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Projekt3_Layout 1 08.05.17 09:39 Seite 1



B. Braun Melsungen AG · 34209 Melsungen, Germany

Nutriflex® plus Solution for Infusion
Amino acids / Glucose / Electrolytes

Read all of this leaflet carefully before you start using this medicine because it contains important information for you.
• Keep this leaflet. You may need to read it again.
• If you have any further questions, please ask your healthcare professional.
• This medicine has been prescribed for you only. Do not pass it on to others. It may harm them, even if their symptoms are the same as yours.
• If you get any side effects, talk to your healthcare professional. This includes any possible side effects not listed in this leaflet. See section 4.

What is in this leaflet:

If you receive more Nutriflex plus than you should

1. What Nutriflex plus is and what it is used for
2. What you need to know before you use Nutriflex plus
3. How to use Nutriflex plus
4. Possible side effects
5. How to store Nutriflex plus
6. Contents of the pack and other information

If you think that you have been given an overdose, please talk to a doctor
or pharmacist immediately.

If you are given too much of this medicine this may lead to symptoms
• swelling caused by excess body fluid
• changes in your blood, which can be measured in a blood test
• sickness, vomiting, shivering
1. What Nutriflex plus is and what it is used for
• high blood sugar level and glucose in urine
The product contains substances (nutrients) called amino acids, salts • dehydration
(electrolytes) and glucose which are essential for the body to grow or to • unconsciousness caused by extremely high blood glucose levels.
recover and calories in the form of carbohydrates.
If you have any further questions on the use of this product, ask your docYou are given this product by a vein drip (infusion) because you are unable tor or pharmacist.
to eat adequately or cannot be fed via a tube. It is called a nutritional supplement.

4. Possible side effects

2. What you need to know before you use Nutriflex plus Like all medicines, Nutriflex plus can cause side effects, although not

everybody gets them.
Side effects are mainly caused by overdose or too rapid infusion. They will
• if you are allergic (hypersensitive) to active substances or any of the usually disappear when the infusion is stopped.
other ingredients of Nutriflex plus
• if you have a severe inborn disorder of amino acid metabolism, where If you experience any of the following side effects, contact
your doctor or hospital immediately
you need a special protein diet
• if you have any kind of poorly controlled metabolic disorder, for exam- Not known (frequency cannot be estimated from the available
ple severe diabetes mellitus, accumulation of sour (acidic) substances in data)
your blood (acidosis) or inadequate supply of oxygen to cells (hypoxia) • Reactions of intolerance (re-feeding syndrome) may occur if you are in
a state of severe underfeeding and too high doses are administered. The
• if you have excessively high blood sugar level that needs more than 6
symptoms of these intolerance reactions are drops of serum electrolyte
units of insulin per hour to be controlled
levels, sleepiness and damage to red blood cells.
• if you have abnormally high blood electrolyte levels
• Feeling sick (nausea) and vomiting.
• if you have bleeding within the skull or the spinal cord.
Nutriflex plus should not be given to babies and infants that are under • Excessive amounts of urine: If the solution is infused too rapidly, you
may pass excessive amounts of urine.
two years old.
Abnormal results of liver function tests and disturbance of bile flux
As with other medicines of this type Nutriflex plus should not be given if (cholestasis) have been reported in some patients receiving intravenous
you have:
(infusion through a vein) nutrition.
• severe liver disease
If these rare side effects occur your treatment should be stopped, or if the
• severe kidney disease without treatment by artificial kidney
doctor decides, it may be continued but at a lower dose level.
• life threatening blood circulation problems as can occur if you are in a
Not known (frequency cannot be estimated from the available
state of collapse or shock
• heart problems (decompensated cardiac insufficiency).
• If your treatment is stoppedabruptly, your blood sugar level may drop
Warnings and precautions
below normal levels with symptoms such as e.g. feeling of extreme
Talk to your healthcare professional before using Nutriflex plus
hunger, dizziness, blurry vision, trembling or shakiness, headache and
• if you have impaired heart or kidney function
sweating, especially in children under 3 years, patients having diabetes
• if you have disturbances in fluid, electrolyte or acid-base balance, for
or having other problems with glucose tolerance.
example low body water and salt content (hypotonic dehydration), low
If any of the side effects gets serious, or if you notice any side effects not
sodium or potassium level in your blood
listed in this leaflet, please tell your doctor or pharmacist.
• if you have high blood glucose levels.

Reporting of side effects

Nutriflex plus can interact with some other medicines. Please tell your
doctor if you are taking any of the following:
• medicines for treatment of inflammation (corticosteroids)
• hormone preparations affecting your fluid balance (‘ACTH’)
• medicines that promote urine flow such as triamterene or amiloride
• medicines for treatment of high-blood pressure (ACE-inhibitors)
• medicines used in transplant medicine such as cyclosporine and

What Nutriflex plus contains

If you get any side effects, talk to your healthcare professional. This
includes any possible side effects not listed in this leaflet. You can also
report side effects directly via the Yellow Card Scheme at:

5. How to store Nutriflex plus

Keep this medicine out of the sight and reach of children.
Do not store above 25°C.
Keep bag in the outer carton in order to protect from light.
Do not use Nutriflex plus after the expiry date which is stated on the bag
printing and on the carton label. The expiry date refers to the last day of
that month.
Other medicines and Nutriflex plus
Only use Nutriflex plus if the solution is clear and the bag undamaged.
Please tell your doctor or pharmacist if you are taking or have recently After infusion, any remaining solution should never be stored for later use.
taken any other medicines, including medicines obtained without a prescription.
6. Contents of the pack and other information

Pregnancy, breast-feeding and fertility
If you are pregnant or breast-feeding, think you may be pregnant or are
planning to have a baby, ask your doctor for advice before taking this
If you are pregnant, you will receive this medicine only if the doctor considers it absolutely necessary for your recovery.
Breast-feeding is not recommended during treatment with this medicine.

Driving and using machines
This medicine is normally given to immobile patients, e.g. in a hospital or
clinic which would exclude driving and using machines. However, the
medicine itself has no effect on the ability to drive or use machines.

3. How to use Nutriflex plus
Your doctor will decide how much of this medicine you need and for how
long you will require treatment with this medicine.

The daily dose for this age group is up to 40 ml of solution for infusion
per kg body weight ( BW) per day. This solution will be administered to you
at a maximum rate of 1.7 ml per kg BW per hour.

Patients with special conditions
If you have any condition where you have an abnormally high blood sugar
level, e.g. after injury, if you have oxygen deficiency or otherwise impaired
organ function, your glucose dose will be reduced accordingly.

Patients with kidney or liver impairment
The doses will be adjusted according to your individual requirements if you
have a liver or kidney disease.

Route of administration
Nutriflex plus will be administered to you by infusion into a large central

- The active substances are amino acids, glucose and electrolytes.
Each bag contains after mixing:
1000 ml
2000 ml
2.82 g
5.64 g
3.76 g
7.52 g
Lysine hydrochloride
3.41 g
6.82 g
equivalent to lysine
2.73 g
5.46 g
2.35 g
4.70 g
4.21 g
8.42 g
2.18 g
4.36 g
0.68 g
1.36 g
3.12 g
6.24 g
Arginine monoglutamate
5.98 g
11.96 g
equivalent to arginine
3.24 g
6.48 g
equivalent to glutamic acid
2.74 g
5.48 g
Histidine hydrochloride monohydrate
2.03 g
4.06 g
equivalent to histidine
1.50 g
3.00 g
5.82 g
11.64 g
Aspartic acid
1.80 g
3.60 g
Glutamic acid
1.47 g
2.94 g
1.98 g
3.96 g
4.08 g
8.16 g
3.60 g
7.20 g
Magnesium acetate tetrahydrate
1.23 g
2.46 g
Sodium acetate trihydrate
1.56 g
3.12 g
Sodium dihydrogen phosphate dihydrate 3.12 g
6.24 g
Potassium hydroxide
1.40 g
2.80 g
Sodium hydroxide
0.23 g
0.46 g
Glucose monohydrate
165.0 g
330.0 g
equivalent to glucose
150.0 g
300.0 g
Calcium chloride dihydrate
0.53 g
1.06 g
- The other ingredients are citric acid monohydrate and water for injections.
1000 ml
2000 ml
37.2 mmol
74.4 mmol
25.0 mmol
50.0 mmol
3.6 mmol
7.2 mmol
5.7 mmol
11.4 mmol
35.5 mmol
71.0 mmol
20.0 mmol
40.0 mmol
22.9 mmol
45.8 mmol


