Posology : מינונים

4.2       Posology and method of administration
Posology
The mode of therapy, frequency of treatment, exchange volume, duration of dwell and length of dialysis should be selected by the physician.
To avoid the risk of severe dehydration, hypovolaemia and to minimise the loss of proteins, it is advisable to select the peritoneal dialysis solution with the lowest osmolarity consistent with fluid removal requirements for each exchange.

•     Adults: patients on continuous ambulatory peritoneal dialysis (CAPD) typically perform             4 cycles per day (24 hours). Patients on automated peritoneal dialysis (APD) typically perform 4-5 cycles at night and up to 2 cycles during the day. The fill volume depends on body size, usually from 2.0 to 2.5 litres.

•     Elderly:
 as for adults.
•     Paediatric population :

The safety and efficacy of PHYSIONEAL 40 in paediatric patients have not been established. Therefore the clinical benefits of PHYSIONEAL 40 have to be balanced versus the risks of side effects in this patient category.

For pediatric patients >2 years old, 800 to 1400 mL/m2 per cycle up to a maximum amount of 2000 mL, as tolerated, has been recommended. Fill volumes of 200 to 1000 mL/m2 are recommended in children less than 2 years of age.


Method of administration
Precautions to be taken before handling or administering the medicinal product 
•     PHYSIONEAL 40 is intended for intraperitoneal administration only. Not for intravenous administration.

•     Peritoneal dialysis solutions may be warmed to 37°C to enhance patient comfort.
However, only dry heat (for example, heating pad, warming plate) should be used.
Solutions should not be heated in water or in a microwave oven due to the potential for patient injury or discomfort.

•     Aseptic technique should be employed throughout the peritoneal dialysis procedure.

•     Do not administer if the solution is discoloured, cloudy, contains particulate matter, shows evidence of leakage between chambers or to the exterior, or if seals are not intact.

•     The drained fluid should be inspected for the presence of fibrin or cloudiness, which may indicate the presence of peritonitis.

•     For single use only.

•     After removal of the overpouch, immediately break the interchamber frangible pin to mix the two solutions. Wait until the upper chamber has completely drained into the lower chamber. Mix gently by pushing with both hands on the lower chamber walls. The intraperitoneal solution must be infused within 24 hours after mixing.

•     For instructions on the use of the medicinal product see section 6.6 Special precautions for disposal and other handling.