Lipofundin infusion MCT/LCT 20% B.Braun provides energy, fat (100ml)

Dosage form Bottle x 100ml
Specifications Medium-Chain Triglicerides, Soya Oil, Lecithin, Glycerol, Tocopherol

Ingredient

Composition information	Content
Medium-Chain Triglicerides	100g
Soya Oil	100g
Lecithin	12g
Glycerol	25g
Tocopherol	45mg

Uses

indications

Lipofundin MCT/LCT 20% are indicated in the following cases:

Provides energy because the lipid ingredient is available (MCT). For this purpose, Lipofundin MCT/LCT contains medium -chain triglycerides, long chain triglycerides (soybean oil), phosphatide (lecithin in eggs) and glycerol.

triglycerides have just been hydrolyzed, removed faster from circulation and oxidized completely more completely more triglycerides. Therefore, they are the preferred energy mechanics, especially when there are disorders of deserted and /or the use of long -chain triglycerides, for example, in the case of Lipase Lipoprotein deficiency, lack of lipase lipoprotein, carnitine deficiency and Carnitine dependent shipping system.

Only long -chain triglycerides provide unsaturated fatty acids, so they are mainly used in disease prevention and treat essential fatty acids and are only used as an energy source as a secondary function.

Besides the function of emulsion for triglycerides, phosphatide is the composition of the cell membrane and ensures their liquid state and biological function.

glycerol is added with the purpose of providing emulsion is the blood of the blood, which is the physiological intermediate in the process of metabolism of glucose and lipid: metabolized to bring energy or be used to synthesize glucose, glycogen and triglycerides.

Pharmacological studies on safety have not disclosed any specific effects compared to the above nutritional effects, like when the special substrates are used by oral.

pharmacokinetics

absorption:

Because the use of veins, the bioavailability of the components of Lipofundin MCT/LCT is 100%.

Distribution:

Dosage, injection speed, metabolism and specific elements of each patient (hunger level) are the most relevant factors to determine maximum triglyceride concentration. When used according to the instructions and follow the principle of dosage, triglyceride concentration usually does not exceed 4.6 mmol/l.

Metabolism:

After infusion, triglycerides are hydrolyzed into glycerol and fatty acids. Both are included in physiological paths to produce energy, synthesize biological activity molecules, road birth and re -synthesize lipids.

Era:

The semi -disintegration cycle in the plasma of Lipofundin MCT/LCT is about 9 minutes. Both triglycerides soybean oil and chain triglycerides have just been completely converted into CO2 and H2O. Only small amounts of lipids in the process of removing cells from the skin and other epithelial membranes. Kidney excretion almost does not occur.

Before taking Lipofundin infusion MCT/LCT 20% B.Braun provides energy, fat (100ml)

How to use

Intravenous infusion.

Shake gently before use.

Lipid emulsion is suitable for use in peripheral veins and can also be used separately through peripheral veins as part of the whole nourishment through the vein.

Must put the Y -connector or the connector as close to the patient as possible, if the lipid emulsion is used simultaneously with the amino and carbohydrate acid solutions.

Time to use Lipofundin® MCT/LCT20% usually 1-2 weeks. If the venous nurturing mode with lipid emulsion is added, it is possible for using Lipofundin® MCT/LCT 20% for a longer time as long as it has appropriate monitoring.

Dosage

is only given the maximum daily dose after increasing step by step with careful monitoring of the ability to tolerate transmission.

The use of lipids in veins depends on the severity of the disease available, the form of the gestational and the age of postpartum and the specific functions of the body.

Depending on the energy requirements, the following daily doses are recommended:

Adults

Normal dose is 0.7 to 1.5 g lipid/kg body weight (tt) per day.

Do not exceed the maximum dose of 2.0 g lipid/kg TT/day, for example when there is a high requirement of energy or when increased fat use (such as cancer patients).

For long -term venous nurturing treatment (> 6 months) and in patients with short bowel syndrome, lipid transmission in veins must not exceed 1.0 g/kg TT/day.

For patients weighing 70 kg, daily dose is 2.0 g/kg TT/day corresponding to the maximum daily dose of 700 ml of mCT/LCT 20%lipofundin.

Children

Pediatric group:

Increase the amount of lipids introduced in the increase of 0.5 - 1.0 g/kg body weight/day may benefit the ability to monitor the increase in plasma triglyceride levels and prevent excess lipids.

Infants lack monthly, newborn babies, newborns and children to practice:

The recommendation must not exceed the daily dose of 3.0 (maximum 4.0) g/kg body weight/day for lipids and must be transmitted continuously for 24 hours.

Children and adolescents:

The recommendation must not exceed the daily lipid dose of 2.0 - 3.0 g/kg body weight/day.

Other objects

Note: The above dose is for reference only. Specific dosage depends on the condition and level of progression of the disease. For a suitable dose, you need to consult a doctor or medical specialist.

What to do when overdose? In addition, fat overload syndrome may appear.

Treatment: Stop transmission as soon as there are signs of overdose. Other treatments will depend on specific symptoms and their severity. After the symptoms have decreased, the infusion is recommended, so the transmission rate should be monitored at regular periods.

What to do when forgetting 1 dose?

Side Effects

When using Lipofundin MCT/LCT 20%, you may experience unwanted effects (ADR).

Rare, 1/10000

Blood and lymphatic system: increased blood clotting, leukemia, platelets.

