AMINOSYN II 15% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for AMINOSYN II 15% IN PLASTIC CONTAINER (AMINOSYN II 15% IN PLASTIC CONTAINER).
Provides essential amino acids for protein synthesis, serving as substrates for nitrogen balance and tissue repair.
| Metabolism | Amino acids undergo hepatic metabolism via transamination, deamination, and urea cycle; excreted as urea. |
| Excretion | Renal: amino acids are filtered and reabsorbed; excess nitrogen is excreted as urea in urine. <5% fecal. |
| Half-life | Amino acids: rapid clearance, half-life 0.5-2 hours depending on individual and metabolic state. Clinical context: continuous infusion maintains steady state. |
| Protein binding | Variable; individual amino acids bind to albumin and other proteins (e.g., tryptophan ~90% bound to albumin, others low). Overall <20%. |
| Volume of Distribution | Approximately 0.3-0.5 L/kg for total amino acids; distributes into total body water. |
| Bioavailability | IV: 100% (only route used). |
| Onset of Action | IV: immediate (within minutes) as amino acids enter circulation. |
| Duration of Action | IV: continuous infusion required to maintain effect; metabolic effects persist hours after infusion ends depending on dose and clinical status. |
Intravenous infusion: 1.0 to 2.0 g amino acids/kg/day, maximum 125 mL/hour (3 g amino acids/kg/day).
| Dosage form | INJECTABLE |
| Renal impairment | GFR <50 mL/min: reduce dose to 0.5-1.0 g/kg/day; GFR <15 mL/min: contraindicated unless on renal replacement therapy. |
| Liver impairment | Child-Pugh Class B: reduce to 50% of dose; Child-Pugh Class C: avoid use due to risk of hepatic encephalopathy. |
| Pediatric use | Neonates: 2.0-3.0 g/kg/day; Infants/Children: 1.5-2.5 g/kg/day; maximum infusion rate 0.1 g/kg/hour. |
| Geriatric use | Start at lower end of dosing range (1.0 g/kg/day) and titrate based on renal function and nutritional status. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for AMINOSYN II 15% IN PLASTIC CONTAINER (AMINOSYN II 15% IN PLASTIC CONTAINER).
| Breastfeeding | Compatible with breastfeeding; M/P ratio unknown. Excreted in breast milk as endogenous amino acids. |
| Teratogenic Risk | No evidence of teratogenicity in animal studies; insufficient human data. Use during pregnancy only if clearly needed. |
| Fetal Monitoring | Monitor serum electrolytes, acid-base balance, blood glucose, renal and hepatic function, and nutritional status. |
■ FDA Black Box Warning
Not for use in patients with inborn errors of amino acid metabolism, such as maple syrup urine disease (MSUD).
| Serious Effects |
["Inborn errors of amino acid metabolism (e.g., MSUD)","Severe hepatic failure with hyperammonemia","Severe renal failure without dialysis"]
| Precautions | ["Monitor serum electrolytes, acid-base balance, and liver function","Risk of hypervolemia, pulmonary edema, and hyperglycemia","Avoid in severe renal/hepatic failure"] |
| Food/Dietary | No direct food interactions; this is a parenteral formulation. However, concurrent enteral nutrition may affect metabolic balance and should be managed by a dietitian. Avoid excessive potassium- or phosphorus-rich foods if electrolyte abnormalities are present. |
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| Fertility Effects | No known adverse effects on fertility; provides essential nutrients for reproductive health. |
| Clinical Pearls | Aminosyn II 15% is a crystalline amino acid solution used for parenteral nutrition. It contains 15 g amino acids per 100 mL and provides 0.6 kcal/mL. Do not administer simultaneously with blood through the same infusion set due to risk of pseudoagglutination. Use in-line filter (0.22 micron) during administration. Monitor serum electrolytes, BUN, ammonia, and liver function tests frequently. Do not use in patients with severe hepatic encephalopathy or inborn errors of amino acid metabolism. Solution should be clear; discard if discolored or turbid. |
| Patient Advice | This medication is given through a vein to provide nutrition when you cannot eat. · You may experience fever, chills, or pain at the infusion site; report these to your nurse. · Regular blood tests are needed to monitor your liver and kidney function. · Do not stop the infusion without consulting your healthcare provider. · Inform your doctor if you have diabetes, liver disease, or kidney problems. |