Ceredase Infusions: Timing and Dilutions

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Several members have reported that they are being infused with Ceredase over different lengths of time and with different dilutions of saline. Professor Timothy Cox, Addenbrooke's Hospital, Cambridge explains why some patients' regimes are different:

The Company (Genzyme Biotherapeutics) suggests that intravenous infusion should be given over one to two hours with an initial dosage up to 60 units per kg of bodyweight per infusion. The Company recommends that the appropriate amount of Ceredase for each patient should be diluted with normal saline with an infusion volume not exceeding 100 mls. Since the preparation does not contain preservative, open bottles should not be stored for subsequent use.

Clearly the doses that are being administered in the UK are generally lower by a considerable factor than the original official dosage of 60 units per kg. I believe the same dosage rate can be adhered to on a minute by minute basis but I believe that this should be done with a syringe injector that does not involve a large area of tubing or plastic bag that may bind and remove active Ceredase from the fluid. In other words I believe slow infusions of Ceredase diluted in a small volume are appropriate, in the context of the Company's recommendations.

Aseptic procedures should be used to remove the Ceredase from the storage vial (bottle) and great caution should be undertaken if any re-usage is planned of residual quantity. The Company's provision of a 50 unit bottle appears to be quite adequate for intermediate dosage schedules instead of the 400 unit bottle.

Source: Gauchers News September 1993
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