The immune system: allergic reactions (such as anaphylactic reactions, skin rash, larynx edema, mouth and face). Metabolic and nutrition: hyperlipidemia, hyperlemia, metabolic acidosis, keratoma infection. Systemic: headache, drowsiness, hypertension, blush, erythema, sweating, increased body temperature, feeling cold, cold tremor, fat overload syndrome.

Muscle system: back pain, bowel movement, chest and lumbar area.

Respiratory system: shortness of breath, purple blue.

Digestive system: Nausea, vomiting, appetite, cholestasis.

Instructions on how to handle ADR

If the adverse reaction occurs, the lipofundin transmission must be discontinued or, if necessary, continue at lower doses.

If you start passing down, you must monitor the patient carefully, especially at the beginning, and must identify serum triglycerides in short time.

Warnings

Before using the drug you need to read the instructions carefully and refer to the information below.

Contraindicated

Lipofundin MCT/LCT 20% contraindicated in the following cases:

Hypersensitivity to egg protein or soybean, soybean products or peanuts or any active or excipients;

Severe blood lipid increase;

Severe coagulation disorders;

Severe liver failure;

Molecularity in the liver;

Serious renal failure without kidney replacement therapy;

Acute thrombosis;

Fat vessels;

Objective hemorrhage;

Metabolic acidosis;

Unstable circulatory situation is life -threatening (collapse and shock);

Unstable metabolic conditions (for example, severe post -invasive post -invasive syndrome, severe infections, unexplained coma);

The acute phase of the heart infarction or stroke;

Disorders of fluid and electrolytes are not adjusted, such as hypokalemia and weak dehydration;

Damaged heart failure;

acute pulmonary edema.

Be cautious when using

Serly triglyceride concentration must be monitored regularly during lipofundin transmission.

Must adjust the fluid, electrolyte or base-base balance disorders before starting the infusion. It is necessary to control the electrolyte balance in serum, fluid, acid -base, cardiovascular function and - in the long -term transmission process - the number of blood cells, blood clotting and liver function.

Hypersensitivity reactions with a component of lipofundin (for example, the trace of protein in soybean or lecithin in eggs) is extremely rare, but cannot be completely excluded for sensitive patients. Lipofundin should be stopped immediately in the event of any signs of allergic reactions, such as fever, chilling, rash, shortness of breath.

Providing energy with only lipid emulsion can cause metabolic acidosis. Therefore, the amount of carbohydrates and amino acids should be adequate in the vein with fat emulsion.

For patients who need to be completely nourished by intravenous lines, it is necessary to use carbohydrates, amino acids, electrolytes, vitamins and trace elements. In addition, must ensure adequate total translation.

Mixing with incompatible substances can lead to the decomposition of emulsion or precipitating elements, both of which lead to high risk of vascular obstruction.

In solutions with higher lipid content (eg lipofundin MCT/LCT 20%), the ratio of emulsifier (phospholipid) on oil is lower than in lipid emulsion with lower content. This ensures the concentration of triglycerides, phospholipids, free fatty acids as well as lipoprotein-x causing diseases in plasma. Therefore, priority should be given to lipid emulsion with higher content such as Lipofundin MCT/LCT 20% compared to lower lipid emulsion.

Be careful in patients with other diseases such as heart failure or kidney failure, diseases often related to high age.

Be cautious in patients with lipid metabolism disorders, such as renal failure, diabetes, pancreatitis, impaired liver function, hypothyroidism (hyperplyceride blood) and blood infections.

In infants nourished by intravenously, there is a risk of excess bilirubin, triglycerides and serum bilirubin must be monitored and must adjust the lipid transmission speed if necessary. In the process of transmission of Lipofundin® MCT/LCT, it must be protected to avoid the light of therapeutic light to reduce the formation of triglycerides hydroferoxide.

Lipid can affect certain tests (such as bilirubin, lactate dehydrogenase, oxygen saturation) when taking blood samples before lipid is cleared from blood flow; This process can take 4 to 6 hours.

The ability to drive and operate machinery

does not affect.

Pregnancy

There is no data or limited data on the use of lipofundin MCT/LCT in pregnant women. Animal data is incomplete to toxicity for the reproductive system.

Nursing through intravenously may be necessary during pregnancy. Only for using Lipofundin MCT/LCT in pregnant women after considering the benefits - the risk of careful.

Lactation period

The components/metabolites of Lipofundin MCT/LCT are secreted into breast milk, but at the dose of treatment, there is no impact on infants to breastfeed. In general, mothers who receive nutrition by vein should not breastfeed.

Interactive/Cavalry

Drug interaction

Heparin is used in clinical doses that cause temporary liberation of lipoprotein lipase into the blood. This may initially lead to an increase in plasma lipid resolution, then the most relieved news of Triglyceride clearance.

Soybean oil has a natural content of vitamin K1. However, this content is very low in the Lipofundin MCT/LCT that it does not significantly affect the blood clotting process in patients treated with Coumarin derivatives. But, blood clotting must be monitored in patients treated simultaneously with Coumarin.

Cavalry

Do not use Lipofundin MCT/LCT as a conductive solution for electrolytes or other drugs, nor mixed emulsion with other transmission solutions in an uncontrolled way, because the full stability of the emulsion will no longer be guaranteed.

Only coordinated in intravenous nurturing after controlling and ensuring the compatibility of the drugs.

Storage

Do not be stored above 25 ° C.

Do not freeze.

Put the bottle in the carton box to avoid light.

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