CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER (CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER).
CLINIMIX E 2.75/10 is a parenteral nutrition solution providing amino acids, dextrose, electrolytes, and calcium. Amino acids serve as substrates for protein synthesis, dextrose provides caloric energy, and electrolytes maintain fluid and electrolyte balance.
| Metabolism | Amino acids are metabolized via transamination, deamination, and the urea cycle; dextrose is metabolized via glycolysis and the Krebs cycle; electrolytes are handled by renal and gastrointestinal mechanisms. |
| Excretion | Renal excretion of infused amino acids and electrolytes; glucose is metabolized to CO2 and water; 100% of water and electrolytes excreted renally. |
| Half-life | Not applicable as a fixed combination product; individual components have half-lives: amino acids ~0.5-2 h, dextrose ~2-4 h, electrolytes vary (e.g., calcium ~2-4 h). |
| Protein binding | Amino acids: minimal (<20% bound); calcium: ~45% bound to albumin; dextrose: negligible. |
| Volume of Distribution | Amino acids: 0.5-1 L/kg (total body water); calcium: 0.6 L/kg; dextrose: 0.2-0.4 L/kg. |
| Bioavailability | 100% intravenous bioavailability. |
| Onset of Action | Immediate upon IV infusion; metabolic effects begin within minutes. |
| Duration of Action | Duration of nutritional support equals infusion duration; metabolic effects persist for 1-4 h post-infusion depending on component. |
| Molecular Weight | 180.16 |
Intravenous infusion. Adult dose: 1-2 L per day, administered at a rate not exceeding 100 mL/hour initially, then adjusted based on metabolic and fluid requirements. Each liter contains amino acids 27.5 g, dextrose 100 g, and electrolytes including calcium.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR < 30 mL/min: use with caution, reduce protein load to 0.6-0.8 g/kg/day; monitor phosphate and potassium levels closely. For GFR 30-60 mL/min: standard dosing but monitor electrolytes. For GFR >60 mL/min: no adjustment needed. |
| Liver impairment | For Child-Pugh class B or C: reduce amino acid content to 0.5-0.7 g/kg/day; avoid use in hepatic encephalopathy. For Child-Pugh A: standard dosing with monitoring of ammonia levels. |
| Pediatric use | Weight-based dosing: initial infusion rate 0.1-0.15 mL/kg/hour, increase gradually to target 0.3-0.5 mL/kg/hour; maintain total fluid intake 100-150 mL/kg/day. Adjust based on glucose tolerance and electrolyte balance. |
| Geriatric use | Elderly patients: start at lower end of dosing range (e.g., 500 mL to 1 L per day) and titrate slowly; monitor for fluid overload, hyperglycemia, and electrolyte imbalances due to reduced renal and cardiac reserve. |
| 1st trimester | Parenteral nutrition is considered safe in pregnancy when indicated. No specific risks identified with Clinimix E 2.75/10 formulation in first trimester. |
| 2nd trimester | Safe for maternal nutritional support; monitor electrolytes. No increased risk of fetal harm. |
| 3rd trimester | Safe for maternal and fetal nutritional support; adjust for metabolic demands. Use with caution in preterm labor. |
Clinical note
Comprehensive clinical and safety monograph for CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER (CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER).
| Placental transfer | Amino acids, dextrose, electrolytes, and calcium cross placenta freely; used for fetal nutrition. No specific data on Clinimix E formulation, but components are known to transfer. |
| Breastfeeding | Excretion into breast milk is not significant for nutrients; however, additives like electrolytes and dextrose are normal milk components. No known adverse effects on nursing infant. Use only if clearly indicated and monitor infant for gastrointestinal disturbances. |
| Lactation Rating | Safe |
| Teratogenic Risk | No known teratogenic risk; amino acids, dextrose, and electrolytes are essential nutrients. Inadequate nutrition may pose risks, but the formulation itself is not associated with teratogenicity. Standard precautions apply for intravenous therapy during pregnancy. |
| Fetal Monitoring | Monitor maternal serum electrolytes, blood glucose, acid-base balance, hydration status, and fetal growth/well-being as clinically indicated. Assess for signs of infection, phlebitis, or metabolic complications. |
| Fertility Effects | No known adverse effects on fertility. Proper nutritional support may improve fertility by addressing maternal malnutrition. |
■ FDA Black Box Warning
None.
| Serious Effects |
Hypersensitivity to any componentSevere electrolyte disorders (e.g., hypercalcemia, hyperkalemia)Anuria or severe oliguriaSevere hepatic dysfunction with hyperammonemia
| Precautions | Risk of infections due to central line use, Metabolic complications including hyperglycemia, acidosis, and electrolyte imbalances, Hepatic steatosis and cholestasis, Osteoporosis and bone demineralization, Withdrawal symptoms if discontinued abruptly |
| Food/Dietary | No direct food interactions as this is an intravenous solution. However, oral dietary intake should be coordinated with TPN to avoid overfeeding or electrolyte imbalances. Avoid concurrent administration of oral calcium or phosphate supplements without medical guidance due to potential precipitation risk in the IV line. Monitor total nutrient intake from all sources. |
| Clinical Pearls | CLINIMIX E 2.75/10 SULFITE FREE W/ ELECT IN DEXTROSE 10% W/ CALCIUM IN PLASTIC CONTAINER is a total parenteral nutrition (TPN) solution. Do not administer simultaneously with blood products through same IV line. Monitor for signs of phlebitis, infection, hyperglycemia, and electrolyte imbalances. Use inline filter (1.2 micron) to reduce particulate load. Check for precipitate formation; do not use if discolored or containing particulates. Assess daily labs including glucose, electrolytes, renal function, and liver enzymes. Adjust infusion rate gradually to avoid metabolic complications. For patients with renal or hepatic impairment, dose modifications may be necessary. |
| Patient Advice | This is a nutrition solution given intravenously (through a vein) to provide calories, protein, and electrolytes when you cannot eat by mouth. · Report any redness, swelling, pain, or warmth at the infusion site immediately. · You may experience changes in blood sugar; symptoms such as thirst, frequent urination, or headache should be reported. · Do not stop the infusion suddenly; the dose will be tapered as directed by your healthcare provider. · Inform your healthcare provider of all medications, including over-the-counter and herbal supplements, as some may interact with this product. · This solution is a clear liquid; do not use if it appears cloudy, discolored, or contains particles. · Follow any dietary restrictions advised by your healthcare team; this solution is used because oral intake is inadequate. |
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