Medication Guide App

Enteral Nutrition Formulas (Systemic)

This monograph includes information on the following:

1) Blenderized Enteral Nutrition Formulas
2) Disease-specific Enteral Nutrition Formulas §
3) Fiber-containing Enteral Nutrition Formulas
4) Milk-based Enteral Nutrition Formulas
5) Modular Enteral Nutrition Formulas
6) Monomeric (Elemental) Enteral Nutrition Formulas
7) Polymeric Enteral Nutrition Formulas

VA CLASSIFICATION
Primary: TN200



§ Use for product as stated in product information.
Note: For a listing of dosage forms and brand names by country availability, see Dosage Forms section(s).



Category:


Nutritional replacement—

Indications

Accepted

Nutritional deficiency (prophylaxis and treatment)—Enteral nutritional formulas are indicated to provide nutritional support for individuals with impaired digestion or specialized nutritional support for individuals with special nutritional needs. Enteral nutrition formulas may be the sole source of nutrition or a partial supplement to the diet. Under most circumstances, enteral feeding is preferred over parenteral feeding. {37} {51}Enteral nutrition may be necessary in certain persons or conditions, such as:

• Acquired immunodeficiency syndrome (AIDS) {50}


• Burns {36}


• Cancer {36}


• Dysphagia {65}


• Gastrointestinal disorders—bowel resection, Crohn's, inflammatory bowel disease, malabsorption, partial gastrointestinal obstruction, stricture, ulcerative colitis {19}


• Hepatic dysfunction {36} {38}


• Pancreatic insufficiency {61}


• Pancreatitis {60}


• Pulmonary dysfunction {36}


• Renal dysfunction {36} {39}


• Sepsis, prolonged {36}


• Surgery, major {36} {37}


• Trauma, major {36}

For Blenderized Formulas Blenderized enteral nutrition formulas are made from selected, blended, foods. {01} These formulas use milk or beef or a combination of the 2 as the main source of protein, and may contain pectins, some saturated fat, and cholesterol. {01} These formulas are made from a limited range of foods. {01}
For Disease-specific Formulas Disease-specific enteral nutrition formulas are formulated to meet nutrient requirements for patients with specific medical diseases and can be divided into products containing branched-chain amino acids, high-fat formulas, essential amino acid-as-protein-source formulas, and formulas high in omega fatty acids. {01} Branched-chain amino acids may have beneficial effects on nitrogen balance. {01} High-fat formulas provide calories through fat rather than through carbohydrates, and thus may be beneficial in patients with respiratory problems. {01} Essential amino acid formulas minimize nitrogen waste because they contain only essential amino acids; these formulas may be beneficial to patients with renal dysfunction. {01} {39} Omega-3 fatty acid formulas are believed by some clinicians to modify the immune response and diminish inflammation. {01} While polymeric and blenderized formulas are used for a variety of disease states, disease-specific formulas should only be administered for their claimed use. {19} In general, scientific evidence for efficacy of these products for a specific disease state is weak and requires further study. {54}
For Fiber-containing Formulas Fiber-containing enteral nutrition formulas may be beneficial in modulating stool consistency. {35} {44} However, fiber-containing formulas may cause gastrointestinal symptoms. {46}
For Milk-based Formulas Milk-based enteral nutrition formulas contain the same nutrients as polymeric formulas but in a milk-based formula. They should not be used in patients who are lactose intolerant.
For Modular Formulas Modular enteral nutrition formulas provide carbohydrates, proteins, fats, vitamins, and minerals separately and in varying combinations for addition to foods or other formulas. {01} These are not nutritionally complete.
For Monomeric (Elemental) Formulas Monomeric (elemental) enteral nutrition formulas contain fats, carbohydrates, and proteins in a more easily absorbed state. {01} The term ``elemental'' is being replaced by ``monomeric'' because these formulas are not truly elemental in nature. {63} These products contain protein in the form of peptides and/or amino acids; fat as medium-chain triglycerides and/or polyunsaturated oils such as safflower, corn, soy, or sunflower; and carbohydrates in the form of intermediate starches such as maltodextrins and glucose oligosaccharides. {01} Monomeric (elemental) enteral formulas may be useful in patients with compromised digestive or absorptive capabilities, but, because of cost, they should be used only in patients who cannot tolerate polymeric enteral formulas. {01}
For Polymeric Formulas Polymeric enteral nutrition formulas are the most common and are all lactose-free. Some polymeric formulas have a high caloric density and provide more calories per volume for patients on fluid restriction. However, patients receiving high-caloric-density formulas are more prone to dehydration and nitrogen or electrolyte retention problems due to an increased renal solute load. {01}

Unaccepted
There is no documented benefit for use of enteral products in healthy populations. {19}


Pharmacology/Pharmacokinetics


Other actions/effects:

Enteral Nutrition formulas are designed into varying formula types: blenderized, disease-specific, fiber-containing, milk based, modular, monomeric, and polymeric.{01}{35}


Precautions to Consider

Pregnancy/Reproduction

Pregnancy—
Studies have not been done in humans or animals; however, problems would not be expected. {19} {33} {55} {56}

Breast-feeding

Problems in humans would not be expected. {19}

Pediatrics

Appropriate studies performed to date have not demonstrated pediatrics-specific problems that would limit the usefulness of enteral feedings in children. {29} {30} {31} However, children up to one year of age are known to have immature gastrointestinal, hepatic, and renal systems, which may determine the type of enteral formula the infant should receive. {29} {31} Pediatric patients may also have milk sensitivity and metabolic disorders. {19}


Geriatrics


Studies performed to date indicate that the elderly may be more at risk of developing nasogastric tube problems such as aspiration pneumonia, especially with prolonged use of enteral feeding. {20} {21} {22} {23} The elderly are also more likely to remove the nasogastric tube. {21} {22} {23}

Drug interactions and/or related problems
The following drug interactions and/or related problems have been selected on the basis of their potential clinical significance (possible mechanism in parentheses where appropriate)—not necessarily inclusive (» = major clinical significance):


Note: Combinations containing any of the following medications, depending on the amount present, may also interact with enteral nutrition formulas.
Only specific interactions between enteral formulas and other oral medications have been identified in this monograph. However, enteral formulas that are administered continuously may reduce the rate and/or extent of absorption of medications that must be given on an empty stomach. {19} {52}

Ciprofloxacin    (concurrent administration of ciprofloxacin and enteral formulas has been found to decrease the absorption of ciprofloxacin; ciprofloxacin administration should be separated from enteral feedings if possible {13})


Phenytoin, oral    (enteral formulas have been found to decrease the absorption of phenytoin; the enteral feeding should be held and the nasogastric tube should be flushed 2 hours before and 2 hours after administration of phenytoin; monitoring of phenytoin blood levels is recommended {06} {07} {08} {09} {18})


Sucralfate    (concurrent use of sucralfate and enteral nutrition formulas in a nasogastric feeding tube has resulted in bezoar formation due to the protein-binding properties of sucralfate {40} {41})


Warfarin, oral    (warfarin resistance has been reported with concurrent administration of enteral feedings, possibly due to the vitamin K found in some products; more frequent monitoring of prothrombin times may be recommended {10} {11} {12} {19})



Laboratory value alterations
The following have been selected on the basis of their potential clinical significance (possible effect in parentheses where appropriate)—not necessarily inclusive (» = major clinical significance):

With physiology/laboratory test values
Alkaline phosphatase, serum and
Cholesterol, serum and
Glucose, serum and
Phospholipids, serum and
Transaminase, serum and
Triglycerides, serum    (concentrations may be increased)


Electrolytes, serum    (concentrations may be increased or decreased)


Medical considerations/Contraindications
The medical considerations/contraindications included have been selected on the basis of their potential clinical significance (reasons given in parentheses where appropriate)— not necessarily inclusive (» = major clinical significance).


Except under special circumstances, this enteral nutrition formula should not be used when the following medical problems exist:
» Bowel obstruction, total or{05}
» Ileus preventing nutrient absorption or
» Ischemic bowel or{57}
» Pancreatitis, severe or{62}
» Perforated bowel    (some patients may require post-pyloric feeding to achieve enteral nutrition; patients with pancreatitis must be fed beyond the Ligament of Treitz {66} {19})


Risk-benefit should be considered when the following medical problems exist

Note: Administration of enteral formulas in patients with the following medical problems may be accomplished by careful selection of an enteral formula or by changing the manner of administration. {19}

Aspiration pneumonitis, especially in the presence of severe pulmonary disease{05}    (condition may be exacerbated by introduction of nasogastric tube, especially in the elderly {20} {22})


Cardiac insufficiency    (condition may be exacerbated, especially during initiation of feeding in severely malnourished patients; adjustment of infusion rate may be required {47} {48})


Dehydration    (condition may be exacerbated, especially if supplementary fluids are not given; patients should be monitored for signs of dehydration {03} {04})


Diabetes mellitus or
Hyperglycemia    (the carbohydrate content of many enteral formulas may require adjustment of antidiabetic therapy or addition of insulin or other antidiabetic medications to the treatment regimen in patients with diabetes mellitus or hyperglycemia {03} {04} {05} {14} {32} {33})


Diarrhea, severe    (condition may be exacerbated by enteral feedings; use of formulas with a low osmolality may decrease the risk of diarrhea {49} {03} {04} {05})


Electrolyte abnormalities    (electrolyte disturbances may occur with enteral feedings; patient monitoring may be necessary {03} {04} {14} {24})


» Gastric function abnormalities    (gastric emptying may be delayed with certain disease processes, which may lead to retention, nausea, and/or vomiting; passing the tube into the duodenum {53} or switching to a formula with a low osmolality {69} may be necessary {03})


Hepatic function impairment    (enteral formulas have been reported to alter hepatic function {15} {25})


Hyperlipidemia    (the fat content of some enteral formulas may exacerbate the condition)


Lactose intolerance    (some enteral formulas contain lactose)


» Malnutrition, severe    (severe cardiopulmonary and neurologic complications have been reported when refeeding severely malnourished patients; adjustment of infusion rate may be required {58})


Pancreatic insufficiency with fat malabsorption{03}    (condition may be exacerbated; use of an enteral supplement with a low fat content may be necessary)


Phenylketonuria    (some enteral formulas contain phenylalanine, which may exacerbate the condition)


Renal function impairment    (certain components such as fluid, proteins, {64} electrolytes, vitamins, and minerals may need to be used with caution in patients with compromised renal function {34})


Respiratory difficulty    (condition may be exacerbated, especially with high carbohydrate formulas in patients who retain carbon dioxide {64}, or during initiation of feeding in severely malnourished patients; adjustment of infusion rate may be required {47} {48})


» Vomiting, severe{03}{04}{05}

Patient monitoring
The following (listed in order of progression) may be especially important in patient monitoring (other tests may be warranted in some patients, depending on condition; (» = major clinical significance):
Anthropometric measurements and{49}
Body weight{49}    (recommended periodically as a measure of lean body or adipose tissue mass or fluid status {59}; body weight should be determined daily for patients on short-term enteral nutrition therapy and weekly for patients on long-term therapy {19})


Albumin, serum and
Prealbumin, serum and
Transferrin, serum and
Urea nitrogen, 24-hour, urinary    (recommended periodically to assess protein status; transferrin should be monitored in patients receiving short-term enteral nutrition therapy and albumin in those receiving long-term enteral nutrition therapy; some clinicians recommend monitoring prealbumin, but this test is expensive and may not be available in some institutions {49} {68})


Energy expenditure{19}    (may be necessary, to determine success of short-term enteral nutrition therapy)


Complete blood count and{19}
Electrolytes, serum and{34}
Glucose, serum and{43}
Hepatic function determinations and{03}{26}{32}
Renal function determinations and{03}{27}{32}
Vitamin and mineral status{19}    (recommended periodically depending on patient condition; abnormal serum glucose may require an adjustment of insulin dosage in diabetic patients; mineral status determinations may be necessary in patients receiving long-term enteral nutrition therapy; if a patient has an abnormal renal function, there may be a need to restrict fluids, electrolytes, vitamins, and/or trace minerals)




Side/Adverse Effects

Note: Aspiration pneumonitis may occur with enteral tube feedings, and is more common in the elderly. {20} {21} {22} {23} {25}

The following side/adverse effects have been selected on the basis of their potential clinical significance (possible signs and symptoms in parentheses where appropriate)—not necessarily inclusive:

Those indicating need for medical attention
Incidence more frequent
    
Dehydration{03}{25} (decrease in urine volume ; unusual tiredness or weakness)
    
hyperglycemia (frequent urination or unusual thirst)
    
hyperkalemia (confusion; irregular heartbeat; numbness or tingling in hands, feet, or lips; shortness of breath or difficulty breathing; unexplained nervousness; unusual tiredness or weakness; weakness or heaviness of legs){03}{14}{16}{24}{25}
    
hypokalemia (dryness of mouth; increased thirst; irregular heartbeat; mood or mental changes; muscle cramps or pain; weak pulse){03}{14}{16}{25}
    
hypophosphatemia {03}(convulsions; respiratory distress; unusual tiredness or weakness)

Incidence less frequent
    
Hyperphosphatemia (muscle cramps; numbness, tingling, pain, or weakness in hands or feet; shortness of breath or troubled breathing){14}



Those indicating need for medical attention only if they continue or are bothersome
Incidence more frequent
    
Gastrointestinal disturbances, specifically constipation{04}{67}
or diarrhea {02}{03}{04}{16}{17}{25}
    
nausea and vomiting{03}{04}{16}{25}


Note: Gastrointestinal disturbances may also be a complication of feeding tube use, with or without pneumonitis.





Patient Consultation
As an aid to patient consultation, refer to Advice for the Patient, Enteral Nutrition Formulas (Systemic).

In providing consultation, consider emphasizing the following selected information (» = major clinical significance):

Before using this enteral nutrition formula
»   Conditions affecting use, especially:
Sensitivity to any ingredient in the enteral nutrition formula





Use in children—Use with caution in children up to one year of age because of their decreased ability to metabolize certain components of enteral feeding






Use in the elderly—Elderly more at risk of developing aspiration pneumonitis or of self-extubation
Other medical problems, especially bowel obstruction, gastric function abnormalities, ileus preventing nutrient absorption, ischemic or perforated bowel, severe pancreatitis, severe malnutrition, or severe vomiting

Precautions while using this enteral nutrition formula
Caution about bacterial contamination, particularly with home use


Side/adverse effects
Dehydration, hyperglycemia, hyperkalemia, hypokalemia, hyperphosphatemia, and hypophosphatemia


General Dosing Information
Bacterial contamination of enteral feedings may occur due to improper handling. Enteral formulas for tube-feeding use should not be hung or left for longer than 12 hours at room temperature. {23} {26} {27} {28}

Some products may be given either orally or by feeding tube; other products are designed to be given only by feeding tube.

The complication of aspiration can be reduced by confirming the anatomic position of the feeding tube, elevating the patient's head to 30° while feeding, and limiting the administration rate to 150 mL per hour or less. {42}

Formulas that are dense in consistency are more likely to clog the feeding tube. {19}

ENTERAL NUTRITION FORMULAS


Oral Dosage Forms

ENTERAL NUTRITION FORMULAS

Usual adult and adolescent dose
The administration of enteral formula by continuous or intermittent feeding and the dosage are very individualized and are a decision of the prescribing physician. {12}

Usual pediatric dose
The administration of enteral formula by continuous or intermittent feeding and the dosage are very individualized and are a decision of the prescribing physician. {19}

Strength(s) usually available
U.S.—
See Tables 1—7.

Canada—
See Tables 1—7.

Packaging and storage:
The unopened product should be stored below 40 °C (104 °F), preferably between 15 and 30 °C (59 and 86 °F), unless otherwise specified by the manufacturer.

Preparation of dosage form:
For formulas in the powder form—This product must be reconstituted before administration. Follow carefully the directions for mixing on the product container.

Stability:
For formulas in the ready-to-use form—Formulas should be refrigerated after opening. Any unused portions should be discarded within 24 to 48 hours after opening.

For formulas in the powder form—Any unused solution should be refrigerated and used within 24 to 48 hours after preparation, depending on the manufacturer"s instructions.

Auxiliary labeling:
Shake container well before opening.

Additional information:

Table 1. Blenderized Formulas


Note: Some products may be given either orally or by feeding tube; others are designed to be given by feeding tube only.



Brand name
[availability]
KCal
(kJoules)
per mL
mOsm
per kg
water
Protein
Carbohydrates
Fat
Na +
mg
(mEq)
per L
K +
mg
(mEq)
per L
Ca ++
mg
(mEq)
per L
Mg ++
mg
(mEq)
per L
Phos
mg
per L
mL
to
supply
100%
RDI for
vitamins
Comments
Grams
per
1000
mL
 
Source;
% KCal
 
Nonprotein
KCal
per gm
of
Nitrogen
 
Grams
per
1000
mL
 
Source;
% KCal
 
Grams
per
1000
mL
 
Source;
%KCal
 
Compleat Modified Oral Solution
[U.S.]
1.07
(4.5)
300
43
Beef,
calcium
caseinate; 16
131:1
140
Maltodextrin,
vegetables,
fruits; 53
37
Beef,
canola oil;
31
1000
(43)
1400
(36)
670
(33.5)
270
(22)
870
1500
Lactose-free,
contains 4.2 grams
fiber per 1000 mL
Oral solution
[Canada]
1.07
(4.5)
300
43
Beef,
calcium
caseinate; 16
131:1
140
Maltodextrin,
vegetables,
fruits; 53
37
Beef,
corn oil; 31
850
(37)
1400
(36)
730
(36)
270
(22)
930
N/A
Lactose-free,
contains 4.2 grams
fiber per 1000 mL
Compleat Regular Oral Solution
[U.S.]
1.07
(4.5)
450
43
Beef,
nonfat
milk; 16
131:1
130
Maltodextrin,
vegetables,
fruits, nonfat
milk; 48
43
Beef,
corn oil; 36
1300
(57)
1400
(36)
670
(33)
270
(22)
1200
1500
Contains lactose,
contains 4.2 grams
fiber per 1000 mL
Vitaneed Oral Solution
[U.S.]
1
(4.2)
300
40
Beef,
calcium and
sodium
caseinates; 16
134:1
128
Maltodextrin
vegetables,
fruits,
soy fiber; 48
40
Corn oil; 36
680
(30)
1250
(32)
667
(33.4)
267
(21.4)
667
1500
Lactose-free,
contains 8 grams
fiber per 1000 mL

Table 2. Disease-specific Formulas


Note: Some products may be given either orally or by feeding tube; others are designed to be given by feeding tube only.



Brand name
[availability]
KCal
(kJoules)
per mL
mOsm
per kg
water
Protein

Carbohydrates

Fat

Na +
mg
(mEq)
per L
K +
mg
(mEq)
per L
Ca ++
mg
(mEq)
per L
Mg +
mg
(mEq)
per L
Phos
mg
per L
mL
to
supply
100%
RDI for
vitamins
Comments
Grams
per
1000
mL
 
Source;
% KCal
 
Nonprotein
KCal
per gm
of
Nitrogen
 
Grams
per
1000
mL
 
Source;
% KCal
 
Grams
per
1000
mL
 
Source;
%KCal
 
For Patients with Hepatic
Disease *
                               
Hepatic-Aid II for Oral Solution
[U.S.]
1.2
(5)
560
44.1
Crystalline
amino acids;
15
148:1
168.5
Malto-
dextrins,
sucrose; 57.3
36.2
Soybean
oil, lecithin
monodigly-
cerides; 27.7
Less
than
339
(14.7)
Less
than
230.3
(5.9)
N/A
N/A
N/A
N/A
Contains phenylalanine, contains tartrazine
NutriHep Oral Solution
[U.S.]
1.5
(6.3)
690
40
Crystalline
L-amino
acids, whey
protein
concentrate;
11
209:1
290
Maltodextrin,
modified
cornstarch;
77
21.2
MCT oil,
canola oil,
lecithin,
corn oil;
12
320
(14)
1320
(34)
1000
(50)
400
32
1000
1000
Lactose-free
For Immunocompromised
Patients or Patients with
Metabolic Stress/Trauma *
                               
Advera Oral Solution
[U.S.]
1.28
680
60
Soy protein
hydrolysate,
sodium
caseinate; 18.7
108:1
215.8
Maltodextrin,
sucrose,
soy fiber;
65.5
22.8
Canola oil,
MCT oil,
refined
deodorized
sardine oil;
15.8
1056
(45.9)
2827
(72.5)
1083
(54.2)
338
(27.5)
1083
1184
 
Crucial Oral Solution
[U.S.]
1.5
(6.3)
490
94
Enzymati-
cally
hydrolyzed
casein;
L-arginine; 25
75:1
135
Maltodextrin,
cornstarch;
36
68
MCT ,
fish oil,
soy oil; 39
1168
(51)
1872
(48)
1000
(50)
400
(32)
1000
1000
Lactose-free
Immun-Aid for Oral Solution
[U.S.]
1
(4.2)
580
37
Amino
acids; 15
167:1
120
Maltodextrin;
48
22
MCT oil,
canola oil;
20
800
(35)
1756
(45)
600
(30)
200
(16)
600
2000
 
Impact Oral Solution
[U.S./Canada]
1
(4.2)
375
56
Sodium and
calcium
caseinates;
L-arginine; 22
71:1
130
Hydrolyzed
cornstarch;
53
28
Structured
lipid,
menhaden
oil; 25
1100
(48)
1400
(36)
800
(40)
270
(22)
800
(26)
1500
Lactose-free
Impact with Fiber Oral Solution
[U.S.]
1
(4.2)
375
56
Sodium and
calcium
caseinates,
L-arginine;
22
71:1
140
Hydrolyzed
cornstarch,
soy fiber,
enzymatically
modified
guar; 53
28
Structured
lipid,
menhaden
oil; 25
1100
(48)
1400
(36)
800
(40)
270
(22)
800
(26)
1500
Lactose-free,
contains 10 grams
fiber per 1000 mL
Perative Oral Solution
[U.S.]
1.3
(5.4)
385
66.6
Partially
hydrolyzed
sodium
caseinate,
lactalbumin
hydrolysate,
L-arginine;
20.5
97:1
177.2
Maltodextrin;
54.5
37.4
Canola oil,
MCT
oil, corn
oil; 25
1040
(45.2)
1730
(44.2)
867
(43.3)
347
(28.9)
867
1155
 
Protain XL Oral Solution
[U.S.]
1
(4.2)
340
55
Sodium and
calcium
caseinates; 14
92:1
138
Maltodextrin,
soy fiber; 51
30
MCT ,
corn oil; 27
860
(37.4)
1500
(38.4)
800
(40)
320
(25.6)
800
1250
Lactose-free
TraumaCal Oral Solution
[U.S.]
1.5
(6.3)
560
82
Sodium and
calcium
caseinates; 22
91:1
142
Corn syrup,
sugar; 38
68
MCT oil,
soy oil; 40
1180
(51)
1390
(36)
750
(37)
200
(16.5)
750
2000
Lactose-free
Traum-Aid HBC for Oral Solution
[U.S.]
1
(4.2)
640
56
Crystalline
amino acids;
22.4
132:1
166
Maltodextrin;
66.4
12.4
Soybean oil,
MCT oil,
lecithin;
11.2
530
(23)
1173
(30)
400
133
400
3000
 
For Patients with Fat
Malabsorption *
                               
Citrotein for Oral Solution
[Canada]
0.67
(2.8)
  41
Egg white
solids: 25
76:1
120
Maltodextrin
sugar; 73
1.6
Partially
hydroge-
nated
soybean
oil; 2
670
(29)
550
(14)
1100
(56)
420
(35)
1100
N/A
Lactose-free,
cholesterol-free
orange
490
punch
480
Lipisorb for Oral Solution
[U.S.]
Dilution #1
1
(4.2)
320
35
Sodium
caseinate; 14
157:1
116
Corn syrup,
sucrose; 46
48
MCT oil,
corn oil; 40
740
(32)
1260
(32)
710
(36)
200
(16.5)
710
2000
Lactose-free
  Dilution #2
1.35
(5.6)
470
47
Sodium
caseinate; 14
157:1
155
Corn syrup,
sucrose; 46
65
MCT oil,
corn oil; 40
990
(43)
1690
(43)
950
(48)
270
(22)
950
1480
Lactose-free
Oral Solution
[U.S.]
1.35
(5.6)
630
57
Sodium and
calcium
caseinates; 17
125:1
161
Maltodextrin,
sucrose; 48
57
MCT oil,
soy oil; 35
1350
(59)
1690
(43)
850
(43)
340
(28)
850
1180
Lactose-free
Nutren 2.0 Oral Solution
[U.S.]
2
(8.4)
720
80
Calcium and
potassium
caseinates; 16
131:1
196
Corn syrup
solids,
maltodextrin,
sucrose; 39
106
MCT oil,
canola oil,
corn oil; 45
1300
(56.5)
1920
(49.2)
1340
(67)
536
(42.9)
1340
750
Lactose-free,
vanilla
Peptamen Oral Solution
[U.S.]
1
(4.2)
270
40
Hydrolyzed
whey; 16
131:1
127
Maltodextrin,
starch; 51
39
MCT oil,
sunflower
oil; 33
500
(22)
1250
(32)
800
(40)
400
(32)
700
1500
Lactose-free
Peptamen Junior Oral Solution
[U.S.]
1
(4.2)
260
30
Enzymati-
cally
hydrolyzed
whey protein;
12
183:1
137.5
Maltodextrin,
cornstarch;
55
38.5
MCT ,
soybean oil,
canola oil;
33
460
(20)
1320
(34)
1000
(50)
200
(16)
800
1000
Lactose-free
Peptamen VHP Oral Solution
[U.S.]
1
(4.2)
300
62.5
Enzymati-
cally
hydrolyzed
whey protein;
25
75:1
104.5
Maltodextrin,
cornstarch;
42
39
MCT ,
soybean oil;
33
560
(24)
1500
(38.5)
800
(40)
300
(24)
700
1500
Lactose-free
For Patients with Glucose
Intolerance *
                               
