TheraRadar
Data updated: May 26, 2026

EXTRANEAL (icodextrin)

Trial Activity: Mature
Renal Approved 2002-12-20

Extraneal (icodextrin) is indicated as a single daily exchange for the long dwell (8 to 16 hours) in patients with kidney failure undergoing continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD). It is specifically indicated to improve long-dwell ultrafiltration and the clearance of creatinine and urea nitrogen in patients with "high average" or "high" transport characteristics (as defined by PET), providing superior ultrafiltration compared to 4.25% dextrose solutions.

Source: FDA Label • VANTIVE US HLTHCARE

How EXTRANEAL Works

Extraneal is an isosmotic peritoneal dialysis solution that utilizes icodextrin, a starch-derived glucose polymer, as its primary osmotic agent. Unlike traditional dextrose-based solutions that rely on crystalloid osmosis, icodextrin functions as a colloid osmotic agent. It exerts osmotic pressure across small intercellular pores in the peritoneal membrane, resulting in sustained transcapillary ultrafiltration during

Development Insights

Vantive Health LLC conducting 2 trials (33%)
8 indications explored (Moderate)
esrd (2 trials)
diabetes (2 trials)
capd (1 trials)
2
Indications
--
Phase 3 Trials
1
Priority Reviews
23
Years on Market

Details

Status
Prescription
First Approved
2002-12-20
Routes
INTRAPERITONEAL
Dosage Forms
SOLUTION

Companies

Active Ingredient: ICODEXTRIN

EXTRANEAL Approval History

2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
2016
2017
2018
2019
2020
2021
2022
2023
2024
2025
2026
Original
New Indication
New Form
Label Update
19 FDA actions from 2002 to 2024 · 1 indication expansions
Apr 2024 SUPPL
Label · Labeling
Dec 2019 SUPPL
Update · REMS
Dec 2016 SUPPL
Label · Labeling

What EXTRANEAL Treats

1 indications

EXTRANEAL is approved for 1 conditions since its original approval in 2002. These indications span multiple therapeutic areas including oncology, immunology, and more.

  • Kidney Failure
Source: FDA Label

EXTRANEAL Competitive Set

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Three rings of competition based on shared molecular targets and treated indications.

Indication competitors

2

Same indication, different mechanism — what else might this patient receive?

Filters applied: drops same-active-ingredient (505(b)(2) reformulations), route-mismatch (topical vs systemic), and cross-therapeutic-area matches in same-indication rings.

Drugs Similar to EXTRANEAL

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DEFENCATH
HEPARIN SODIUM
1 shared
CORMEDIX
Shared indications:
Kidney Failure
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Clinical Trial Registry

6 trials
Trial Sponsor ID Phase Status Title
NCT00567489 Impendia results posted 31998 Ph 4 completed IMPENDIA- PEN VS Dianeal Only Improved Metabolic Control In Diabetic CAPD and APD Patients
NCT00567398 Impendia results posted 34202 Ph 3 completed IMPENDIA- PEN VS Dianeal Only Improved Metabolic Control In Diabetic CAPD and APD Patients
NCT01944852 DIDo UCL_2011_DIDo Ph 4 completed Efficacy and Safety of a Double Icodextrin Dose in Elderly Incident CAPD Patients on Incremental PD.
NCT01124227 PDinCHF PDinCHF 2009-017711-15 Ph 3 terminated Peritoneal Dialysis in Congestive Heart Failure
NCT01242904 R-10-460 17193 Ph 2 completed Use of a Bimodal Solution for Peritoneal Dialysis
NCT01044446 CRE-2009.481 Ph 4 completed Effect of Icodextrin on the Treatment Outcome of Peritoneal Dialysis Patients During Acute Peritonitis
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Active Pipeline

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Ongoing clinical trials by development phase

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Key Completed Trials

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Completed studies with published results, ranked by significance

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Trial Timeline

Full development history with FDA approval milestones

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Understanding FDA Approval Types
Count Type What it means
- ORIG Original approval - drug first enters market
- SUPPL - Efficacy New indication (new disease/condition approved)
- SUPPL - Labeling Label text changes (warnings, dosing updates)
- SUPPL - Manufacturing Production changes (new facility)
- SUPPL - Chemistry Formulation changes (new dosage strength)

Green lines in the timeline show ORIG and Efficacy approvals - the clinically meaningful milestones.

EXTRANEAL FDA Label Details

Indications & Usage

FDA Label (PDF)

EXTRANEAL is indicated for the treatment of Kidney Failure.

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Data Sources

Data sourced from official FDA and NIH databases. Click links to verify on original sources.

How We Calculate These Metrics

Trial Activity Stage

Measures the current development activity pattern based on trial phases, status, and trends. Important: This measures R&D activity, not commercial lifecycle.

Trial statuses: "Active" means recruiting or ongoing. "Completed" means reached planned endpoint. "Terminated" means stopped early—often due to safety, efficacy, or business reasons.

  • Growth: High proportion of early-phase trials (Phase 1/2), active development
  • Expansion: Significant Phase 3 activity, approaching or pursuing approvals
  • Mature: Substantial Phase 4 post-marketing studies
  • Stable: Mixed phase distribution, steady development
  • Declining: Low active trial ratio, reduced R&D investment