Gamunex – Administration Process concerns – saline vs dextrose

    • Anonymous
      July 30, 2010 at 9:44 am

      My husband was diagnosed with CIDP in April and has received 5 loading doses of Gamunex and nine maintenance doses. We are receiving inconsistent information about the administration of Gamunex infusions. Some centers say hydrate with saline (using a bag of solution), they then use new tubing prior to administering the Gamunex. The same IV port is used and the vein is flushed with dextrose prior to administering the Gamunex. At the end of the infusion, one syringe of dextrose is used for flushing the vein.

      We’re concerned about this process since the documentation states that Gamunex is not compatible with saline at all and may be flushed before and after the infusion with dextrose.

      Since this process is new for us, we’re curious about others’ experiences and knowledge. Is anyone hydrated with dextrose before and after the infusion – if so, how much is given? For others, is saline used? Other experiences/knowledge also welcome.

      Thanks for your input!


    • Anonymous
      July 31, 2010 at 12:32 am

      Hi, I received Gammunex infusions for around 2 years. Nurses in two different infusion centers – Denver and Fort Collins – always used saline for flushing.

    • Anonymous
      July 31, 2010 at 7:22 pm

      But, pre-hydrating with saline isn’t mentioned. I tend to try and self-hydrate starting two days before w/a Gatorade pint and then drinking as much of fluids, juices, gingerale, tea, water as possible! Being hydrated is important for successful infusions? But additional hydration can be equally problematic. As long as they can ‘stick’ you successfully w/o blow-outs, you should be doing fine. Unless the nurses don’t ‘stick’ well!
      I had gone thru a phase while having hospital out-patient infusions where I was ALWAYS given a huge bag of saline prior to infusions…. after about an hour? All I could taste was a bitter salty type of ick! I would gain at least 4-5 pounds between the saline, hydrating AND the infusion! Which would take me about 10 days to lose. It IS surprising to go get infused and come out soo much heavier?
      For me now and before? Some sucrose was injected thru the catheter when I was getting ‘sticked’, now that I’ve got a port? I get first some blood thinner, then some sucrose [NOT GLUCOSE-they’re more than slitely different compounds, I believe?] to start things, then sucrose followed by blood thinner to end things. It sounds drastic at first? But really it isn’t.
      Here is the ‘full prescribing information’ for Gammunex: url- Read the whole thing! Memorize it! There are a lot of good and some confusing bits of info in there? But the Preparations and Side effects are your key clues to minor or sometimes [not often tho] major problems.
      If you have doubts or questions? Call Gammunex’s 800 number-Talecris has a ‘contact us’ feature on their web site. Good luck!

      Btw? My port access tubing? All stuff goes into that one tube…how it’s accessed can vary at times tho. My port tubing has two access venues. AND with the port? Sterile procedures: Mask, special gloves and special site cleansers are used. So Get used to that ‘alcohol’ smell!
      I’d ask those doing the extra saline infusions? WHY? Either get a good note pad and super short-hand to get it all down? Or, have a secret recorder handy [this is usually illegal in most states -w/o the permission of the other party to record] But It can help YOU sort out and make better notes of what’s said or not said, vs what the Talecris folks say.
      For both or your sakes’ I sure hope it ultimately works! Hope and good things – SOON!

    • July 31, 2010 at 9:46 pm

      I responded to your private message.

    • Anonymous
      August 2, 2010 at 11:56 am

      We contacted the manufacturers of Gamunex – they said saline should never touch saline – if so, it could possibly cause clumps in the line or crystallization. So based on what you’re saying, maybe it’s best to hydrate yourself prior to the infusion.

    • August 2, 2010 at 3:12 pm

      I have been taking Gamunex for about 18 months now and never had saline prior to infusions. My doc and infusion nurses say plenty of fluid intake the day before the infusion helps veins “pop up” and accept med better. Take pre-meds 30 minutes prior to Gamunex: benadryl, 125mg iv solumedrol and 2 tylenol. They use a small amount of saline to flush the iv. Have had no problems. Good luck.