Article date: August 2007
Extraneal (icodextrin 7·5%) is used as part of continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD) for treatment of chronic kidney failure.
Patients who are given Extraneal or other products that contain (or are metabolised to) maltose, xylose, or galactose (eg, the intravenously administered normal human immunoglobulin Octagam) should use only glucose-specific blood-glucose monitors.
Roche’s Accu-Check monitor (a glucose dehydrogenase pyrroloquinolinequinone or GDH-PQQ system) and the glucose-dye-oxidoreductase-based system are not specific for glucose, and false readings are common in the presence of maltose, galactose, and xylose. This interference does not occur when a glucose-dehydrogenase-NAD-based system is used.
Use of the wrong test may cause a falsely high reading of blood glucose, which could result in administration of more insulin than needed and subsequent hypoglycaemia, loss of consciousness, coma, neurological damage, or death. Alternatively, a false reading of high glucose may mask true hypoglycaemia and allow it to go untreated with similar consequences.
Healthcare professionals who advise use of non-glucose-specific blood monitors routinely should identify whether the patient is taking concomitant medication before use, and should inform patients who are given Extraneal or other products that contain (or are metabolised to) maltose, xylose, or galactose to use only glucose-specific monitors to measure their blood glucose.
Article citation: Drug Safety Update August 2007; Vol 1, Issue 1: 4.