Albumin (20%) is a sterile, pyrogen-free, concentrated human serum albumin solution prepared from pooled human venous plasma. It is a hyperoncotic colloidal plasma volume expander containing 200 mg/mL of albumin, with approximately 130-160 mmol/L of sodium. In the Indian context, it is a critical, high-value biological used primarily in hospital settings for acute volume resuscitation and oncotic pressure correction.
Adult: Dose is highly individualized. For shock: 1-2 g/kg (5-10 mL/kg of 20% solution), not to exceed 250 g in 48 hours. Repeat based on clinical response. For hypoalbuminemia: 1 g/kg/day, monitor serum albumin. Post-paracentesis: 8 g per liter of ascitic fluid removed.
Note: For IV use only. 20% solution is hyperoncotic and MUST be infused slowly. Initial rate: 1-2 mL/min for the first 15-30 minutes. If tolerated, rate can be increased but should generally not exceed 4-5 mL/min. Can be administered undiluted or diluted with Normal Saline or 5% Dextrose. Do not use sterile water for injection (risk of hemolysis). Use a separate infusion line. Do not mix with other drugs, protein hydrolysates, or alcohol solutions.
Albumin (20%) is a hyperoncotic solution. Its primary mechanism is to increase the oncotic (colloid osmotic) pressure within the intravascular compartment. This draws fluid from the interstitial space into the circulation, thereby expanding plasma volume. Each gram of albumin can draw approximately 18 mL of fluid into the intravascular space. It also serves as a carrier protein and contributes to acid-base buffering capacity.
Pregnancy: Category C. Use only if clearly needed. No well-controlled studies. Should be used for life-threatening maternal indications like hemorrhagic shock.
Driving: No effect on ability to drive or operate machinery. However, the underlying condition being treated may impair these abilities.
| ACE Inhibitors (e.g., Enalapril, Ramipril) | Increased risk of anaphylactoid reactions, especially during LDL apheresis with albumin. | Moderate |
| Loop Diuretics (e.g., Furosemide) | Concomitant use can be synergistic in mobilizing edema fluid (albumin draws fluid intravascularly, furosemide promotes diuresis). | Low (Therapeutic) |
| Vasopressors | Albumin volume expansion may potentiate pressor effects. Monitor blood pressure closely. | Moderate |
Same composition (Albumin (20%)), different brands: