Indications for CLINOLIPID:
To provide a source of calories and essential fatty acids in adults requiring parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated.
Individualize. Dose based on patient’s energy expenditure, clinical status, body wt, tolerance, ability to metabolize Clinolipid, and additional energy given orally/enterally. Administer by IV infusion via central or peripheral vein. Usual dose: 1–1.5g/kg/day (5–7.5mL/kg/day); max: 2.5g/kg/day. Initiate rate at max 0.5mL/min for the first 15–30mins; increase gradually to required rate after 30mins. Usual infusion duration: 12–24 hours based on patient’s clinical status. If serum triglycerides (>400mg/dL): initiate at a lower dose and increase in smaller increments; check levels before each adjustment. For complete parenteral nutrition: supplement with amino acids, carbohydrates, electrolytes, vitamins and trace elements.
Egg or soybean allergy. Severe hyperlipidemia or severe disorders of lipid metabolism characterized by hypertriglyceridemia (serum triglyceride >1000mg/dL).
Risk of deaths in preterm and low birth weight infants: see full labeling. Correct severe fluid and electrolyte disorders, fluid overload states, and metabolic disorders prior to initiating. Measure serum triglycerides at baseline, with each dose increase, and regularly during therapy. Discontinue and treat if hypersensitivity reactions occur. Monitor for signs/symptoms of infection and essential fatty acid deficiency (EFAD). Severely undernourished: avoid overfeeding. Patients with pulmonary edema, heart failure: monitor fluid status closely. Risk of Parenteral Nutrition Associated Liver Disease (PNALD); consider discontinuation or dose reduction if abnormal LFTs occur. Monitor fluids, electrolytes, serum osmolarity, blood glucose, liver and kidney function, CBCs, platelets, coagulation parameters throughout treatment. Hepatic impairment. Pregnancy (Cat.C). Nursing mothers.
Vitamin K content may antagonize anticoagulants (eg, coumarin, warfarin); monitor. High lipid levels in plasma may interfere with the results of certain blood tests. May precipitate if mixed with dextrose and/or amino acid solutions; check compatibility.
Nausea, vomiting, hyperlipidemia, hyperglycemia, hypoproteinemia, abnormal LFTs; hypersensitivity reactions, infections, refeeding syndrome, PNALD, hypertriglyceridemia, aluminum toxicity (esp. preterm infants, renal impairment); rare: fat overload syndrome.
Emulsion (1000mL)—1, 6