AMINOSYN 7%
Clinical safety rating: caution
Comprehensive clinical and safety monograph for AMINOSYN 7% (AMINOSYN 7%).
Aminosyn 7% provides a mixture of essential and nonessential amino acids, serving as substrates for protein synthesis, thereby supporting nitrogen balance and tissue repair. It acts as a source of caloric nitrogen in parenteral nutrition.
| Metabolism | Amino acids are metabolized in the liver via transamination, deamination, and urea cycle; excreted as urea and ammonia. |
| Excretion | Primarily renal elimination of infused amino acids as metabolic byproducts (urea, ammonia) and a small fraction of unchanged amino acids. Renal excretion accounts for >90% of elimination; negligible biliary/fecal. |
| Half-life | Not applicable as a single entity; amino acids are utilized rapidly for protein synthesis and energy. Plasma amino acid levels decline with a terminal half-life of approximately 10-20 minutes post-infusion, reflecting rapid tissue uptake. |
| Protein binding | Minimal to negligible; amino acids are not significantly bound to plasma proteins. |
| Volume of Distribution | Approximately 0.3-0.5 L/kg, reflecting distribution into total body water and extracellular fluid. |
| Bioavailability | 100% by intravenous route; not administered orally due to extensive first-pass metabolism and lack of enteral absorption as intact amino acids. |
| Onset of Action | Immediately upon intravenous infusion; clinical effect (plasma amino acid elevation) occurs within minutes. |
| Duration of Action | Duration of effect corresponds to infusion period; after cessation, plasma amino acid levels return to baseline within 1-2 hours due to rapid metabolism and tissue distribution. |
Intravenous: 500 mL to 2 L of 7% solution (35-140 g amino acids) per day by central or peripheral infusion, adjusted based on metabolic needs and nitrogen balance, usually infused at a rate not exceeding 0.1 g/kg/hour.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <30 mL/min/1.73 m²: Avoid use or reduce dose by 50% and monitor for uremia; GFR 30-50: Reduce dose by 25-50%; GFR >50: No adjustment required. |
| Liver impairment | Child-Pugh class B or C: Avoid use due to risk of hepatic encephalopathy; class A: Use with caution, reduce initial dose by 50% and monitor serum ammonia. |
| Pediatric use | Neonates and children: 2-3 g amino acids/kg/day (equivalent to 28-43 mL/kg/day of 7% solution) by continuous infusion. Adjust based on age and clinical response, not to exceed 0.1 g/kg/hour. |
| Geriatric use | Elderly patients: Use lowest effective dose, monitor renal function; typical starting dose 500-1000 mL (35-70 g amino acids) per day, adjust based on nitrogen balance and tolerance. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for AMINOSYN 7% (AMINOSYN 7%).
| Breastfeeding | Excretion in breast milk is considered low. M/P ratio not established. Use with caution. The drug is unlikely to cause adverse effects in a breastfed infant due to rapid endogenous amino acid metabolism. Generally compatible with breastfeeding. |
| Teratogenic Risk | No fetal risks identified. Amino acid infusions are essential during pregnancy to correct maternal malnutrition. The drug is generally required to maintain maternal and fetal nitrogen balance. No teratogenicity observed. |
| Fetal Monitoring |
■ FDA Black Box Warning
None
| Serious Effects |
["Hypersensitivity to any component","Inborn errors of amino acid metabolism (e.g., maple syrup urine disease)","Severe hepatic failure with risk of hepatic coma","Severe renal failure without dialysis"]
| Precautions | ["Monitor for metabolic acidosis, hyperammonemia, and electrolyte imbalances","Risk of infection due to central line use","Hepatic encephalopathy risk in patients with hepatic impairment","Renal function monitoring required in renal disease"] |
| Food/Dietary | No specific food interactions. However, enteral intake may need to be restricted or coordinated with parenteral nutrition to avoid overfeeding or imbalances. Administer with caution in patients with galactosemia or other metabolic disorders. |
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| Monitor maternal serum electrolytes, blood urea nitrogen (BUN), ammonia, acid-base balance, and glucose levels. In prolonged therapy, monitor hepatic and renal function. Assess fetal growth and well-being with serial ultrasounds if maternal malnutrition is severe. |
| Fertility Effects | No adverse effects on fertility reported. This product is a nutritional supplement and may improve fertility in malnourished women by correcting protein deficiency. |
| Clinical Pearls | AMINOSYN 7% is a crystalline amino acid solution used for parenteral nutrition. Always check for proper intravenous access before infusion. Monitor serum electrolytes, blood glucose, and liver function tests regularly. Avoid rapid infusion to prevent hyperosmolar complications. Use with caution in patients with renal or hepatic impairment; adjust amino acid load accordingly. Do not administer simultaneously with blood products via the same line. |
| Patient Advice | This solution is given intravenously to provide protein when you cannot eat by mouth. · Report any signs of allergic reaction, such as rash, itching, or difficulty breathing. · Tell your healthcare provider if you experience headache, nausea, or swelling. · Regular blood tests will be needed to monitor your response to treatment. · Do not stop the infusion without consulting your doctor. |