Hextend (hydroxyethyl starch) is made from natural sources of starch. This medicine increases the volume of blood plasma that can be lost from bleeding or severe injury. Plasma is needed to circulate red blood cells that deliver oxygen throughout the body.

Hextend is used to treat or prevent hypovolemia (decreased blood plasma volume, also called "shock") that may occur as a result of serious injury, surgery, severe blood loss, burns, or other trauma.

Hextend may also be used for purposes not listed in this medication guide.

You should not receive this medication if you have a bleeding or blood clotting disorder, congestive heart failure, kidney disease, or urination problems not caused by hypovolemia (decreased blood plasma volume).

Hextend can harm your kidneys. Call your doctor at once if you have any of these symptoms of kidney damage: swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no urinating.

Hextend is injected into a vein through an IV. A healthcare provider will give you this injection.

Your breathing, blood pressure, oxygen levels, kidney function, and other vital signs will be watched closely while you are receiving Hextend. Your blood will also need to be tested daily during treatment.

You should not receive this medication if you are allergic to Hextend, or if you have:

• a bleeding or blood clotting disorder;

• kidney disease;

• congestive heart failure; or

• urination problems not caused by hypovolemia (decreased blood plasma volume).

If possible before you receive Hextend, tell your doctor if you have:

• liver disease;

• a history of heart disease; or

• if you are allergic to corn.

FDA pregnancy category C. It is not known whether Hextend will harm an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant while using this medication.

It is not known whether hetastarch passes into breast milk or if it could harm a nursing baby. Tell your doctor if you are breast-feeding a baby.

In an emergency situation it may not be possible to tell your caregivers about your health conditions, or if you are pregnant or breast-feeding. Make sure any doctor caring for your pregnancy or your baby knows you have received Hextend.

Because you will receive Hextend in a clinical setting, you are not likely to miss a dose.

Since Hextend is given by a healthcare professional in a medical setting, an overdose is unlikely to occur.

Follow your doctor's instructions about any restrictions on food, beverages, or activity.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Tell your caregivers right away if you have:

• wheezing or gasping for breath, rapid breathing, sweating, and anxiety;

• a light-headed feeling, like you might pass out;

• weak pulse, slow breathing;

• chest pain, fever, chills, cough; or

• easy bruising, unusual bleeding, or any bleeding that will not stop.

Rare but serious side effects may include:

• severe headache, vision or speech problems, mental changes;

• drooping eyelids, loss of feeling in your face, tremors, trouble swallowing; or

• severe skin reaction -- fever, sore throat, swelling in your face or tongue, burning in your eyes, skin pain, followed by a red or purple skin rash that spreads (especially in the face or upper body) and causes blistering and peeling.

Hextend can harm your kidneys. Call your doctor at once if you have any of these symptoms of kidney damage: swelling, rapid weight gain, unusual tiredness, nausea, vomiting, feeling short of breath, red or pink urine, painful or difficult urination, or little or no urinating.

Common side effects of Hextend may include:

• mild itching or skin rash;

• mild headache;

• muscle pain; or

• swollen glands, mild flu symptoms.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.