210x594 mm
Lätus: 623
Font size 9



Special care will be taken to adjust and control your daily dose if you have
impairment of kidneys, liver, adrenal glands, heart or lungs or if you have
altered amino acid metabolism.
If you are in a state of severe underfeeding, special care will be taken to
build up your intravenous feeding gradually.
Nutriflex plus contains glucose (a sugar) so this may affect your blood
sugar level. Blood samples may have to be taken to check this.
Moreover other tests may be performed in order to ensure that your fluid
levels, electrolytes, and acid-base balance are correct. For longer administration times, some tests on your blood as well as kidney and liver function will be done as well.
Special precautions will be taken when you receive this medicine to
ensure that the product remains sterile.


Do not use Nutriflex plus

Projekt3_Layout 1 08.05.17 09:39 Seite 2



Amino acid content
Nitrogen content
Carbohydrate content
Non-protein energy [kJ (kcal)]
Total energy [kJ (kcal)]

1000 ml
48 g
6.8 g
150 g
1000 ml
2510 (600)
3310 (790)
1400 mOsm/l
4.8 – 6.0

2000 ml
96 g
13.6 g
300 g
2000 ml
5025 (1200)
6615 (1580)
1400 mOsm/l
4.8 – 6.0

Marketing Authorisation Holder and Manufacturer
B. Braun Melsungen AG
Carl-Braun-Straße 1
34212 Melsungen, Germany
Tel.: +49-5661-71-0
Fax: +49-5661-71-4567

Postal address
34209 Melsungen, Germany

This leaflet was last revised in April 2017

What Nutriflex plus looks like and contents of the pack
Nutriflex plus is presented in an infusion bag with two compartments. The
lower compartment contains glucose while the upper compartment contains the amino acid solution. The glucose and the amino acid solution are
clear, colourless or faintly straw-coloured.
The product is supplied in two-chamber plastic bags containing:
• 1000 ml (400 ml of amino acids solution + 600 ml of glucose solution)
• 2000 ml (800 ml of amino acids solution + 1200 ml of glucose solution)
Pack sizes: 5 × 1000 ml, 5 × 2000 ml
Not all pack sizes may be marketed.

THE FOLLOWING INFORMATION IS INTENDED FOR MEDICAL An additive port is provided for admixing of supplements to Nutriflex plus.
When admixing other solutions or fat emulsions to Nutriflex plus, aseptic
The solution should always be brought to room temperature prior to infu- precautions must be strictly observed. Fat emulsions can be easily
admixed by means of a special transfer set.
Preparation of the mixed solution:
Immediately before use the internal peel seam between the two compartments must be opened allowing the respective contents to be aseptically


Remove the bag from its protective bag and proceed as follows:
• Open out the bag and lay on a solid surface
• Open the peel seam by using pressure with both hands
• Briefly mix the contents of the bag together

Storage after mixing of the contents
Ideally after mixing the two solutions, Nutriflex plus should be administered immediately but in special circumstances it can be stored for up to
7 days at room temperature and up to 14 days if stored in a refrigerator
(including administration time). Partially used containers must not be
stored for later use.

210x594 mm
Lätus: 623
Font size 9

B. Braun Melsungen AG
34209 Melsungen




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Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.