(mo LIB de num)
- Ammonium Molybdate
Excipient information presented when available (limited, particularly for generics); consult specific product labeling. [DSC] = Discontinued product
Generic: 30 mcg
Solution, Intravenous [preservative free]:
Generic: 25 mcg/mL (10 mL [DSC])
- Trace Element, Parenteral
Molybdenum, an essential trace element, is a cofactor for enzymes involved in the catabolism of sulfur amino acids, purines, and pyrimidines (IOM, 2011).
Primarily though kidneys; some through bile.
Use: Labeled Indications
Molybdenum supplement: Supplement to total parenteral nutrition (TPN) solutions
Undiluted administration into peripheral vein; copper-deficient patients without copper supplementation.
Note: Ammonium molybdate injection has been discontinued in the US for more than 1 year.
Molybdenum supplementation: IV: 20 to 120 mcg per day.
Molybdenum deficiency from prolonged TPN support: IV: 163 mcg per day for 21 days.
Refer to adult dosing.
Dosing: Renal Impairment
There are no dosage adjustments provided in the manufacturer’s labeling; dosage adjustment may be needed.
Dosing: Hepatic Impairment
There are no dosage adjustments provided in the manufacturer’s labeling; dosage adjustment may be needed in patients with bile duct obstruction.
IV: Administer only in admixtures. Do not administer undiluted into a peripheral vein.
Dietary reference intake (IOM, 2011):
0 to 6 months: Adequate intake: 2 mcg daily
7 to 12 months: Adequate intake: 3 mcg daily
1 to 3 years: RDA: 17 mcg daily
4 to 8 years: RDA: 22 mcg daily
9 to 13 years: RDA: 34 mcg daily
≥14 to 18 years: RDA: 43 mcg daily
>18 years: RDA: 45 mcg daily
Pregnancy and lactation: RDA: 50 mcg daily
Store at 20°C to 25°C (68°F to 77°F); excursions are permitted between 15°C and 30°C (59°F and 86°F).
There are no known significant interactions.
Postmarketing and/or case reports: Copper deficiency (high doses)
Concerns related to adverse effects:
• Copper deficiency: Molybdenum promotes tissue copper mobilization and increases urinary copper excretion; copper deficiency may occur. Frequently monitor the metabolism of copper.
• Hepatic impairment: Use with caution in patients with bile duct obstruction; dosage adjustment may be needed.
• Renal impairment: Use with caution in patients with renal impairment; dosage adjustment may be needed.
Dosage form specific issues:
• Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register, 2002). See manufacturer’s labeling.
• Appropriate use: Injection solution is a hypotonic solution; administer in admixtures only.
• Purine and sulfur metabolism: Molybdenum is a cofactor in purine and sulfur metabolism; assess purine and sulfur metabolic profiles (eg, serum uric acid or urine uric acid, sulfite, and/or xanthine) frequently.
Sulfur and purine metabolic profiles (eg, serum uric acid or urine uric acid, sulfite, and/or xanthine); serum copper levels and copper metabolism
Pregnancy Risk Factor
Animal reproduction studies have not been conducted. Molybdenum crosses the placenta. Molybdenum requirements are higher in pregnant women (IOM, 2011).
• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)
• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.
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