DiabetiSource Oral Solution
[U.S.]
1
(4.2)
360
50
Beef and
calcium
caseinates; 20
100:1
90
Maltodextrin,
fructose; 36
49
High-oleic
sunflower
oil, canola
oil; beef
fat; 44
1000
(43)
1400
(36)
670
(33)
270
(22)
670
1500
Lactose-free,
contains 6.4 grams
fiber per 1500 mL
Glucerna Oral Solution
[U.S./Canada]
1
(4.2)
375
41.8
Sodium and
calcium
caseinates;
16.7
125:1
93.7
Hydrolyzed
cornstarch,
soy fiber,
fructose; 33.3
55.7
High-oleic
safflower
oil,
soy oil; 50
930
(40.5)
1560
(40)
704
(35.2)
282
(23.5)
704
1422
Lactose-free,
contains 14.4 grams
fiber per 1000 mL
Glytrol Oral Solution
[U.S.]
1
(4.2)
380
45
Calcium and
potassium
caseinates; 18
114:1
100
Maltodextrin,
modified
cornstarch,
fructose; 40
47.5
Canola oil,
high-oleic
safflower oil,
MCT ; 42
740
(32)
1400
(36)
720
(36)
286
(23)
720
1400
Lactose-free,
contains 15 grams
fiber per 1000 mL
For Patients with Pulmonary Disease *
                               
NutriVent Oral Solution
[U.S.]
1.5
(6.3)
330
67.5
Calcium and
potassium
caseinates; 18
113:1
100
Maltodextrin,
sugar; 27
94
MCT oil,
canola oil,
corn oil,
lecithin; 55
1170
(51)
1872
(48)
1200
(60)
480
(38)
1200
1000
Lactose-free
Pulmocare Oral Solution
[U.S./Canada]
1.5
(6.3)
475
62.6
Sodium and
calcium
caseinates;
16.7
125:1
105.7
Sucrose,
maltodextrin;
28.2
93.3
Canola oil,
MCT oil,
corn oil,
high-oleic
safflower
oil; 55.1
1310
(57)
1730
(44.2)
1056
(52.8)
423
(35.3)
1056
947
Lactose-free
Respalor Oral Solution
[U.S.]
1.52
(6.4)
580
76
Sodium and
calcium
caseinates; 20
102:1
148
Corn syrup,
sucrose; 39
71
MCT oil,
canola oil;
41
1270
(55)
1480
(38)
710
(36)
280
(23)
710
1420
 
For Patients with Renal
Disease *
                               
Amin-Aid for Oral Solution
[U.S.]
2
(8.4)
510
19.4
Crystalline,
amino acids; 4
640:1
365.6
Malto-
dextrins,
sucrose; 74.8
46.2
Partially
hydroge-
nated
soybean oil
lecithin,
mono- and
diglycerides
Less
than
339
(14.7)
Less
than
230.3
(5.9)
N/A
N/A
N/A
N/A
Contains tartrazine
Magnacal Oral Solution
[U.S.]
2
590
70
Sodium and
calcium
caseinates; 14
154:1
250
Maltodextrin
sucrose; 50
80
Soy oil; 36
1000
(43.5)
1250
(32)
1000
(50)
400
(32)
1000
1000
 
Nepro Oral Solution
[U.S./Canada]
2
(8.4)
635
69.9
Calcium,
magnesium,
and sodium
caseinates; 14
154:1
215.2
Corn syrup,
sucrose; 43
95.6
High-oleic
safflower
oil, soy
oil; 43
829
(36.1)
1057
(27)
1373
(68.6)
211
(17.6)
686
947
 
Suplena Oral Solution
[U.S./Canada]
2
(8.4)
600
30
Sodium and
calcium
caseinates; 6
393:1
255.2
Maltodextrin,
sucrose; 51
95.6
High-oleic
safflower
oil, soy
oil; 43
783
(34)
1116
(28.5)
1385
(69.2)
211
(17.6)
728
947
 
Travasorb Renal Diet for Oral Solution
[U.S.]
1.35
(5.6)
590
22.9
Amino
acids; 6.9
339:1
270.5
Glucose
oligo-
saccharides,
sucrose;81.1
17.7
MCT oil,
sunflower
oil; 12
N/A
N/A
N/A
N/A
N/A
N/A
 
* Manufacturer suggested use as stated in the product information
 Medium-chain triglyceride

Table 3. Fiber-containing Formulas


Note: Some products may be given either orally or by feeding tube; others are designed to be given by feeding tube only.



Brand name
[availability]
KCal
(kJoules)
per mL
mOsm
per kg
water
Protein

Carbohydrates

Fat

Na +
mg
(mEq)
per L
K +
mg
(mEq)
per L
Ca
mg
(mEq)
per L
Mg ++
mg
(mEq)
per L
Phos
mg
per L
mL
to
supply
100%
RDI for
vitamins
Comments
Grams
per
1000
mL
 
Source;
% KCal
 
Nonprotein
KCal
per gm
of
Nitrogen
 
Grams
per
1000
mL
 
Source;
% KCal
 
Grams
per
1000
mL
 
Source;
%KCal
 
Ensure with Fiber Oral Solution
[U.S./Canada]
1.1
(4.6)
480
39.7
Sodium and
calcium
caseinates,
soy protein
isolate; 14.5
148:1
162
Maltodextrin,
sucrose, soy
fiber; 55
37.2
Corn oil; 30.5
846
(36.8)
1693
(43.3)
719
(35.9)
288
(24)
719
1391
Lactose-free,
contains 14.4 grams
fiber per 1000 mL
Fiberlan Oral Solution
[U.S.]
1.2
(5)
310
50
Caseinates;
16.7
122:1
160
Maltodextrin;
53.3
40
MCT oil,
corn oil; 27.8
1012
(44)
1716
(44)
800
(40)
320
(25.6)
800
1250
Lactose-free,
contains 14 grams
fiber per 1000 mL
Fibersource Oral Solution
[U.S.]
1.2
(5)
390
43
Sodium and
calcium
caseinates; 14
151:1
170
Hydrolyzed
cornstarch,
soy fiber; 56
41
MCT oil,
canola oil;
30
1100
(48)
1800
(46)
670
(33)
270
(22)
670
1500
Lactose-free,
contains 10 grams
fiber per 1000 mL
Fibersource HN Oral Solution
[U.S.]
1.2
(5)
390
53
Sodium and
calcium
caseinates; 18
118:1
160
Hydrolyzed
cornstarch,
soy fiber; 52
41
MCT oil,
canola oil;
30
1100
(48)
1800
(46)
670
(33)
270
(22)
670
1500
Lactose-free,
contains 6.7 grams
fiber per 1000 mL
Glytrol Oral Solution
[U.S.]
1.0
(4.2)
380
45
Calcium and
potassium
caseinate; 18
114:1
100
Maltodextrin,
modified
cornstarch,
fructose; 40
47.5
Canola oil,
high-oleic
safflower oil,
MCT ; 42
740
(32)
1400
(36)
720
(36)
286
(23)
720
1400
Lactose-free,
15 grams
fiber/1000 mL
Impact with Fiber Oral Solution
[U.S.]
1
(4.2)
375
56
Sodium
and calcium
caseinates,
L-arginine; 22
71:1
140
Hydrolyzed
cornstarch,
soy fiber,
enzymatically
modified
guar; 53
28
Structural
lipid
menhaden
oil; 25
1100
(48)
1400
(36)
800
(40)
270
(22)
800
(26)
1500
Lactose-free,
contains 10 grams
fiber per 1000 mL
IsoSource VHN Oral Solution
[U.S.]
1
(4.2)
300
62
Sodium and
calcium
caseinates; 25
77:1
130
Hydrolyzed
cornstarch,
soy fiber and
hydrolyzed
guar fiber;
50
29
MCT oil,
canola oil;
25
1300
(57)
1600
(41)
800
(40)
320
(25.6)
800
1250
Lactose-free,
contains 12.5 grams
fiber per 1250 mL
Jevity Oral Solution
[U.S.]
1.06
(4.4)
310
44.3
Sodium and
calcium
caseinates;
16.7
125:1
154.4
Maltodextrin,
soy fiber; 54.3
34.7
High-oleic
safflower oil,
canola oil,
MCT oil;
29
930
(40.5)
1570
(40.2)
909
(45.4)
304
(25.3)
758
1321
Lactose-free,
contains 14.4 grams
fiber per 1000 mL
Oral Solution
[Canada]
1.06
(4.4)
310
44
Sodium and
calcium
caseinates;
16.7
125:1
152
Hydrolyzed
cornstarch,
soy fiber; 53.3
37
MCT oil,
corn oil; 30
740
(32)
1240
(32)
908
(45.4)
302
(24.2)
748.8
1321
Lactose-free,
contains 14.4 grams
fiber per 1000 mL
Kindercal Oral Solution
[U.S.]
1.06
(4.4)
310
34
Sodium and
calcium
caseinates,
milk protein
concentrate;
13
171:1
135
Maltodextrin,
sucrose; 50
44
MCT oil,
canola oil,
corn oil,
high-oleic
safflower oil;
37
370
(16.1)
1310
(34)
850
(43)
210
(17.4)
850
950
Lactose-free,
contains 6.3 grams
fiber per 1000 mL
NuBasics with Fiber Oral Solution
[U.S.]
1
(4.2)
520
35
Calcium and
potassium
caseinates; 14
153:1
132.4
Corn syrup
solids,
sucrose; 53
36.8
Canola oil,
corn oil; 33
876
(38)
1248
(32)
500
(25)
200
(16)
500
2000
Lactose-free,
contains 14 grams
fiber per 1000 mL
Nutren 1.0 with Fiber Oral Solution
[U.S.]
1
(4.2)
310
40
Calcium and
potassium
caseinates; 16
131:1
127
Maltodextrin,
corn syrup
solids; 51
38
MCT oil,
canola oil,
corn oil; 33
876
(38)
1250
(32)
668
(33)
268
(21.4)
668
1500
Contains 14 grams
fiber per 1000 mL
NutriSource Oral Solution
[Canada]
1.2
(5)
390
43
Sodium
and calcium
caseinates; 14
151:1
170
Maltodextrin,
corn syrup
solids, soy
fiber; 56
41
MCT oil,
canola oil;
30
1100
(48)
1800
(46)
670
(33)
270
(22)
670
N/A
Lactose-free,
contains 10 grams
fiber per 1000 mL
NutriSource HN Oral Solution
[Canada]
1.2
(5)
390
53
Sodium
and calcium
caseinates; 18
118:1
160
Maltodextrin,
corn syrup
solids, soy
fiber; 52
41
MCT oil,
canola oi;
30
1100
(48)
1800
(46)
670
(33)
270
(22)
670
N/A
Lactose-free,
contains 6.7 grams
fiber per 1000 mL
Pediasure with Fiber Oral Solution
[U.S.]
1
(4.2)
<345
30
Sodium
caseinate,
whey
protein
concentrate;
12
185:1
113.5
Hydrolyzed
cornstarch,
sucrose,
soy fiber; 43.9
49.7
High-oleic
safflower oil,
soy oil,
MCT oil;
44.1
380
(16.5)
1310
(33.5)
970
(48.5)
200
(16.7)
800
1000
Trace lactose,
contains 5 grams
fiber per 1000 mL
ProBalance Oral Solution
[U.S.]
1.2
(5)
350
54
Calcium and
potassium
caseinates; 18
114:1
156
Maltodextrin;
52
40.6
Canola oil,
MCT , corn
oil; 30
763
(33)
1560
(40)
1250
(62.5)
400
(32)
1000
1000
Lactose-free,
contains 10 grams
fiber per 1000 mL
Profiber Oral Solution
[U.S.]
1
(4.2)
300
40
Sodium and
calcium
caseinates; 16
134:1
147
Maltodextrin,
soy fiber; 54
35
Corn oil,
MCT oil;
30
800
(34.8)
1500
(38.4)
800
(40)
320
(25.6)
800
1250
Lactose-free,
contains 12 grams
fiber per 1000 mL
Promote with Fiber Oral Solution
[U.S.]
1
370
62.5
Sodium and
calcium
caseinates; 25
75:1
139.4
Hydrolyzed
cornstarch,
sucrose, oat
fiber, soy
fiber; 50
28.2
High-oleic
safflower
oil, canola
oil, MCT
oil; 25
1300
(56.6)
1980
(50.6)
1200
(60)
400
(32.6)
1200
1000
Lactose-free,
contains 14.4 grams
fiber per 1000 mL
Replete with Fiber Oral Solution
[U.S.]
1
(4.2)
300
62.5
Calcium and
potassium
caseinates; 25
75:1
113
Maltodextrin,
corn syrup
solids; 45
34
Canola oil;
MCT oil;
30
876
(38)
1500
(38)
1000
(50)
400
(32)
1000
1000
Lactose-free,
contains 14 grams
fiber per 1000 mL
Sustacal with Fiber Oral Solution
[U.S.]
1.06
(4.4)
490
46
Sodium and
calcium
caseinates,
soy protein
isolates; 17
120:1
139
Maltodextrin,
sugar; 53
35
Corn oil; 30
720
(31)
1390
(36)
850
(43)
280
(23)
710
1420
Lactose-free,
contains 10.6
grams fiber per
1000 mL
Ultracal Oral Solution
[U.S.]
1.06
(4.4)
310
44
Sodium and
calcium
caseinates; 17
128:1
123
Maltodextrin;
46
45
MCT oil,
canola
oil; 37
930
(40)
1610
(41)
850
(43)
340
(28)
850
1180
Lactose-free,
contains 14.4 grams
fiber per 1000 mL
 Medium-chain triglyceride

Table 4. Milk-based Formulas


Note: Some products may be given either orally or by feeding tube; others are designed to be given by feeding tube only.



Brand name
[availability]
KCal
(kJoules)
per mL
mOsm
per kg
water
Protein

Carbohydrates

Fat

Na +
mg
(mEq)
per L
K +
mg
(mEq)
per L
Ca ++
mg
(mEq)
per L
Mg ++
mg
(mEq)
per L
Phos
mg
per L
mL
to
supply
100%
RDI for
vitamins
Comments
Grams
per
1000
mL
 
Source;
% KCal
 
Nonprotein
KCal
per gm
of
Nitrogen
 
Grams
per
1000
mL
 
Source;
% KCal
 
Grams
per
1000
mL
 
Source;
%KCal
 
Carnation Instant Breakfast for Oral Solution
[U.S.]
1
(4.2)

63.3
Nonfat
dry milk,
fluid milk §

149.6
Lactose,
sucrose §
34.6
Milk fat §
1062.5
(45.8)
3083.3
(78.8)
2045.8
(102.3)
470.8
(37.7)
1700
N/A
Contains lactose
Carnation Instant Breakfast No Sugar Added for Oral Solution
[U.S.]
0.7
(2.9)

62.5
Casein,
nonfat
dry milk,
fluid milk §

86.3
Lactose, §
maltodextrin
20.8
Milk fat §
1041.7
(45.4)
2822.9
(72.5)
1716.7
(85.8)
470.8
(37.7)
1362.5
N/A
Contains lactose,
sugar-free,
contains aspartame
Great Shake Oral Solution
[U.S.]
1.67
(7.04)
910
50
Nonfat milk,
skim milk;
12
183:1
261
Corn syrup,
high fructose
corn syrup,
lactose; 62.7
50
Partially
hydroge-
nated
soybean
oil, milk-
fat; 27
1100
(48.1)
1940
(49.5)
1670
(83.5)
670
(54.7)
1110
900
Contains lactose
Great Shake Jr. Oral Solution
[U.S./Canada]
1.92
(7.95)
890
66.7
Nonfat milk,
skim milk;
13.9
155:1
165
Corn syrup,
high fructose
corn syrup,
lactose; 57.4
35
Partially
hydroge-
nated
soybean
oil, milk-
fat; 27.4
800
(35)
1500
(38.3)
1000
(50)
400
(32)
1000
800
Contains lactose
Menu Magic Instant Breakfast for Oral Solution
[U.S.]
1.12
(5)

64
Nonfat
milk, whole
milk, isolated
soy protein;
22.1
113:1
144
Sucrose,
lactose; 49.9
36
Milk fat; 28
900
(39)
2960
(75)
3600
(180)
320
(25.6)
1800
715
Contains lactose
Menu Magic Milk Shake Oral Solution
[U.S.]
1
(4.2)

32
Nonfat milk,
whole milk; 13.5
187.5:1
136
Lactose,
dextrose,
maltodextrin;
56.5
32
Milk fat; 30
600
(26.3)
1600
(41.1)
1400
(67)
560
(45.7)
1200
1000
Contains lactose
Meritene for Oral Solution
[U.S.]
1.06
(4.4)
690
69
Nonfat milk,
whole milk; 26
71:1
120
Lactose,
sugar,
hydrolyzed
corn starch; 45
34
Milk fat; 29
1100
(48)
2800
(72)
2200
(110)
380
(31)
1900
1040
Contains lactose
for Oral Solution
[Canada]
1.06
(4.4)
690
72
Nonfat milk,
whole milk; 26
96:1
120
Corn syrup
solids; 45
35
Partially
hydroge-
nated
soybean oil;
29
960
(42)
3000
(77)
2300
(110)
380
(31)
1900
N/A
Contains lactose
206 Shake Oral Solution
[U.S.]
1.67
(7.04)
910
50
Nonfat milk,
skim milk; 12
183:1
261
Corn syrup,
high fructose
corn syrup,
lactose; 62.7
50
Partially
hydroge-
nated
soybean oil,
milkfat; 27
1100
(48.1)
1940
(49.5)
1670
(83.5)
670
(54.7)
1110
900
Contains lactose
Sustagen for Oral Solution
[U.S./Canada]
1.86
(7.8)
1130
115
Nonfat milk,
whole milk,
calcium
caseinate; 25
78:1
320
Lactose,
dextrose,
corn syrup
solids; 67
16.8
Milk fat; 8
1060
(46)
3400
(87)
3400
(170)
420
(35)
2500
950
Contains lactose
Tasty Shake Oral Solution
[U.S.]
1.2
(5)

64
Whole milk,
nonfat milk,
isolated
soy protein;
22.1
113.3:1
144
Sucrose,
lactose; 49.9
36
Milk fat; 28
900
(39.5)
2960
(75)
3600
(180)
320
(26.7)
1800
715
Contains lactose
§ The percent KCal for protein, carbohydrates, and fat depends on the fat content of the beverage used to prepare the product.

