Fat Emulsion Dosage

Applies to the following strengths: 30%; 10%; 20%; with fish oil 10%; with fish, medium chain, olive, and soy oil 20%

Usual Adult Dose for Dietary Supplement

Usual dosage: 1 to 2 g/kg/day, IV

Initial infusion rate should be 0.1 g/min for the first 15 to 30 minutes.
May gradually increase rate after 30 minutes if tolerated.
Maximum rate should not exceed 0.1 g/kg/hour.
Duration of infusion is from 12 to 24 hours, depending on clinical situation.
Maximum dose: 2.5 grams/kg/day, also, the daily dose should not exceed a maximum of 60% of total energy requirements.

Comments:

Recommended dosage depends on age, energy expenditure, clinical status, body weight, tolerance, ability to metabolize, and consideration of additional energy given to the patient.
Take energy supplied by dextrose and amino acids, as well as enteral nutrition into account when determining dose.
Correct severe fluid and electrolyte disorders prior to administration.
The daily dose should not exceed 60% of total energy requirements.
Obtain a baseline serum triglyceride level; if triglycerides are elevated, initiate at a lower dosage and advance in smaller increments, monitoring triglyceride levels with each adjustment.

Use: Parenteral nutrition when oral or enteral nutrition is not possible, insufficient or contraindicated

Birth to 2 years old (including preterm and term infants):
Initial dose: 0.5 to 1 g/kg/day

Maximum dose: 3 g/kg/day

Duration of infusion: 20 to 24 hours for preterm and term neonates, and 12 to 24 hours for patients 1 month to 2 years

2 years to less than 12 years old:
Initial dose: 1 to 2 g/kg/day

Maximum dose: 3 g/kg/day

12 to 17 years old:
Initial dose: 1 to 2 g/kg/day
Maximum dose: 2.5 g/kg/day

Comments:

Recommended dosage depends on age, energy expenditure, clinical status, body weight, tolerance, ability to metabolize, and consideration of additional energy given to the patient.
The duration of infusion will vary depending on the clinical situation but infuse over a longer duration in neonates.
Do not exceed an infusion rate of 0.15 g/kg/h.
The administration flow rate is determined by dividing the volume of lipid by the duration of the infusion.

Use: Parenteral nutrition when oral or enteral nutrition is not possible, insufficient or contraindicated

Data not available

Use with caution.

Monitor liver function closely, as hepatobiliary disorders are known to develop in some patients.

CONTRAINDICATIONS:

Known hypersensitivity to fish, egg, soybean, peanut protein, or to any of the active or inactive ingredients- Severe disorders of lipid metabolism characterized by hypertriglyceridemia (serum triglyceride >1,000 mg/dL)

Consult WARNINGS section for additional precautions.

Data not available

Administration advice:

This product is for intravenous infusion only into a peripheral or central vein.
When given with dextrose and amino acids, the choice of central or peripheral administration should depend on the osmolarity of the final infusion:
If osmolarity is 900 mOsm/L or higher it must be infused through a central vein.
Less than 900 mOsm/L may be administered either through central or peripheral vein.
Use a dedicated line for parenteral nutrition.
Use a 1.2 micron in-line filter.

Storage requirements:

Once removed from the overpouch, store at 2C to 8C (36F to 46F) for no longer than 24 hours.

Reconstitution/preparation techniques:

Read the US FDA-approved patient labeling for further preparation and administration instructions.

Monitoring:

The lipids in this product may interfere with some blood tests (e.g. hemoglobin, lactate dehydrogenase, bilirubin, and oxygen saturation) if blood is sampled before lipids have cleared from the bloodstream.
Lipids are normally cleared 5 to 6 hours after the lipid infusion is stopped.
Monitor fluid status closely in patients with pulmonary edema or heart failure.
Routinely monitor serum triglycerides, fluid and electrolyte status, blood glucose, liver and kidney function, blood count including platelets, and coagulation parameters throughout treatment.
Monitoring for signs and symptoms of essential fatty acid deficiency (EFAD) is recommended.
Consult reference values of serum fatty acid level tests to determine adequacy of essential fatty acid status.
Increasing essential fatty acid intake (enterally or parenterally) is effective in treating EFAD.

Patient advice: