Parenteral Manual

Albumin (BLOOD PRODUCT from TML)

Disclaimer: Official controlled document is the CHEO online copy. It is the responsibility of user to ensure that any paper copy version is the same as the online version before use.

Alternate Name(s): 
PLASBUMIN-5, PLASBUMIN-25, ALBUMIN 5% SOLUTION
Classification: 
Plasma protein, plasma volume expander
Original Date: 
August 2005
Revised Date: 
September 2011
Indications: 
  • Treatment of hypovolemia
  • Plasma volume expansion
  • Treatment of hypoproteinemia
  • Acute nephrotic syndrome
Reconstitution and Stability: 
  • Available: 50 mg/mL (5% solution) in 50 mL, 250 mL, 500 mL and 1,000 mL vials
                      250 mg/mL (25% solution) in 20 mL, 50 mLand 100 mL vials
  • Use within 4 hours of opening
  • 25% aqueous solution may be diluted in D5W or NS to a final concentration of 5%, DO NOT use Sterile Water for Injection
Compatibility: 

- Solution Compatible:  dextrose (up to D10W), NS, ringer's lactate

- Additives/Above Cassette Compatible:  no information

- Y-site Compatible:  diltiazem, amino acids and dextrose

- Incompatible:  Sterile Water for Injection, lipids, midazolam, vancomycin, verapamil

Administration: 

(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

SC NO
IM NO
IV Direct NO
IV Intermittent Infusion YES
Hypoproteinemia: infuse over 2-4 hours

Hypovolemia: usually infuse over 30-60 min (faster rates may be clinically necessary).  Rate depends on severity and patient's symptoms
IV Continuous Infusion YES
Dosage: 

(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Pediatrics:  

  • Hypovolemia: 0.5-1 g/kg/dose (10-20 mL/kg/dose of 5% albumin) IV; may repeat as needed.
                  Maximum: 6 g/kg/day
  • Hypoproteinemia: 0.5-1 g/kg/dose (2-4 mL/kg/dose of 25% albumin) IV, may repeat every 1-2 days.
                  Maximum: 2 g/kg/day
  • Nephrotic syndrome: 0.25 - 1 g/kg/dose (1-4 mL/kg/dose of 25% albumin) IV

Adolescent/Adults: 

  • 25 g IV.  May repeat in 15-30 minutes. Daily maximum = 125 g
Potential hazards of parenteral administration: 
  • Too rapid infusion may lead to acute hypertension or vascular overload, causing pulmonary edema or cardiac failure
  • Allergic reactions may occur: chills, fever, nausea, vomiting, increased salivation, and urticaria.
  • Using Sterile Water for Injection  as a diluent reduces tonicity and may lead to fatal hemolysis and acute renal failure.
Notes: 
  • Rate of administration is variable depending on indication, blood volume, patient response and concentration of solution.
  • If normovolemia:   5% solution: maximum of 2-4 mL/min
                                    25% solution: maximum of 1 mL/min
  • Albumin 5% should be used in hypovolemic patients; albumin 25% should be used in patients with fluid or sodium restrictions (hypoproteinemia, nephrotic syndrome).
  • Contraindicated in patients with hypersensitivity to albumin and in patients at risk for acute circulatory overload (cardiac failure, pulmonary edema and severe anemia).
  • Caution in patients with hypertension, low cardiac reserve, hepatic or renal failure or lack of albumin deficiency.
  • Monitor serum fibronectin and transferrin levels, hemoglobin, hematocrit, urine specific gravity, ins and outs.
  • Sodium content is approximately 14.5 mmol/100mL in 5% and 25% solutions.
  • Do not administer albumin to burn patients for the first 24 hours after the burn (capillary exudation of albumin will occur).

  • This medication contains albumin or human blood products. Consent (Informed Consent for Transfusion of Blood/Blood Products - form #1084) is required prior to administration to the patient.

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