How should haem arginate (human hemin) be administered in the management of acute porphyria?

· UKMi

  • The recommended dose for haem arginate is 3mg/kg (to a maximum of 250mg) once daily for 4 consecutive days.
  • It should be administered as an intravenous infusion in 100mL of sodium chloride 0.9% over 30 minutes into a large antecubital vein or preferably via a central line.
  • An in-line filter should be used to filter out any unseen particles from the dark solution (most giving sets contain a 15 micron filter, but check packaging first).
  • After infusion, the vein should be flushed well.
  • Infusions should be administered via alternate arms each day
  • Haem arginate infusion should be protected from light.
  • It is recommended that haem arginate is diluted in sodium chloride 0.9% in a glass bottle. However, as there may be difficulties obtaining these, a pragmatic approach to avoid delaying emergency treatment, would be to use plastic containers and the infusion should be administered immediately.
  • Haem arginate is irritant to the veins and may cause thrombophlebitis. Extravasation is a risk factor with treatment.
  • Repetitive peripheral use may lead to the loss of the superficial venous system and the consequent need for a central line. Central lines may also, in time, become obstructed with haem deposits. Haem arginate may be administered in 100mL of human albumin (20%) to help reduce these problems (unlicensed use) and infused over 60 minutes.
Haem arginateNutritional and metabolic disordersParenteral AdministrationQ&A

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