Table 5. Modular Formulas


Note: Some products may be given either orally or by feeding tube; others are designed to be given by feeding tube only.



Brand name
[availability]
KCal
(kJoules)
per
gram
Protein

Carbohydrates

Fat

Na +
mg
(mEq)
per
100
grams
K +
mg
(mEq)
per
100
grams
Ca ++
mg
(mEq)
per
100
grams
Mg ++
mg
(mEq)
per
100
grams
Phos
mg per
100
grams
Comments 
Grams
per
100
grams
 
Source
 
Grams
per
100
grams
 
Source
 
Grams
per
100
grams
 
Source
 
Casec Oral Powder
[U.S.]
3.8
(15.9)
90
Calcium caseinate
    2
Milk fat
100
(4.3)
10
(0.26)
1400
(70)
N/A
800
 
Elementra Oral Powder
[U.S.]
3.8
(16)
79
Hydrolyzed
whey protein
        39
(1.7)
1515
(39)
909
(45)
35
(2.8)
454
 
MCT Oil Oral Solution
[U.S./Canada]
7.7
(32)
per mL
          Fractionated
coconut oil
N/A
N/A
N/A
N/A
N/A
 
Microlipid Oral Solution
[U.S.]
4.5
(18.8)
per mL
        0.5 gm
per mL
Safflower
oil
N/A
N/A
N/A
N/A
N/A
 
Moducal Oral Powder
[U.S.]
3.8
(15.9)
    95
Maltodextrin
    70
(3)
Less
than
10 mg
(0.26)
N/A
N/A
N/A
N/A
Polycose Oral Solution
[U.S./Canada]
2
(8.4)
per mL
    50 gm
per
100
mL
Glucose polymers
    Does
not
exceed
70 (3)
per
100
mL
Does
not
exceed
6 (.15)
per
100
mL
Does
not
exceed
20 (1)
per
100
mL
N/A
Does not
exceed 3 mg
per 100 mL
Lactose-free
Oral Powder
[U.S./Canada]
3.8
(15.9)
    94
Glucose polymers
    Does
not
exceed
110
(4.8)
Does
not
exceed
10
(0.3)
Does
not
exceed
30
(1.5)
N/A
Does not
exceed 5 mg
Lactose-free
ProMod Oral Powder
[U.S./Canada]
4.2
(23.4)
75
Whey protein
concentrate
Does
not
exceed
10.2
  Does
not
exceed
9
Soy lecithin
Does
not
exceed
227
(9.8)
Does
not
exceed
985
(25.2)
Does
not
exceed
667
(33.4)
N/A
Does not
exceed
500 mg
 
Propac Plus Oral Powder
[U.S.]
3.7
88.5
Milk protein from
skimmed milk
<1
Lactose
<2
Milk protein,
soy, lecithin
30
50
1350
20
700
Lactose-free, protein
from casein and whey
Sumacal Oral Powder
[U.S.]
3.8
(15.9)
    95
Maltodextrin
    100
(4.3)
N/A
N/A
N/A
N/A
 

Table 6. Monomeric (Elemental) Formulas


Note: Some products may be given either orally or by feeding tube; others are designed to be given by feeding tube only.



Brand name
[availability]
KCal
(kJoules)
per mL
mOsm
per kg
water
Protein

Carbohydrates

Fat

Na +
mg
(mEq)
per L
K +
mg
(mEq)
per L
Ca ++
mg
(mEq)
per L
Mg ++
mg
(mEq)
per L
Phos
mg
per L
mL
to
supply
100%
RDI for
vitamins
Comments
Grams
per
1000
mL
 
Source;
% KCal
 
Nonprotein
KCal
per gm
of
Nitrogen
 
Grams
per
1000
mL
 
Source;
% KCal
 
Grams
per
1000
mL
 
Source;
%KCal
 
Accupep HPF for Oral Solution
[U.S.]
1
(4.2)
490
40
Hydrolyzed
lactalbumin;
16
132:1
188
Maltodextrin;
75.5
10
MCT oil,
corn oil; 8.5
680
(29.6)
1150
(29.5)
625
(31.3)
250
(20)
625
1600
 
Alitraq for Oral Solution
[U.S.]
1
(4.2)
575
52.5
Soy
hydrolysate,
L-glutamine,
whey protein
concentrate,
lactalbumin
hydrolysate,
free amino
acids; 21
94:1
165
Maltodextrin,
sucrose,
fructose; 66
15.5
MCT oil,
safflower
oil; 13
1000
(43.5)
1200
(30.7)
733
(36.6)
267
(22.3)
733
1500
 
Criticare HN Oral Solution
[U.S.]
1.06
(4.4)
650
38
Hydrolyzed
casein, amino
acids; 14
149:1
220
Maltodextrin,
cornstarch;
81.5
5.3
Safflower
oil; 4.5
630
(27)
1310
(34)
530
(26)
210
(17)
530
1890
Lactose-free
Peptamen Oral Solution
[U.S.]
1
(4.2)
270
40
Hydrolyzed
whey; 16
131:1
127
Maltodextrin,
starch; 51
39
MCT oil,
sunflower
oil; 33
500
(22)
1250
(32)
800
(40)
400
(32)
700
1500
Lactose-free
Peptamen Junior Oral Solution
[U.S.]
1
(4.2)
260
30
Enzymati-
cally
hydrolyzed
whey protein;
12
183:1
137.5
Maltodextrin,
cornstarch;
55
38.5
MCT ,
soybean oil,
canola oil;
33
460
(20)
1320
(34)
1000
(50)
200
(16)
800
1000
Lactose-free
Peptamen VHP Oral Solution
[U.S.]
1.0
(4.2)
300
62.5
Enzymati-
cally
hydrolyzed
whey protein;
25
75:1
104.5
Maltodextrin,
cornstarch;
42
39
MCT ,
soybean oil;
33
560
(24)
1500
(38.5)
800
(40)
300
(24)
700
1500
Lactose-free
Reabilan Oral Solution
[U.S.]
1
(4.2)
350
31.5
Whey
peptides,
casein
peptides; 12.5
175:1
131.5
Maltodextrin,
tapicoa
starch; 52.5
40.5
MCT oil;
soy oil,
canola oil;
35
700
(30.4)
1250
(32)
500
(25)
250
(20.1)
500
2000
Lactose-free
Reabilan HN Oral Solution
[U.S.]
1.33
(5.6)
490
58.2
Whey
peptides,
casein
peptides; 17.5
125:1
158
Maltodextrin,
tapioca
starch; 47.5
54
MCT oil,
soy oil,
canola oil;
35
1000
(43.5)
1662
(42.4)
665
(33.3)
332
(26.5)
665
1500
Lactose-free
SandoSource Peptide Oral Solution
[U.S./Canada]
1
(4.2)
500
50
Hydrolyzed
casein
caseinates; 20
100:1
160
Hydrolyzed
cornstarch;
65
17
MCT ,
soybean oil;
15
1100
(48)
1490
(38)
570
(28.5)
230
(18.7)
570
1750
Lactose-free
Tolerex Oral Solution
[U.S./Canada]
1
(4.2)
550
21
Amino
acids; 8
282:1
230
Glucose,
oligo-
saccharides;
91
1.5
Safflower
oil; 1
470
(20)
1200
(31)
560
(28)
220
(18)
560
3160
Lactose-free
Travasorb HN for Oral Solution
[U.S.]
1
(4.2)
560
45
Hydrolyzed
lactalbumin;
18
126:1
175
Glucose,
oligo-
saccharides;
70
13.5
MCT oil,
sunflower
oil; 12
920
(40)
1170
(30)
500
(25)
200
(16.5)
500
2000
Lactose-free
Travasorb STD for Oral Solution
[U.S.]
1
(4.2)
560
30
Hydrolyzed
lactalbumin;
12
171:1
190
Glucose,
oligo-
saccharides;
76
13.5
MCT oil,
sunflower
oil; 12
920
(40.1)
1170
(30)
500
(25)
200
(16.5)
500
2000
Lactose-free
Vital High Nitrogen Oral Solution
[U.S./Canada]
1
(4.2)
500
41.7
Partially
hydrolyzed
whey, meat
and soy
protein,
free amino
acids; 16.7
125:1
185
Hydrolyzed
cornstarch,
sucrose; 73.9
10.8
Safflower
oil,
MCT oil;
9.4
566
(24.6)
1400
(35.8)
667
(33.3)
267
(22.3)
667
1500
 
Vivonex Pediatric Oral Solution
[U.S./Canada]
0.8
(3.3)
360
24
Amino
acids; 12
200:1
130
Maltodextrin,
modified
starch; 63
24
MCT ,
soybean oil;
25
400
(17)
1200
(31)
970
(48.5)
200
(16.4)
800
1000
Lactose-free
Vivonex Plus Oral Solution
[U.S./Canada]
1
(4.2)
650
45
Amino
acids; 18
115:1
190
Maltodextrin,
modified
starch; 76
6.7
Soybean
oil; 6
610
(27)
1100
(28)
560
(28)
220
(17.6)
560
1800
Lactose-free
Vivonex T.E.N. Oral Solution
[U.S./Canada]
1
(4.2)
630
38
Amino
acids; 15
149:1
210
Maltodextrin;
82
2.8
Safflower
oil; 3
460
(20)
780
(20)
500
(25)
200
(16)
500
2000
Lactose-free
 Medium-chain triglyceride

Table 7. Polymeric Formulas


Note: Some products may be given either orally or by feeding tube; others are designed to be given by feeding tube only.



Brand name
[availability]
KCal
(kJoules)
per mL
mOsm
per kg
water
Protein

Carbohydrates

Fat

Na +
mg
(mEq)
per L
K +
mg
(mEq)
per L
Ca ++
mg
(mEq)
per L
Mg ++
mg
(mEq)
per L
Phos
mg
per L
mL
to
supply
100%
RDI for
vitamins
Comments
Grams
per
1000
mL
 
Source;
% KCal
 
Nonprotein
KCal
per gm
of
Nitrogen
 
Grams
per
1000
mL
 
Source;
% KCal
 
Grams
per
1000
mL
 
Source;
%KCal
 
Attain Oral Solution
[U.S.]
1
(4.2)
300
40
Sodium
and calcium
caseinates; 16
134:1
135
Maltodextrin;
54
35
MCT oil,
corn oil; 30
805
(35)
1600
(41)
960
(48)
320
(25.6)
800
1250
Lactose-free
CitriSource Oral Solution
[U.S.]
0.76
(3.2)
700
37
Whey
protein
concentrate;
20
105:1
150
Sugar,
hydrolyzed
corn
starch; 80
0
0
230
(10)
63
(1.6)
570
(28)
210
(17)
680
1890
Not appropriate
for total feeding
Oral Solution
[Canada]
0.77
(3.2)
700
37
Whey
protein
concentrate;
20
107:1
150
Sugar,
corn syrup
solids; 79
2
soybean oil; 2
230
(10)
63
(1.6)
570
(28)
210
(17)
680
1890
Lactose-free, not
appropriate for
total feeding
Citrotein for Oral Solution
[U.S.]
0.67
(2.8)
  41
Egg white
solids; 25
76:1
120
Maltodextrin,
sugar; 73
1.6
Partially
hydroge-
nated
soybean oil; 2
670
(29)
550
(14)
1100
(55)
420
(34)
1100
1100
Lactose-free,
cholesterol-free
grape
510
orange
490
punch
480
Comply Oral Solution
[U.S.]
1.5
(6.3)
410
60
Sodium and
calcium
caseinates; 16
131:1
180
Hydrolyzed
cornstarch; 48
60
Corn oil; 36
1100
(48)
1850
(47)
1000
(50)
400
(32)
1000
1000
Lactose-free
Deliver 2.0 Oral Solution
[U.S.]
2
(8.4)
640
75
Sodium and
calcium
caseinates; 15
145:1
200
Corn syrup; 40
102
MCT oil,
soy oil; 45
800
(35)
1690
(43)
1010
(51)
400
(33)
1010
1000
Lactose-free
Enercal Oral Solution
[Canada]
1
(4.2)
370
38
Whey protein
concentrate,
soy protein
isolate; 15
144:1
144
Maltodextrin,
sucrose; 55
34
Soybean oil;
oleic oil, 30
500
(22)
1250
(32)
670
270
670
  Lactose-free
Ensure Oral Solution
[U.S.]
1.06
(4.4)
470
37.2
Sodium and
calcium
caseinates,
soy protein
isolate; 14
153:1
145
Corn syrup,
sucrose; 54.5
37.2
Corn
oil; 31.5
846
(36.8)
1564
(40)
530
(26.5)
212
(17.7)
530
1887
Lactose-free
Oral Solution
[Canada]
1.06
(4.4)
470
37.2
Sodium and
calcium
caseinates,
soy protein
isolate; 14
153:1
145
Maltodextrin,
corn syrup,
sucrose; 54.5
37.2
Corn
oil; 31.5
700
(30.4)
1200
(30.7)
500
(25)
200
(16)
500
  Lactose-free
Ensure High Protein Oral Solution
[U.S./Canada]
0.95
(4)
610
50.7
Calcium and
sodium
caseinates,
soy protein
isolate; 21.3
92:1
130
Sucrose,
maltodextrin;
54.7
25.4
High-oleic
safflower
oil, canola
oil, soy
oil; 24
1224
(53.2)
2110
(53.9)
1055
(52.7)
422
(35.2)
1055
948
Lactose-free
Ensure HN Oral Solution
[U.S.]
1.06
(4.4)
470
44.4
Sodium and
calcium
caseinates,
soy protein
isolate; 16.7
125:1
141.2
Corn syrup,
maltodextrin,
sucrose; 53.2
35.5
Corn
oil; 30.1
802
(34.9)
1564
(40)
758
(37.9)
303
(25.3)
758
1321
Lactose-free
Ensure Plus Oral Solution
[U.S./Canada]
1.5
(6.3)
690
54.9
Sodium and
calcium
caseinates,
soy protein
isolate; 14.7
146.1
200
Corn syrup,
maltodextrin
sucrose; 53.3
53.3
Corn oil; 32
1050
(45.7)
1940
(49.6)
705
(35.2)
282
(23.5)
705
1420
Lactose-free
Ensure Plus HN Oral Solution
[U.S.]
1.5
(6.3)
650
62.6
Sodium and
calcium
caseinates,
soy protein
isolate; 16.7
125:1
199.9
Maltodextrin,
sucrose; 53.3
50
Corn oil; 30
1180
(51.3)
1820
(46.5)
1056
(52.8)
423
(35.3)
1056
947
Lactose-free
Entrition Half-Strength Oral Solution
[U.S.]
0.5
(2.1)
120
17.5
Sodium and
calcium
caseinates; 14
153:1
68
Maltodextrin;
54.5
17.5
Corn
oil; 31.5
350
(15.2)
600
(15.4)
250
(12.5)
100
(8)
250
N/A
Lactose-free
Entrition HN Oral Solution
[U.S.]
1
(4.2)
300
44
Sodium and
calcium
caseinates,
soy; 17.6
117:1
114
Maltodextrin;
45.6
41
Corn
oil; 36.8
845
(36.7)
1579
(40.5)
770
(38.5)
308
(24.6)
770
1300
Lactose-free
Introlan Oral Solution
[U.S.]
.5
(2.2)
150
22.5
Sodium and
calcium
caseinates; 17
125:1
70
Maltodextrin;
53
18
MCT oil,
corn oil; 30
344.4
(15)
589.3
(15)
500
(25)
200
(16)
500
2000
Lactose-free
Introlite Oral Solution
[U.S.]
0.53
(2.2)
220
22.2
Sodium and
calcium
caseinates,
soy protein
isolate; 16.7
125:1
70.5
Hydrolyzed
cornstarch;
53.3
18.4
MCT oil,
corn oil,
soy oil; 30
930
(40.5)
1570
(40.2)
758
(37.9)
304
(25.3)
758
1321
Lactose-free
Isocal Oral Solution
[U.S.]
1.06
(4.4)
270
34
Sodium and
calcium
caseinates,
soy protein
isolate; 13
167:1
135
Maltodextrin;
50
44
MCT oil,
soy oil; 37
530
(23)
1310
(34)
630
(32)
210
(17.4)
530
1890
Lactose-free,
fiber-free
Isocal HN Oral Solution
[U.S.]
1.06
(4.4)
270
44
Sodium and
calcium
caseinates,
soy protein
isolate; 17
125:1
124
Maltodextrin;
46
45
MCT oil,
soy oil; 37
930
(40)
1610
(41)
850
(43)
340
(28)
850
1180
Lactose-free
Isolan Oral Solution
[U.S.]
1.06
(4.4)
300
40
Caseinates;
16
141:1
144
Maltodextrin;
54
36
MCT oil,
corn
oil; 28
897
(39)
1200
(52)
800
(40)
320
(25.6)
800
1250
Lactose-free
Isosource Oral Solution
[U.S./Canada]
1.2
(5)
360
43
Sodium and
calcium
caseinates,
soy protein
isolate; 14
148:1
170
Hydrolyzed
cornstarch; 56
41
MCT oil,
canola
oil; 30
1200
(52)
1700
(43)
670
(33)
270
(22)
670
1500
Lactose-free,
fiber-free
Isosource HN Oral Solution
[U.S./Canada]
1.2
(5)
330
53
Sodium and
calcium
caseinates,
soy protein
isolate; 18
116:1
160
Hydrolyzed
cornstarch; 52
41
MCT oil,
canola
oil; 30
1100
(48)
1700
(43)
670
(33)
270
(22)
670
1500
Lactose-free,
fiber-free
Isotein HN for Oral Solution
[U.S.]
1.2
(5)
300
68
Delactosed
lactalbumin;
23
86:1
160
Hydrolyzed
cornstarch,
mono-
saccharides;
52
34
MCT oil,
partially
hydroge-
nated soy-
bean oil; 25
620
(27)
1100
(28)
560
(28)
230
(19)
560
1770
Lactose-free
Magnacal Oral Solution
[U.S.]
2
(8.4)
590
70
Sodium and
calcium
