Purified Soybean Oil/ Purified Egg Phospholipids/ Glycerol (Intravenous Fat Emulsion)

Registered South African indications:

• Intravenous nutrition

Contraindications

• Hypersensitivity to active ingredient or any of its excipients
• Hypersensitivity to egg, soy or peanut protein
• Acute shock
• Disturbances in lipid metabolism

Cautions

• Pregnancy
• Breastfeeding
• Renal impairment
• Hepatic impairment
• Hyperlipidaemia
• Uncontrolled diabetes mellitus
• Pancreatitis
• Hypothyroidism
• Sepsis
• Neonates and premature infants  

Forms avail. in SA and covered in this monograph: inj

Parenteral nutrition

• IV: Initial dose: 1-1.5g/kg/day; Max rate: 500ml/5hrs (10%, 20%); Max rate: 330ml/5hrs (30%); Max: 3g/kg/24hrs

Local anaesthetic toxicity
Calcium channel blocker overdose

• IV: Initial: 1.5ml/kg of 20% sol, bolus given over 1min; Then 0.25-0.5ml/kg/min for 30-60mins; Initial bolus may be repeated; Max: 10-12ml/kg in the first hour

Forms avail. in SA and covered in this monograph: Inj

Parenteral nutrition

Neonates and infants 

• IV: 0.5-4g/kg/day of 10% or 20% sol; Max rate: 0.17g/kg/hr; Max: 4g/kg/24hrs

Premature and low birth weight neonates

• IV: 0.5-1g/kg/day of 10% or 20% sol; Titrate by 0.5-1g/kg/day to 2g/kg/day; Max: 4g/kg/24hrs

Should preferably be infused continuously over 24hrs

Do not exceed these rates in order to compensate for missed doses

Calcium channel blocker overdose

• See adult dosage

Pregnancy

• FDA Pregnancy Category C

Breastfeeding

• Caution

Renal Impairment

• Caution, no dose adjustment recommended

Hepatic Impairment

• Caution, no dose adjustment recommended

Elderly

• No dose adjustment recommended

Porphyria Information

• Not porphyrinogenic (NP)

Cardiovascular Disorders

• Hypertension
• Hypotension 

Respiratory Disorders

• Tachypnoea

Gastrointestinal Disorders

• Abdominal pain
• Nausea and vomiting

Hepatobiliary Disorders

• Transient increases in liver enzymes
• Fat overload syndrome
• Pigmentation of tissues

Genitourinary Disorders

• Priapism

Musculoskeletal Disorders

• Abdominal pain

Skin and Subcutaneous Tissues Disorders

• Rash
• Urticaria

Immune System Disorders

• Hypersensitivity reactions

• Insulin
• Heparin
• Warfarin

• Serum triglyceride
• Hepatic function
• Pulse oximetry 
• Electrolyte levels

Specific cases may require

• Blood glucose 

Infused fat particles cause a transient increase in plasma triglyceride concentrations. The triglycerides are then hydrolysed to free fatty acids and glycerol. Fat emulsion is metabolised and utilised as an energy source, providing the essential fatty acids, linoleic acid, and alpha linolenic acid necessary for normal structure and function of cell membranes.

COMBINATION PREPARATIONS

Purified soybean oil/Purified egg phospholipids/Glycerol(anhydrous)/Sodium hydroxide/ Water for injection

Injection (per 1000ml) 200g/12g/22.0g/to pH 8

• Intralipid 20%  (Fresenius) originator