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:
Usual Pediatric Dose for:
Additional dosage information:
Usual Adult Dose for Dietary Supplement
Usual dosage: 1 to 2 grams/kg/day, IV
- Initial infusion rate should be 0.5 mL/min for the first 15 to 30 minutes.
- May gradually increase rate after 30 minutes if tolerated.
- Maximum rate should not exceed 0.5 mL/kg/hour.
- Duration of infusion is from 12 to 24 hours, depending on clinical situation.
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.
Usual Pediatric Dose for Dietary Supplement
Preterm infants and term infants under 1 year:
Initial dose: 1 to 2 grams/kg/day
- Initial infusion rate is 0.05 mL/min for the first 10 to 15 minutes
- Gradually increase to required rate after 15 minutes
- Maximum infusion rate is 0.75 mL/kg/hour
- See precautions
1 to 10 years old:
Initial dose: 1 to 2 grams/kg/day
- Initial infusion rate is 0.05 mL/min for the first 10 to 15 minutes
- Gradually increase to required rate after 15 minutes
- Maximum infusion rate is 0.75 mL/kg/hour
11 to 17 years:
Initial dose: 1 gram/kg/day
- Initial infusion rate is 0.05 mL/min for the first 10 to 15 minutes
- Gradually increase to required rate after 15 minutes
- Maximum infusion rate is 0.5 mL/kg/hour
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.
Renal Dose Adjustments
Data not available
- Aluminum toxicity may develop in patients with impaired kidney function.
Liver Dose Adjustments
Use with caution.
- Monitor liver function closely, as hepatobiliary disorders are known to develop in some patients.
Precautions
US BOXED WARNING(S):
- Deaths have been reported after infusion of intravenous fat emulsion in preterm infants; autopsy findings included intravascular fat accumulation in the lungs.
- Premature and small for gestational age infants have poor clearance of intravenous fat emulsion and increased free fatty acid plasma levels following fat emulsion infusion.
- Treatment of premature or low birth weight infants with this product must be based on a careful risk-benefit assessment.
- Strict adherence to the recommended total daily dose is mandatory; infusion rate should be as slow as possible and should in any case exceed 1 g fat/kg in 4 hours.
- Seriously consider administering less than the maximum recommended dose in premature or small for gestational age infants to reduce the risk of intravenous fat overload.
- Carefully monitor (e.g. serum triglycerides and/or plasma free fatty acid levels) infants ability to eliminate the infused fate from the circulation.
- Lipemia must clear between daily infusions.
Consult WARNINGS section for additional precautions.
Dialysis
Data not available
Other Comments
Administration advice:
- 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 infusate.
- If osmolarity is 900 mOsm/L or higher it must be infused through a central vein.
- Use a dedicated line for parenteral nutrition.
- May be infused concurrently into the same vein as dextrose-amino acid solutions by a Y-connector located near the infusion site; control flow rates of each solution separately using an infusion pump.
- Use a 1.2 micron in-line filter.
- Use a non-vented infusion set or close the vent on a vented set to prevent air embolism, do not connect flexible bags in a series, fully evacuate residual gas in the bag prior to administration, do not pressurize the bag to increase flow rate, and if using a pump, turn the pump off before the bag runs dry.
- Do not use administration sets that contain di-2-ethylhexyl phthalate (DEHP); administration sets with polyvinyl chloride (PVC) component have DEHP as a plasticizer.
- Take into account vitamin E content of this product when determining the need for additional supplementation.
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.
More about fat emulsion
- Check interactions
- Compare alternatives
- Side effects
- During pregnancy
- Drug class: intravenous nutritional products
Patient resources
- Fat emulsion advanced reading
- Fat emulsion and soybean oil (Advanced Reading)
- Fat emulsion, fish oil, and soybean oil (Advanced Reading)
- Fat Emulsion (Plant Based)
Other brands
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Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.