Safety of parenteral hydroxypropyl beta-cyclodextrin

Abstract

Post-treatment data were collected on a patient who received intravenous hydroxypropyl beta-cyclodextrin in a dose of 1.5 g/kg in 1985. Although no untoward effects were observed in this patient, rarely occurring agitation and pulmonary edema have been noted after injections into rabbits and dogs, respectively. These complications are analyzed here on the basis of symptoms and on the effects of hydroxypropyl beta-cyclodextrin on the biochemistry of a representative lipid, cholesterol, which were studied in rats. It is hypothesized that these untoward effects of parenteral hydroxypropyl beta-cyclodextrin are due to complex formation, with lipid mediators of pathological responses, of which prostaglandins are one example. These mediators normally have brief and localized functions; if hydroxypropyl beta-cyclodextrin happens to be injected when these mediator systems are activated, their influence and the responses of the organism may be increased.