caseinates; 14
154:1
250
Maltodextrin,
sucrose; 50
80
Partially
hydroge-
nated
soy oil; 36
1000
(43.5)
1250
(32)
1000
(50)
400
(32)
1000
1000
Lactose-free
NuBasics Oral Solution
[U.S.]
1
(4.2)
500
35
Calcium and
potassium
caseinates; 14
153:1
132.4
Corn syrup
solids,
sucrose; 53
36.8
Canola oil,
corn oil; 33
876
(38)
1248
(32)
500
(25)
200
(16)
500
2000
Lactose-free
NuBasics Plus Oral Solution
[U.S.]
1.5
(6.3)
620
52.4
Calcium and
potassium
caseinates; 14
153:1
176.4
Corn syrup
solids,
sucrose; 47
64.8
Canola oil,
corn oil; 39
1168
(51)
1868
(48)
748
(37.4)
300
(24)
748
1333
Lactose-free
NuBasics VHP Oral Solution
[U.S.]
1
(4.2)
460
62.4
Calcium and
potassium
caseinates; 25
75:1
112.8
Corn syrup
solids,
sucrose; 45
33.2
Canola oil,
corn oil; 30
876
(38)
1248
(32)
580
(25)
200
(16)
580
2000
Lactose-free
Nutren 1.0 Oral Solution
[U.S.]
1
(4.2)
300
40
Calcium and
potassium
caseinates; 16
131:1
127
Maltodextrin,
corn syrup
solids; 51
38
MCT oil,
canola oil,
corn oil; 33
876
(38)
1248
(32)
668
(33.4)
268
(21.4)
668
1500
Lactose-free
Nutren 1.5 Oral Solution
[U.S.]
1.5
(6.3)
430
60
Calcium and
potassium
caseinates; 16
131:1
169.2
Maltodextrin,
sucrose; 45
67.6
MCT oil,
canola oil,
corn oil; 39
1170
(50.9)
1872
(48)
1000
(50)
400
(32)
1000
1000
Lactose-free
Nutren 2.0 Oral Solution
[U.S.]
2
(8.4)
720
80
Calcium and
potassium
caseinates; 16
131:1
196
Corn syrup
solids,
maltodextrin;
sucrose; 39
106
MCT oil,
canola oil,
corn oil; 45
1300
(56.5)
1920
(49.2)
1340
(67)
536
(42.9)
1340
750
Lactose-free
Nutrilan Oral Solution
[U.S.]
1.06
(4.4)
520
38
Sodium and
calcium
caseinates; 14
149:1
143
Maltodextrin,
sugar; 54
37
MCT oil,
corn oil; 31
690
(30)
1326
(34)
630
(31.5)
253
(202)
630
1585
Lactose-free
Osmolite Oral Solution
[U.S.]
1.06
(4.4)
300
37.1
Sodium and
calcium
caseinates,
soy protein
isolate; 14
153:1
151.1
Maltodextrin;
57
34.7
High-oleic
safflower
oil, canola
oil,
MCT oil;
29
640
(27.8)
1020
(26.1)
530
(26.5)
212
(17.7)
530
1887
Lactose-free
Osmolite HN Oral Solution
[U.S./Canada]
1.06
(4.4)
300
44.3
Sodium and
calcium
caseinates,
soy protein
isolate; 16.7
125:1
143.9
Maltodextrin;
54.3
34.7
High-oleic
safflower oil,
canola oil,
MCT oil;
29
930
(40.5)
1570
(40.2)
758
(37.9)
304
(25.3)
758
1321
Lactose-free
Pediasure Oral Solution
[U.S./Canada]
1
(4.2)
<310
30
sodium
caseinate,
whey protein
concentrate;
12
185:1
109.7
Hydrolyzed
cornstarch,
sucrose; 43.9
49.7
High-oleic
safflower
oil, soy
oil, MCT
oil; 44.1
380
(16.5)
1310
(33.5)
970
(48.5)
200
(16.7)
800
1000
Trace lactose
Pre-Attain Oral Solution
[U.S.]
.5
(2.1)
150
20
Sodium
caseinate; 16
131:1
60
Maltodextrin;
48
20
Corn oil; 36
340
(15)
575
(15)
312.5
(15.6)
250
(20)
312.5
2000
Lactose-free
Promote Oral Solution
[U.S.]
1
(4.2)
340
62.5
Sodium and
calcium
caseinates,
soy protein
isolate; 25
75:1
130
Hydrolyzed
cornstarch,
sucrose; 52
26
High-oleic
safflower
oil, canola
oil; MCT
oil; 23
1000
(43.5)
1980
(50.6)
1200
(60)
400
(33.3)
1200
1000
Lactose-free
Replete Oral Solution
[U.S.]
1
(4.2)
300
62.5
Calcium and
potassium
caseinates; 25
75:1
113
Maltodextrin,
sucrose; 45
34
Canola oil,
MCT oil;
30
876
(38)
1500
(38)
1000
(50)
400
(32)
1000
1000
Lactose-free
Resource Oral Solution
[U.S./Canada]
1.06
(4.4)
430
37
Sodium and
calcium
caseinates,
soy protein
isolate; 14
154:1
140
Hydrolyzed
cornstarch,
sugar; 54
37
Corn oil; 32
890
(39)
1600
(41)
530
(27)
210
(17)
530
1890
Lactose-free
Resource Plus Oral Solution
[U.S./Canada]
1.5
(6.3)
600
55
Sodium and
calcium
caseinates,
soy protein
isolate; 15
146:1
200
Hydrolyzed
cornstarch,
sugar; 53
53
Corn oil; 32
1300
(57)
2100
(54)
700
(35)
310
(26)
700
1400
Lactose-free
Sustacal Oral Solution
(All flavors but
chocolate)
[U.S.]
1
(4.2)
650
61
Sodium and
calcium
caseinates, soy
protein
isolate; 24
78:1
140
Corn syrup,
sugar; 55
23
Partially
hydroge-
nated soy
oil; 21
930
(40)
2100
(54)
1010
(50)
380
(31)
930
1060
Lactose-free,
fiber-free
Oral Solution
(Chocolate)
[U.S.]
1
(4.2)
690
61
Sodium and
calcium
caseinates, soy
protein
isolate; 24
78:1
140
Corn syrup,
sugar; 55
23
Partially
hydroge-
nated soy
oil; 21
930
(40)
2100
(54)
1010
(50)
380
(31)
930
1060
Lactose-free,
fiber-free
Sustacal Basic Oral Solution
(Chocolate)
[U.S.]
1.06
(4.4)
470
37
Casein, soy
protein
isolate; 14
153:1
148
Corn syrup,
sucrose; 56
35
Soy oil; 30
850
(37)
1610
(41)
530
(27)
210
(17.4)
530
1890
Lactose-free
Oral Solution
(Vanilla)
[U.S./Canada]
1.06
(4.4)
500
37
Casein, soy
protein
isolate; 14
153:1
148
Corn syrup,
sucrose; 56
35
Soy oil; 30
850
(37)/
U.S.
740
(32)/
Canada
1610
(41)/
U.S.
1240
(32)/
Canada
530
(27)
210
(17.4)
530
1890
Lactose-free
Sustacal Plus Oral Solution
(All flavors but
chocolate)
[U.S.]
1.52
(6.4)
670
61
Sodium and
calcium
caseinates; 16
134:1
190
Corn syrup
solids,
sugar; 50
58
Corn oil; 34
850
(37)
1480
(38)
850
(43)
340
(28)
850
1180
Lactose-free,
fiber-free
Oral Solution
(Chocolate)
[U.S.]
1.52
(6.4)
630
61
Sodium and
calcium
caseinates; 16
134:1
190
Corn syrup
solids,
sugar; 50
58
Corn oil; 34
850
(37)
1480
(38)
850
(43)
340
(28)
850
1180
Lactose-free,
fiber-free
TwoCal HN Oral Solution
[U.S.]
2
(8.4)
690
83.7
Sodium and
calcium
caseinates;
16.7
125:1
217.3
Maltodextrin,
sucrose; 43.2
90.9
Corn oil,
MCT oil;
40.1
1310
(57)
2456
(62.8)
1052
(52.6)
421
(35.1)
1052
947
Lactose-free
Ultralan Oral Solution
[U.S.]
1.5
(6.3)
540
60
Sodium and
calcium
caseinates,
soy protein
isolate; 16
131:1
202
Maltodextrin;
54
50
MCT oil,
corn oil; 50
1173
(51)
1911
(49)
1000
(50)
400
(32)
1000
1000
Lactose-free
 Medium-chain triglyceride



Revised: 08/03/1995



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