Hetastarch
Hetastarch is a synthetic colloid plasma volume expander used to restore intravascular volume in patients with hypovolemia (low blood volume). It works by drawing fluid from tissues into the bloodstream, increasing blood pressure and improving circulation. This medication is primarily used in hospital settings for fluid resuscitation during surgery, trauma, or severe burns.
Hetastarch is a synthetic plasma volume expander used to treat low blood volume in hospitalized patients.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- B05AA07
- RxNorm
- 5531
- Generic
- Hetastarch
- Class
- atc-b05
- Brands
- Hespan, Hextend
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500-1000mL
- Maximum
- consult physician
- Frequency
- as needed based on clinical indication
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 10-20mL/kg
- Maximum
- consult physician
- Frequency
- as needed based on clinical indication
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250-500mL
- Maximum
- consult physician
- Frequency
- as needed with caution due to renal function
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
11 groupspregnancy
first trimesteravoid if possible
use only if benefits outweigh potential risks to fetus
regular fetal monitoring recommended
Use with caution and monitor for adverse effects.
pregnancy
second trimesteruse lowest effective dose
use only when absolutely necessary for maternal indications
fetal well-being monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteruse lowest effective dose
use only when benefits outweigh risks; avoid if possible near delivery
fetal monitoring and uterine activity assessment
Use with caution and monitor for adverse effects.
lactation
breastfeedingno specific adjustment
discontinue breastfeeding or express and discard milk during treatment
monitor infant for adverse effects
geriatric
elderlyno specific dose adjustment
use with caution; monitor renal function and fluid status
renal function monitoring, fluid balance assessment
Use with caution and monitor for adverse effects.
pediatric_age
infantsreduce dose based on body weight
use only in emergency situations; not recommended for neonates
closely monitor volume status and renal function
Use with caution and monitor for adverse effects.
pediatric_age
childrenuse weight-based dosing
use with caution; limited studies available
monitor renal function and coagulation parameters
Use with caution and monitor for adverse effects.
renal_impairment
mild to moderatereduce dose or increase dosing interval
use with caution; monitor renal function
renal function monitoring, fluid balance
Use with caution and monitor for adverse effects.
renal_impairment
severesignificant dose reduction required
use only if benefits outweigh risks; consider alternatives
close monitoring of renal function and electrolytes
Use with caution and monitor for adverse effects.
hepatic_impairment
moderateno specific adjustment
use with caution; may affect coagulation
coagulation parameters, liver function tests
Use with caution and monitor for adverse effects.
hepatic_impairment
severeuse with caution
use only if benefits outweigh risks
close monitoring of coagulation and liver function
Use with caution and monitor for adverse effects.
Statistics and clinical data
Commonly prescribed since
General prescribing information for plasma volume expanders
Drug class
Pharmacological classification
Common uses
Therapeutic indications
Average molecular weight
Physicochemical properties
Hetastarch is indicated for the treatment of hypovolemia (low blood volume) and for plasma volume expansion during surgery, trauma, shock, and severe burns. It may also be used in cases of acute hemorrhagic shock where blood products are not immediately available.
Hetastarch is a hydroxyethyl starch solution that acts as a colloid osmotic agent. When infused intravenously, it remains in the intravascular space longer than crystalloid solutions due to its large molecular size. It draws fluid from the interstitial and intracellular spaces into the bloodstream through osmotic pressure, thereby expanding plasma volume and improving hemodynamic stability.
Hetastarch should be used with caution in patients with kidney impairment, heart failure, or coagulation disorders. It may cause allergic reactions, pruritus (itching), and has been associated with increased risk of kidney injury and mortality in certain patient populations. Use requires careful monitoring of fluid balance, kidney function, and coagulation parameters. This medication is typically administered in inpatient/hospital settings under medical supervision.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
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This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy