Anticoagulant Citrate Dextrose (ACD-A)

Manufacturer
Terumo BCT, Ltd | Terumo BCT, Inc.
Effective date
2025-01-21
Label type
HUMAN PRESCRIPTION DRUG LABEL
Version
2
Source
full-release
Hydrated at
2026-05-31 21:23:56

Label at a glance#

ProductAnticoagulant Citrate Dextrose (ACD-A)
Active ingredientDextrose Monohydrate, Sodium Citrate, Unspecified Form, Citric Acid Monohydrate
Label structure12 sections

Indications and uses

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A is an anticoagulant intended for use only with devices that prepare Platelet Rich Plasma (PRP) products for extracorporeal use. [See Dosage and Administration (2) .]

Dosage and administration

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A is added to blood products collected for extracorporeal processing. The solution is manually added to collected blood products to facilitate extracorporeal processing. The amount of solution added is specified by the manufacturer of the processing set. It is not intended for direct intravenous infusion. For instructions on the use of the solution with th...

Storage and handling

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A is a clear sterile solution supplied in non-pyrogenic polyolefin solution bags. Each solution bag is individually wrapped in a clear overwrap. Each clear overwrap is then individually foil wrapped. Neither the clear overwrap nor the foil overwrap can be considered a sterile barrier. This product has a sterile fluid pathway only. SIZE CATALOG NUMBER NDC N...

Label contents#

Full prescribing information#

1 INDICATIONS AND USAGE

INDICATIONS & USAGE SECTION

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A is an anticoagulant intended for use only with devices that prepare Platelet Rich Plasma (PRP) products for extracorporeal use. [See Dosage and Administration (2).]

2 DOSAGE AND ADMINISTRATION

DOSAGE & ADMINISTRATION SECTION

2.1 General Dosing Information

SPL UNCLASSIFIED SECTION

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A is added to blood products collected for extracorporeal processing. The solution is manually added to collected blood products to facilitate extracorporeal processing. The amount of solution added is specified by the manufacturer of the processing set. It is not intended for direct intravenous infusion.

For instructions on the use of the solution with the processing set, see the device operator's manual.

2.2 Administration

SPL UNCLASSIFIED SECTION

  • Ensure solution is the ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A and is within the expiration date.
  • Inspect the solution bag. Do not use if the solution bag is damaged, leaking or if there is any visible sign of deterioration.
  • Use only if solution is clear and free of particulate matter.
  • Protect from sharp objects.
SPL UNCLASSIFIED SECTION

Directions for drawing the ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A from the solution bag.

When directed by the processing set instructions and device operator's manual:

  1. Open the foil pouch containing the solution by finding the notch in the foil overwrap and pulling down to present the clear overwrapped solution bag.
  2. Open the clear overwrap material by holding the peelable tabs between your thumb and forefinger. Gently pull the peelable tabs along the top to open the overwrap at both corners. Once both corners are opened, gently peel along the length of the overwrap. Do not place the ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A solution bag into the sterile field. The clear overwrap is not considered a sterile barrier.
  3. Before use, perform the following checks [see Warnings and Precautions (5)]:
    • Check for leaks by gently squeezing the bag. If leaks are found, discard the solution bag.
    • Ensure that the solution is the ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A and is within the expiration date.
    • Inspect the solution in adequate light. Solution showing cloudiness, haze, or particulate matter should not be used.
  4. Aseptically prepare the Needleless Access Valve (NAV).
  5. Using an appropriate syringe and luer, connect to the NAV.
  6. Draw into the syringe the amount of ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A required by the processing set instructions and device operator's manual.
  7. Remove the syringe from the NAV and proceed according to the processing set instructions and device operator's manual.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and solution bag permit.

3 DOSAGE FORMS AND STRENGTHS

DOSAGE FORMS & STRENGTHS SECTION

50 mL ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A is a sterile solution in a polyolefin solution bag. Each 100 mL contains: (%w/v) Citric Acid, Monohydrate 0.8 g; Dextrose Monohydrate 2.45 g; Sodium Citrate Dihydrate 2.2 g; and Water for Injection.

4 CONTRAINDICATIONS

CONTRAINDICATIONS SECTION

NOT FOR PREPARATION OF BLOOD PRODUCTS FOR TRANSFUSION OR FOR DIRECT INTRAVENOUS INFUSION.

5 WARNINGS AND PRECAUTIONS

WARNINGS AND PRECAUTIONS SECTION

  • Do not use the ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A unless the solution is clear and the container is intact and undamaged.
  • Do not transfer the solution bag directly into the sterile field.
  • Do not reuse. Discard unused or partially used solution bags.
  • Discard the product if the Needleless Access Valve (NAV) does not function as intended.
  • Aseptically prepare the NAV before use.

6 ADVERSE REACTIONS

ADVERSE REACTIONS SECTION

Citrate reactions or toxicity may occur with the injection of blood products containing citrate anticoagulant. The recipient of the blood product containing citrate should be monitored for the signs and symptoms of citrate toxicity. The signs and symptoms of citrate toxicity begin with paresthesia, a "tingling" sensation around the mouth or in the extremities, followed by severe reactions that are characterized by hypotension and possible cardiac arrhythmia. Citrate toxicity may occur more frequently in patients who are hypothermic, have impaired liver or renal function, or have low calcium levels because of an underlying disease.

8 USE IN SPECIFIC POPULATIONS

USE IN SPECIFIC POPULATIONS SECTION

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A has not been studied in controlled clinical trials with specific populations.

11 DESCRIPTION

DESCRIPTION SECTION

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A is designed to be added to blood products collected for extracorporeal processing, to prevent platelet activation and coagulation as blood moves throughout the extracorporeal processing set.

The content of the solution bag is considered sterile. This product has a sterile fluid path only. The clear overwrap is not considered a sterile barrier. The solution is non-pyrogenic, and it contains no bacteriostatic or antimicrobial agents.

The formulas of the active ingredients are provided in Table 1.

Table 1: Active Ingredients
IngredientsMolecular Formula Molecular Weight
(%w/v) Citric Acid, MonohydrateC6H8O7 192.12
Dextrose MonohydrateC6H12O6 ∙ H2O198.17
Sodium Citrate DihydrateC6H9Na3O9 294.10
Water for InjectionH2O18.00

Each 100 mL of ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A contains: (%w/v) Citric Acid, Monohydrate 0.8 g; Dextrose Monohydrate 2.45 g; Sodium Citrate Dihydrate 2.2 g; and Water for Injection.

The solution bag is not made with natural rubber latex or PVC.

The solution bag is made from a polyolefin film. It contains materials that have been tested to demonstrate the suitability of the solution bag for storing pharmaceutical solutions. The solution contact layer is a polyolefin. The solution bag is nontoxic and biologically inert. The solution bag is a closed system and is not dependent upon entry of external air during administration. The solution bag is covered with a clear overwrap to provide protection from the physical environment. The content of the solution bag is considered sterile. This product has a sterile fluid path only. The clear overwrap is not considered a sterile barrier.

12 CLINICAL PHARMACOLOGY

CLINICAL PHARMACOLOGY SECTION

12.1 Mechanism of Action

MECHANISM OF ACTION SECTION

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A acts as an extracorporeal anticoagulant by binding the free calcium in the blood. Calcium is a necessary co-factor to several steps in the clotting cascade. The following ingredients are key components of the solution:

  • Citric acid for pH regulation
  • Sodium Citrate for anticoagulation
  • Dextrose for isotonicity

This solution has no pharmacological effect.

16 HOW SUPPLIED/STORAGE AND HANDLING

HOW SUPPLIED SECTION

ANTICOAGULANT CITRATE DEXTROSE SOLUTION USP (ACD) SOLUTION A is a clear sterile solution supplied in non-pyrogenic polyolefin solution bags. Each solution bag is individually wrapped in a clear overwrap. Each clear overwrap is then individually foil wrapped. Neither the clear overwrap nor the foil overwrap can be considered a sterile barrier. This product has a sterile fluid pathway only.

SIZECATALOG NUMBERNDC NUMBER
50 mL40820Case:14537-820-03
Foil:14537-820-01
Bag:14537-820-00

STORAGE AND HANDLING SECTION

STORAGE

Store up to 25 °C.

Avoid excessive heat. Protect from freezing. Protect from direct sunlight.

SPL UNCLASSIFIED SECTION

Issued: June 2024

Manufactured by
Terumo BCT, Inc.
Lakewood, CO 80215

Made in UK

PRINCIPAL DISPLAY PANEL - 50 mL Bag Pouch Case Label

PACKAGE LABEL.PRINCIPAL DISPLAY PANEL

TERUMO

Anticoagulant Citrate Dextrose
Solution USP (ACD) Solution A
Polyolefin Bag

Catalog # 40820
50 mL

NDC 14537-820-00
LPN - 1000066504

Indications for use: Anticoagulant intended for use only with
devices that prepare Platelet Rich Plasma (PRP) products for
extracorporeal use. See Operator's Manuals for additional
information and complete usage instructions.

Caution : Only the solution bag fluid path is sterile and
non-pyrogenic. Do not use unless the solution is clear and the
container is intact and undamaged. Do not transfer solution
bag directly into the sterile field. Sterilized with Steam. Rx only.
Single use container. Not for preparation of blood products for
transfusion or for direct intravenous infusion.

Storage Conditions: Up to 25°C. Avoid excessive heat.
Protect from freezing. Protect from direct sunlight.

Each 10mL contains:
Citric Acid Monohydrate USP
0.08 g
Sodium Citrate Dihydrate USP
0.220 g
Dextrose Monohydrate USP
0.245 g
In Water for Injection USP
STERILE

Manufactured by TERUMO BCT, INC.
10811 West Collins Ave., Lakewood, Colorado 80215-4440, USA
Made in UK

Lot
Expiry Date

PRINCIPAL DISPLAY PANEL - 50 mL Bag Pouch Case Label
PRINCIPAL DISPLAY PANEL - 50 mL Bag Pouch Case Label

DailyMed Pharmacologic Classes#

Class, Version, Type table
ClassVersionTypeEffective
ANHYDROUS CITRIC ACID Pharmacologic Class Indexing3Indexing - Pharmacologic Class20180813
SODIUM CATION Pharmacologic Class Indexing2Indexing - Pharmacologic Class20180813

DailyMed Product Concepts#

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DailyMed Package Descriptions#

Package NDC, Product, Description table
Package NDCProductDescriptionFormQuantityStrengthSPL version
14537-820-00Anticoagulant Citrate Dextrose (ACD-A)50 mL in 1 BAGSOLUTION502
14537-820-01Anticoagulant Citrate Dextrose (ACD-A)1 in 1 POUCHSOLUTION12
14537-820-03Anticoagulant Citrate Dextrose (ACD-A)50 in 1 CASESOLUTION502

DailyMed Dashboard NDC Coverage#

NDC, Dashboard title, SPL version table
NDCDashboard titleSPL versionValidationDashboard ZIP
14537-820ANTICOAGULANT CITRATE DEXTROSE (ACD-A) (DEXTROSE MONOHYDRATE, SODIUM CITRATE, UNSPECIFIED FORM, AND CITRIC ACID MONOHYDRATE) SOLUTION [TERUMO BCT, LTD]2Current NDC, 3 package rows20250124_0130d7c8-d067-4528-beb7-166559c33be9.zip

Products#

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DailyMed product names page 1 of 1 · 9 matching rows.

NDC Codes#

Product NDC, Package NDC table
Product NDCPackage NDC
14537-82014537-820-00, 14537-820-01, 14537-820-03

Ingredients#

Every source-derived ingredient row is available through these pages.

DailyMed ingredient rows page 1 of 1 · 4 matching rows.

Source Document#

Source XML

openFDA label cross-check#

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Matched openFDA labels page 1 of 1 · 1 matching rows.

Brand, Generic, Manufacturer table
BrandGenericManufacturerSPL set IDEffective dateAvailable safety fieldsJoin
Anticoagulant Citrate Dextrose (ACD-A)DEXTROSE MONOHYDRATE, SODIUM CITRATE, UNSPECIFIED FORM, AND CITRIC ACID MONOHYDRATETerumo BCT, Ltd0130d7c8-d067-4528-beb7-166559c33be92025-01-21Warnings, Adverse reactionsExact identifier
ndc (package): 14537-820-01
ndc (package): 14537-820-00
ndc (package): 14537-820-03
ndc (product): 14537-820
ndc11 (package): 14537082000
ndc11 (package): 14537082001
ndc11 (package): 14537082003
spl id: 73126eb8-5fba-4a43-b84a-057382d4f0f4
spl set id: 0130d7c8-d067-4528-beb7-166559c33be9

Reported adverse events (FAERS/openFDA)#

Adverse event summaries are temporarily unavailable. Other product information remains available.