Plasma Protein Solution — Colloid Pregnancy: Safety for use in human pregnancy has not been established in controlled clinical trials. However, clinical experience with albumin suggests that no harmful effects on the course of pregnancy, or on the fetus and the neonate, are to be expected; human albumin is a normal constituent of human blood. No animal reproduction studies have been conducted with this product.

Human Albumin Solution (Surgical — Volume/Oncotic)

Brand names: Albuman, Alburex, Zenalb

Human albumin solution is a colloid plasma-volume expander derived from pooled human plasma, used in the surgical setting for volume replacement and to restore oncotic pressure where crystalloids alone are inadequate.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: No numeric dose is stated in the source SPC. Verbatim §4.2: 'The concentration of the albumin preparation, dosage and the infusion-rate should be adjusted to the patient's individual requirements... The dose required depends on the size of the patient, the severity of trauma or illness and on continuing fluid and protein losses. Measures of adequacy of circulating volume and not plasma albumin levels should be used to determine the dose required.'

Route: Intravenous. 'Human albumin can be directly administered by the intravenous route, or it can also be diluted in an isotonic solution (e.g. 5% glucose or 0.9% sodium chloride).' Albumin solutions must NOT be diluted with water for injections, as this may cause haemolysis in recipients.

Frequency: 'The infusion rate should be adjusted according to the individual circumstances and the indication. In plasma exchange the infusion-rate should be adjusted to the rate of removal.'

Source product is albunorm 20% (200 g/l) solution for infusion; the SPC deliberately gives no fixed regimen, so the dose field above reproduces its wording rather than a number — a clinician must supply the local protocol dose if this page is to display one. MONITORING (§4.2): 'If human albumin is to be administered, haemodynamic performance should be monitored regularly; this may include: arterial blood pressure and pulse rate, central venous pressure, pulmonary artery wedge pressure, urine output, electrolyte, haematocrit/haemoglobin.' §4.4 CAUTIONS: the colloid-osmotic effect of human albumin 200 or 250 g/l is approximately four times that of blood plasma, so adequate hydration must be assured and patients monitored carefully against circulatory overload and hyperhydration; 'Hypervolaemia may occur if the dosage and rate of infusion are not adjusted to the patients circulatory situation. At the first clinical signs of cardiovascular overload (headache, dyspnoea, jugular vein congestion), or increased blood pressure, raised venous pressure and pulmonary oedema, the infusion is to be stopped immediately.' Use with caution where hypervolaemia and its consequences, or haemodilution, pose a special risk — decompensated cardiac insufficiency, hypertension, oesophageal varices, pulmonary oedema, haemorrhagic diathesis, severe anaemia, renal and post-renal anuria. 'In a post-hoc follow-up study of critically ill patients with traumatic brain injury, fluid resuscitation with albumin was associated with higher mortality rates than was resuscitation with saline... caution is advised in the use of albumin in patients with severe traumatic brain injury.' 200-250 g/l solutions are relatively low in electrolytes compared with 40-50 g/l solutions — monitor electrolyte status. If comparatively large volumes are replaced, coagulation and haematocrit controls are necessary and adequate substitution of other blood constituents (coagulation factors, electrolytes, platelets, erythrocytes) must be ensured. Suspicion of allergic or anaphylactic type reactions requires immediate discontinuation of the infusion. Contains 331-368 mg sodium per 100 mL. Record the name and batch number of the administered product for traceability. PAEDIATRIC (verbatim): 'Data on the use of Albunorm 20% in children are limited; therefore, the product should only be administered to these individuals if the benefits clearly outweigh potential risks.' No paediatric dose is stated; verify against a children's formulary.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Hypersensitivity to albumin preparations or to any of the excipients

Side effects

Mild reactions such as flush, urticaria, fever and nausea occur rarely; these normally disappear rapidly when the infusion rate is slowed or the infusion is stopped
Very rarely, severe reactions such as shock may occur — stop the infusion and initiate appropriate treatment
Post-marketing (frequency not known): anaphylactic shock, anaphylactic reaction, hypersensitivity
Post-marketing: hypotension, hypertension, flushing, tachycardia, bradycardia, dyspnoea
Post-marketing: urticaria, angioneurotic oedema, rash erythematosus, hyperhidrosis, pyrexia, chills, headache, confusional state, nausea

Clinical monograph

How it works

Albumin is the major plasma protein and accounts for most of the intravascular oncotic (colloid osmotic) pressure, so an infusion draws and retains fluid within the vascular compartment to support circulating volume.

Prescribing in practice

Infuse with caution in patients at risk of circulatory overload (cardiac failure, renal impairment) as the oncotic load can precipitate pulmonary oedema; stop the infusion at the first sign of hypervolaemia.
Choose concentration by clinical aim — iso-oncotic solution for volume replacement, concentrated solution where fluid restriction or marked hypoalbuminaemia applies — and give through a standard infusion set without an additional filter.
It is a blood-derived product: check the solution is clear before use, do not mix with packed red cells, protein hydrolysates or alcohol-containing solutions, and discard any unused portion of an opened container.

Monitoring

Monitor blood pressure, heart rate, urine output and signs of fluid overload during and after infusion, with haematocrit and electrolytes as guided by the clinical picture.

Counselling the patient

Explain this is a human plasma-derived product given by drip to support blood volume during or after your operation.
Tell staff at once if you feel breathless, flushed or develop a rash during the infusion.

Evidence & guidelines

Albumin is an established perioperative colloid; UK practice and the SPC reserve it for defined volume/oncotic indications rather than routine fluid resuscitation, where crystalloids are generally first-line.

Reference: SAFE Trial (NEJM 2004); NICE CPOC Perioperative Guidelines 2021; EASL Post-Paracentesis Guidelines; MHRA Blood Components Safety Update; Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways