AMINOSYN-HF 8%
Clinical safety rating: caution
Comprehensive clinical and safety monograph for AMINOSYN-HF 8% (AMINOSYN-HF 8%).
Aminosyn-HF 8% is a crystalline amino acid solution that provides essential and non-essential amino acids for protein synthesis, promoting nitrogen balance and tissue repair in patients unable to tolerate oral intake.
| Metabolism | Amino acids are metabolized primarily in the liver via transamination and deamination reactions, with nitrogen converted to urea in the urea cycle. Some metabolism occurs in peripheral tissues. |
| Excretion | Renal: >90% as amino acids and metabolites; fecal: <5%. |
| Half-life | Not applicable as amino acids are rapidly cleared; terminal half-life of infused amino acids is approximately 10-30 minutes. |
| Protein binding | Minimal binding; <10% bound to plasma proteins (primarily albumin). |
| Volume of Distribution | Vd approximately 0.15-0.25 L/kg, reflecting distribution into extracellular fluid and total body water. |
| Bioavailability | Intravenous: 100% (only route administered). |
| Onset of Action | Intravenous: Within 15-30 minutes for nitrogen incorporation. |
| Duration of Action | Intravenous: Approximately 4-6 hours for metabolic effects; depends on infusion rate and patient needs. |
1-2 g/kg/day intravenously as total parenteral nutrition, typically administered as a continuous infusion over 24 hours.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <15 mL/min: reduce dose by 50%; GFR 15-29 mL/min: reduce dose by 25%; GFR ≥30 mL/min: no adjustment required. |
| Liver impairment | Child-Pugh class C: avoid use; class B: reduce dose by 50%; class A: no adjustment. |
| Pediatric use | 0.5-1.5 g/kg/day intravenously for infants and children, adjusted per metabolic needs. |
| Geriatric use | Initiate at lower end of dosing range (1 g/kg/day) due to decreased renal function; monitor fluid and electrolyte balance closely. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for AMINOSYN-HF 8% (AMINOSYN-HF 8%).
| Breastfeeding | Unknown whether amino acids from this solution are excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Aminosyn-HF 8% is administered to a nursing woman. No M/P ratio available. |
| Teratogenic Risk | Aminosyn-HF 8% is an amino acid solution used in parenteral nutrition. No adequate and well-controlled studies in pregnant women. Animal reproduction studies have not been conducted. It should be given to a pregnant woman only if clearly needed. There is no known teratogenic risk, but caution is advised due to lack of data. |
■ FDA Black Box Warning
This product is a hypertonic solution and must be administered through a central venous catheter to prevent thrombophlebitis. Use in patients with significant renal or hepatic impairment requires careful monitoring. Risk of metabolic acidosis, azotemia, and hyperammonemia.
| Serious Effects |
["Severe renal impairment (anuria, oliguria, or acute kidney injury)","Severe hepatic disease with encephalopathy","Inborn errors of amino acid metabolism (e.g., phenylketonuria)","Hypersensitivity to any component"]
| Precautions | Monitor fluid and electrolyte balance, renal function, and serum ammonia levels. Avoid rapid infusion to prevent hyperosmolarity. Use with caution in patients with heart failure or pulmonary edema. Discontinue if signs of allergic reaction occur. |
| Food/Dietary | No oral food interactions as this is an intravenous product. However, the amino acid profile is designed to correct imbalances seen in liver disease; avoid concurrent oral protein supplements unless directed, as they may affect nitrogen balance. Ensure adequate calorie supply from non-protein sources (e.g., lipids, dextrose) to promote protein synthesis. |
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| Fetal Monitoring | Monitor maternal electrolytes, acid-base balance, blood urea nitrogen (BUN), ammonia, liver function tests, glucose, and fluid balance during parenteral nutrition. Fetal monitoring as clinically indicated based on maternal condition. |
| Fertility Effects | No specific data on fertility effects. Amino acid solutions are essential for protein synthesis; malnutrition can impair fertility, but direct effects of Aminosyn-HF 8% on fertility are unknown. |
| Clinical Pearls | Aminosyn-HF 8% is a high-concentration amino acid solution (8% w/v) used for parenteral nutrition. It contains electrolytes and is specifically formulated for patients with hepatic failure or encephalopathy, as it is enriched with branched-chain amino acids (BCAAs) and low in aromatic amino acids. Monitor serum ammonia levels and hepatic function; avoid in severe hepatic coma without proper evaluation. Administer via central line due to high osmolarity (approximately 850 mOsm/L). Adjust infusion rate to prevent hyperglycemia or hypoglycemia; concurrent dextrose may be needed. |
| Patient Advice | This medication is given through a vein to provide nutrition when you cannot eat by mouth. · Report any symptoms of nausea, headache, or confusion, which may indicate high ammonia levels. · You will have regular blood tests to check your liver function and electrolyte levels. · Inform your healthcare provider if you have diabetes, as blood sugar monitoring may be necessary. · Do not stop the infusion abruptly; it will be tapered gradually. |