Toraymyxin Cartridge is used for:

• Selective removal of endotoxin from circulating blood through direct hemoperfusion

• Patients with sepsis or septic shock associated with suspected Gram-negative bacterial infection or endotoxaemia

The decision to use Toraymyxin, the treatment duration and the extracorporeal blood purification procedure are determined by the treating healthcare team.

Toraymyxin contains polymyxin B immobilised on fibres within the cartridge. Polymyxin B has a strong affinity for endotoxin, also known as lipopolysaccharide, which is associated with the outer membrane of Gram-negative bacteria.

During direct hemoperfusion, the patient's blood passes through the cartridge. Endotoxin is adsorbed onto the immobilised polymyxin B fibres, and the treated blood is returned to the patient. The polymyxin B remains bound to the cartridge rather than being administered systemically.

Toraymyxin is a medical device rather than a systemic medicine. Tell the healthcare team about all medicines and treatments you are receiving.

• Anticoagulants are used during the hemoperfusion procedure to reduce clotting within the extracorporeal circuit.

• The anticoagulant dose is adjusted according to the patient's condition and treatment requirements.

• Toraymyxin may be used alongside other treatments for sepsis and septic shock as determined by the treating team.

• Inform the healthcare team about medicines that increase the risk of bleeding.

• Store the Toraymyxin Cartridge according to the manufacturer's specified conditions.

• Keep the cartridge in its original packaging until required for use.

• Do not use the cartridge if the packaging is damaged or the product is past its expiry date.

• The cartridge is intended for single use.

• Toraymyxin is used only by trained healthcare professionals as part of a direct hemoperfusion procedure.

• The cartridge is connected to an extracorporeal blood circuit.

• The cartridge is rinsed and prepared with physiological saline before use.

• Blood is circulated through the cartridge using an appropriate blood pump and returned to the patient.

• For the adult PMX-20R cartridge, the manufacturer's procedure specifies a blood flow rate of approximately 100mL/min, with an operating range of 80 to 120mL/min.

• A typical hemoperfusion duration is approximately 2 hours.

• Appropriate anticoagulation is required to prevent clotting within the extracorporeal circuit.

• The exact procedure must follow the manufacturer's Instructions for Use and the treating team's protocol.

As Toraymyxin is an extracorporeal blood purification device, complications are generally related to the hemoperfusion procedure, extracorporeal circuit or the patient's underlying critical illness.

Common or procedure-related complications

• Low blood pressure

• Bleeding

• Reduced platelet counts

• Clotting within the extracorporeal circuit

• Vascular access-related complications

• Changes related to anticoagulation

Serious complications

Seek immediate medical attention for:

• Severe bleeding

• Severe hypotension

• Significant thrombocytopenia

• Problems with vascular access

• Severe complications related to the extracorporeal circulation

• Toraymyxin must only be used by trained healthcare professionals.

• It is an extracorporeal cartridge, not an antibiotic or systemic medicine.

• The cartridge is used as part of direct hemoperfusion.

• Follow the manufacturer's Instructions for Use for preparation and operation.

• Appropriate anticoagulation is required during treatment.

• Monitor blood pressure and the extracorporeal circuit throughout the procedure.

• Monitor for bleeding and changes in platelet counts.

• Ensure appropriate vascular access before starting the procedure.

• The cartridge is intended for single use.

• Toraymyxin does not replace appropriate treatment of the underlying bacterial infection or sepsis.