Center, Farmington, CT 06030; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Kentucky, Lexington, KY 40506., and Steven I. Shedlofsky, MDFrom University of Texas Medical Branch, Galveston, TX 77555-1109; University of Connecticut Health Center, Farmington, CT 06030; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Kentucky, Lexington, KY 40506.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-144-7-200604040-00023 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:Background: Hemin, the preferred treatment for acute porphyrias (1), is available in the United States as lyophilized hematin (Panhematin, Ovation Pharmaceuticals, Deerfield, Illinois) and is reconstituted with sterile water just before infusion. The product package insert recommends that treatment be administered through a large arm vein or by central venous catheter to avoid phlebitis.Many physicians and medical centers have adopted the published method of Bonkovsky and colleagues (2) for reconstituting hematin with 25% human albumin. Each albumin molecule has a single high-affinity heme binding site and additional lower affinity sites. This reconstitution method uses an equimolar ...References1. Anderson KE, Bloomer JR, Bonkovsky HL, Kushner JP, Pierach CA, Pimstone NR, et al. Recommendations for the diagnosis and treatment of the acute porphyrias. Ann Intern Med. 2005;142:439-50. [PMID: 15767622] LinkGoogle Scholar2. Bonkovsky HL, Healey JF, Lourie AN, Gerron GG. Intravenous heme-albumin in acute intermittent porphyria: evidence for repletion of hepatic hemoproteins and regulatory heme pools. Am J Gastroenterol. 1991;86:1050-6. [PMID: 1713408] MedlineGoogle Scholar3. McEvoy GK. AHFS Drug Information. Bethesda, MD: American Society of Health System Pharmacists; 2002. Google Scholar4. United States Pharmacopeial Convention. USP DI-Volume I, Drug Information for the Health Care Professional. Englewood, CO: Micromedex; 2004. Google Scholar5. Mustajoki P, Tenhunen R, Pierach C, Volin L. Heme in the treatment of porphyrias and hematological disorders. Semin Hematol. 1989;26:1-9. [PMID: 2646718] MedlineGoogle Scholar6. European Porphyria Initiative. Treatment of the acute attack. Accessed at www.porphyria-europe.com/02-for-healthcare/treatment.asp on 26 February 2006. Google Scholar7. Lamon JM, Frykholm BC, Bennett M, Tschudy DP. Prevention of acute porphyric attacks by intravenous haematin. Lancet. 1978;2:492-4. [PMID: 79864] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Karl E. Anderson, MD; Herbert L. Bonkovsky, MD; Joseph R. Bloomer, MD; Steven I. Shedlofsky, MDAffiliations: From University of Texas Medical Branch, Galveston, TX 77555-1109; University of Connecticut Health Center, Farmington, CT 06030; University of Alabama at Birmingham, Birmingham, AL 35294; and University of Kentucky, Lexington, KY 40506.Disclosures: Grants received: J.R. Bloomer (Ovation Pharmaceuticals). PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoRecommendations for the Diagnosis and Treatment of the Acute Porphyrias Karl E. Anderson , Joseph R. Bloomer , Herbert L. Bonkovsky , James P. Kushner , Claus A. Pierach , Neville R. Pimstone , and Robert J. 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