Skip to content
ClinCalc Pro
Menu
Calculators Drugs Pathways AI Dx Donate Get the App
Colloid plasma volume expander Pregnancy: There is very little information available on the use of plasma substitutes in pregnant or lactating women. As with all drugs, the benefits and risks must be assessed. Volplex may be used in the initial treatment of blood loss during pregnancy where plasma volume replacement is needed. (UK SPC §4.6)

Gelatin (succinylated)

Brand names: Gelofusine, Volplex

Succinylated gelatin is a colloid intravenous fluid used for short-term plasma volume expansion in hypovolaemia.

Adult dose

Dose: Initial management of hypovolaemic shock caused by, for example, haemorrhage, acute trauma or surgery, burns, sepsis, peritonitis, pancreatitis or crush injury, and initial treatment of blood loss during pregnancy where plasma volume replacement is needed: Volplex (succinylated gelatin 4% w/v) is administered intravenously; the volume and rate of infusion depend on the condition of the patient (the SPC prints no fixed total volume). In severe acute blood loss it may be given rapidly (500 ml in 5 - 10 minutes) until signs of hypovolaemia are relieved
Route: Intravenous infusion
Frequency: Volume and rate according to the condition of the patient; no fixed schedule is printed (rapid administration in severe acute blood loss until signs of hypovolaemia are relieved)
Product: UK SPC via MHRA Products - VOLPLEX (PL514630104), Kent Pharma UK Limited; §2 (verbatim): 'Succinylated gelatin (Modified Fluid Gelatin) 4% w/v in Water for Injections, also containing sodium chloride. Electrolytes Sodium ion (Na+) 154 mmol/litre Chloride ion (Cl-) 125 mmol/litre'. §4.1 (verbatim): 'Volplex is a colloidal plasma substitute indicated for the initial management of hypovolaemic shock ... Volplex may be used in the initial treatment of blood loss during pregnancy where plasma volume replacement is needed.' COVERAGE: this SPC covers Volplex only; other succinylated gelatin products (e.g. Gelofusine) have their own labelling and are not covered. NO FIXED TOTAL DOSE: the only numeric figure in §4.2 is the rapid-administration example for severe acute blood loss ('500 ml in 5 – 10 minutes'), which is a rate for that situation, not a total volume or a ceiling; the dose is set by the prescriber from the patient's condition. VERBATIM §4.2: 'Volplex is administered intravenously; the volume and rate of infusion will depend on the condition of the patient. The rate of administration can be increased by the application of pressure to the container or by adjusting the giving set pump. When given rapidly Volplex should be warmed to no more than 37ºC if possible.' 'When large volumes are given, suitable monitoring should be used to ensure that an adequate haematocrit is maintained (the haematocrit should not be allowed to fall below 25%) and that dilutional effects upon coagulation are avoided. (Expert haematological advice should be sought, especially in cases of massive blood loss).' 'For massive fluid loss, Volplex may be used concomitantly with blood ... If blood is to be given at the same time as Volplex, it can be given through the same giving set since Volplex has negligible calcium content and therefore does not clot blood. Volplex can also be used to reconstitute packed red cells.' CHILDREN AND ELDERLY (§4.2, verbatim): 'No distinction between the recommended doses and dosage schedule for adults, children and the elderly is necessary as the rate of administration depends on the condition of the individual patient.' The SPC prints no paediatric or neonatal figure, so no paediatric block is written. SODIUM (§4.4): 'This medicinal product contains 1771mg sodium in each dose (500ml), equivalent to 88.5% of the WHO recommended maximum daily dietary intake for sodium ... Volplex is considered high in sodium.' The old openFDA record in this bundle (an OTC gelatin softgel) was not used.

Dose adjustments

Renal

No numeric renal dose adjustment is printed. §4.4: caution in any patient liable to develop circulatory overload (for example congestive cardiac failure or renal failure with oliguria or anuria), since excessive volumes may give rise to circulatory overload and electrolyte imbalance; 'Decreased urinary output secondary to shock is not a contraindication unless there is no improvement in urine output after the initial dose of Volplex.'

Hepatic

No hepatic dose adjustment is printed in the retrieved SPC sections.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via MHRA Products — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • Known hypersensitivity to succinylated gelatin (§4.3)
  • Hypersensitivity to galactose-alpha-1,3-galactose (alpha-Gal) or known allergy to red meat (mammal meat) and offal (§4.3, §4.4)

Side effects

  • Severe anaphylactic or anaphylactoid reactions - the major undesirable effect risk; incidence between 1 in 6,000 and 1 in 13,000 units; more likely if given rapidly to normovolaemic patients and more hazardous in patients with known allergic conditions such as asthma (§4.4, §4.8)
  • Rare (>1 in 10,000 to <1 in 1,000): anaphylactic reaction, anaphylactoid reaction, tremor, tachycardia, hypotension, hypertension, wheezing, dyspnoea, hypoxia, urticarial reactions, sweating, chills, pyrexia (§4.8)
  • Circulatory overload and electrolyte imbalance if excessive volumes are given (§4.4)

Interactions

  • No interaction studies have been performed (§4.5)
  • If blood is given at the same time it can run through the same giving set, since Volplex has negligible calcium content and does not clot blood (§4.2)

Monitoring

  • Haemodynamic status of the patient should be monitored (§4.2)
  • When large volumes are given, suitable monitoring to ensure an adequate haematocrit is maintained (the haematocrit should not be allowed to fall below 25%) and that dilutional effects upon coagulation are avoided; seek expert haematological advice, especially in massive blood loss (§4.2)
  • Anaphylactic or anaphylactoid reaction: stop the infusion and treat according to severity (supplemental oxygen, an alternative infusion fluid, parenteral adrenaline and an antihistamine to be considered) (§4.4)
  • Circulatory overload: stop the infusion, treat symptomatically, monitor electrolytes, and if necessary give a diuretic to promote fluid loss (§4.4)

Clinical monograph

How it works

As a colloid solution it increases intravascular oncotic pressure, transiently expanding plasma volume to support circulating volume and blood pressure.

Prescribing in practice

  • Anaphylactoid reactions can occur — stop the infusion immediately and treat if signs of hypersensitivity develop.
  • Use with caution in patients at risk of fluid overload, such as those with significant cardiac or renal impairment.
  • Assess fluid status and response rather than relying on volume infused, and consider crystalloids per current resuscitation guidance.

Monitoring

Monitor blood pressure, heart rate, fluid balance and signs of hypersensitivity or fluid overload during and after infusion.

Counselling the patient

  • Explain that this drip helps restore circulating fluid volume.
  • Advise reporting itching, rash, breathlessness or swelling promptly.
  • Note for the team that gelatin colloids carry a risk of allergic reactions.

Evidence & guidelines

Gelatin solutions are colloids used for volume expansion, though crystalloids are generally preferred for initial fluid resuscitation in current guidance.

Reference: NICE NG29; UK Resus Council; 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).

Related

Curated clinical cross-links plus same-class fallbacks.

Calculators
Pathways