Selenium (as selenious acid)

Pronunciation

Pronunciation: se-LEE-nee-um
Class: Trace metal

Trade Names

Se-100
- Capsules, oral 100 mcg

Selenicaps-200
- Capsules, oral 200 mcg

Selenium
- Capsules, oral 100 mcg
- Capsules, oral 200 mcg
- Tablets, oral 50 mcg
- Tablets, oral 100 mcg
- Tablets, oral 125 mcg
- Tablets, oral 200 mcg
- Tablets, ER, oral 200 mcg
- Injection 40 mcg/mL

Selenimin-50
- Tablets, oral 50 mcg

Selenimin-200
- Tablets, oral 200 mcg

Versel (Canada)

Pharmacology

Part of glutathione peroxidase, which protects cell components from oxidative damage caused by peroxidases produced in cellular metabolism; spares vitamin E, which in turn boosts the cell's antioxidant defense system; plays a role in the structure of teeth.

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Pharmacokinetics

Absorption

Selenium is readily absorbed from the GI tract.

Distribution

Selenium is stored in the red blood cells, liver, spleen, heart, and nails.

Metabolism

Once selenium reaches the tissues, it is converted to its active form.

Elimination

Primarily excreted in the urine, and to a lesser extent in the feces.

Indications and Usage

Dietary supplement; use as a supplement to IV TPN solutions to prevent depletion of endogenous stores and subsequent deficiency symptoms.

Contraindications

Do not give injection undiluted by direct IV injection.

Dosage and Administration

Adults PO

100 to 200 mcg/day. The 50 mcg tablets may be taken as 1 tablet 4 times daily.

IV Metabolically stable patients

20 to 40 mcg/day added to the TPN.

Selenium deficiency states resulting from long-term TPN support

100 mcg/day for 31 days has reversed deficiency symptoms without toxicity.

Children

IV 3 mcg/kg/day.

General Advice

  • Tablets should be taken with meals.
  • Do not give injection undiluted by direct injection into a peripheral vein.
  • Add injection to TPN solution.

Storage/Stability

Store tablets and capsules in a tightly closed container in a cool, dry place. Store vials between 59° and 86°F.

Drug Interactions

None well documented.

Adverse Reactions

Unlikely to occur at recommended dosage level.

Precautions

Monitor

Frequently assess vascular access site for signs of inflammation or infection. Periodic monitoring of selenium plasma levels is suggested as a guideline for subsequent injections.


Pregnancy

Category C .

Lactation

Undetermined.

Hypersensitivity

Some oral products contain yeast. Avoid these products in patients who are allergic to yeast.

Renal Function

Supplement dosage may need to be adjusted, reduced, or omitted.

Aluminum toxicity

Parenteral products may contain aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk.

GI malfunction

Dose may need to be adjusted, reduced, or omitted.

Overdosage

Symptoms

Acute

Brick red–color gastric mucosa, cerebral edema, coma, death, edematous lungs, fulminating peripheral vascular collapse, garlicky or sour breath odor, GI effects (eg, vomiting), hemolysis, hypersalivation, internal vascular congestion, liver necrosis, muscle spasms, pulmonary edema, and restlessness.

Chronic

Dental defects, dermatitis, garlic odor of breath and sweat, GI disorders, hair loss, mental depression, metallic taste, nervousness, vomiting, weakened nails.

Patient Information

  • Advise patient to take oral supplements with food.
  • Advise patient, family, or caregiver that injection will be added to TPN solution.
  • Advise patient to report pain, redness, warmth, or swelling of TPN access site.

Copyright © 2009 Wolters Kluwer Health.

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