AMINOSYN II 7% W/ ELECTROLYTES
Clinical safety rating: caution
Comprehensive clinical and safety monograph for AMINOSYN II 7% W/ ELECTROLYTES (AMINOSYN II 7% W/ ELECTROLYTES).
Provides essential and non-essential amino acids for protein synthesis, promotes nitrogen balance, and serves as a caloric source in parenteral nutrition.
| Metabolism | Amino acids are metabolized via deamination, transamination, and urea cycle in the liver; some amino acids (e.g., branched-chain) are metabolized in muscle. |
| Excretion | Renal: >80% as amino acids and metabolites; fecal: negligible; biliary: <5% |
| Half-life | Variable; amino acids: 10–40 minutes (rapid distribution and metabolism); clinical context: continuous infusion required to maintain steady state |
| Protein binding | <10% (minimal; amino acids are unbound in plasma) |
| Volume of Distribution | 0.2–0.4 L/kg (distributes primarily in extracellular fluid) |
| Bioavailability | IV: 100% (complete bioavailability); not administered orally |
| Onset of Action | IV: immediate upon infusion; peak plasma amino acid levels achieved within 30 minutes |
| Duration of Action | IV: 2–4 hours post-infusion due to rapid metabolism and renal clearance; continuous infusion needed for sustained effect |
Adults: 500 mL to 2000 mL/day intravenously via central line at a rate not exceeding 100 mL/hour. Dosage based on protein requirement (0.8-1.5 g/kg/day) and nutritional status.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR < 50 mL/min: reduce dose to 0.5-0.8 g/kg/day of amino acids. For GFR < 15 mL/min: use specialized renal formulations; contraindicated if severe renal failure not on dialysis. |
| Liver impairment | Child-Pugh Class C: avoid use or restrict to 0.5-0.7 g/kg/day of amino acids; use with caution in encephalopathy, may require branched-chain amino acid formulations. |
| Pediatric use | Neonates and children: 2-3 g/kg/day of amino acids intravenously. Adjust based on gestational age and clinical condition; typical rate 0.1-0.15 g/kg/hour. |
| Geriatric use | Elderly: start at lower end of adult dosing (0.8-1.0 g/kg/day amino acids); monitor renal function and fluid status; avoid rapid infusion due to risk of fluid overload. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for AMINOSYN II 7% W/ ELECTROLYTES (AMINOSYN II 7% W/ ELECTROLYTES).
| Breastfeeding | It is not known if this drug is excreted in human milk. No M/P ratio is available. Caution should be exercised when administered to a nursing woman, as many drugs are excreted in human milk and there is potential for adverse effects in the infant. Consider the developmental and health benefits of breastfeeding along with the mother's clinical need for the drug and any potential adverse effects on the breastfed child. |
| Teratogenic Risk | Aminosyn II 7% w/ Electrolytes is a crystalline amino acid solution used for parenteral nutrition. No specific fetal risks have been reported in human studies; however, adequate and well-controlled studies in pregnant women are lacking. Amino acid imbalances or high amino acid concentrations may theoretically affect fetal development. In animal studies, high doses of amino acids have been associated with fetal growth retardation. Use during pregnancy only if clearly needed. First trimester: unknown risk, no evidence of teratogenicity in limited data. Second and third trimesters: no specific risks identified but monitor maternal and fetal status during prolonged use. |
■ FDA Black Box Warning
Not for direct intravenous infusion; must be admixed with dextrose and electrolytes. Use only in patients requiring parenteral nutrition. Risk of metabolic acidosis, hyperammonemia, and electrolyte imbalances.
| Serious Effects |
["Hypersensitivity to any component","Inborn errors of amino acid metabolism","Severe hepatic failure with encephalopathy","Severe renal failure without dialysis","Metabolic acidosis"]
| Precautions | Monitor serum electrolytes, blood glucose, liver function, and ammonia levels. Use with caution in renal impairment, hepatic failure, or metabolic disorders. Risk of infection from catheter use. |
| Food/Dietary | No specific food interactions. Parenteral nutrition bypasses the gastrointestinal tract; oral intake should be avoided or limited as directed by the healthcare team. Enteral nutrition is preferred if the gut is functional. |
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| Fetal Monitoring | Regular monitoring of serum electrolytes, blood urea nitrogen, blood glucose, acid-base balance, and fluid status is required. In pregnant patients, additionally monitor fetal growth and well-being (e.g., ultrasound) due to potential effects of nutritional imbalances. Observe for signs of metabolic complications such as hyperammonemia or amino acid imbalances. |
| Fertility Effects | No specific data exist on the effect of Aminosyn II 7% w/ Electrolytes on fertility. Amino acid solutions are essential for protein synthesis, and deficiencies can impair reproductive function; however, therapeutic use is unlikely to adversely affect fertility. No known negative impact from standard parenteral nutrition. |
| Clinical Pearls | Aminosyn II 7% w/ Electrolytes is a crystalline amino acid solution for parenteral nutrition. Contains electrolytes including sodium, potassium, magnesium, acetate, and chloride. Must be administered via central or peripheral vein with appropriate additives (dextrose, lipids, vitamins, trace elements). Monitor serum electrolytes, renal function, and nitrogen balance. Contraindicated in severe hepatic failure, uremia without dialysis, and metabolic acidosis. Do not use as a protein source in patients with inborn errors of amino acid metabolism. |
| Patient Advice | This medication is part of your total parenteral nutrition and is given intravenously. · You will need regular blood tests to monitor kidney function, electrolytes, and nutritional status. · Report any signs of infection at the IV site (redness, swelling, pain). · Do not change the infusion rate or stop the infusion without consulting your healthcare provider. · Tell your doctor if you experience nausea, vomiting, swelling in legs or feet, or shortness of breath. |