TRAVASOL 2.75% IN DEXTROSE 20% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for TRAVASOL 2.75% IN DEXTROSE 20% IN PLASTIC CONTAINER (TRAVASOL 2.75% IN DEXTROSE 20% IN PLASTIC CONTAINER).
Provides exogenous amino acids and dextrose to meet caloric and protein requirements in patients who cannot tolerate enteral nutrition. Amino acids are used for protein synthesis and as substrates for gluconeogenesis and other metabolic pathways.
| Metabolism | Amino acids undergo oxidation, transamination, and urea cycle; dextrose is metabolized via glycolysis and the Krebs cycle. Excretion of nitrogen occurs as urea via the kidneys. |
| Excretion | Amino acids and dextrose are metabolized; excess nitrogen is excreted primarily as urea in urine. Dextrose is metabolized to CO2 and water. Biliary/fecal: negligible. |
| Half-life | Amino acids: not applicable (endogenous metabolites). Dextrose: <15 minutes; clinical context: continuous infusion required to maintain glucose homeostasis. |
| Protein binding | Amino acids: minimal (<10% bound to albumin); dextrose: not bound. |
| Volume of Distribution | Amino acids: ~0.2-0.4 L/kg (confined to extracellular fluid); dextrose: ~0.2 L/kg (distributes in total body water). |
| Bioavailability | Intravenous: 100% (only route of administration). |
| Onset of Action | Intravenous: immediate (within minutes) for caloric and nitrogen provision; metabolic effects begin promptly upon infusion. |
| Duration of Action | Duration depends on infusion rate and metabolic demand; continuous infusion maintains steady state. After cessation, effects decline rapidly (minutes to hours). |
Intravenous infusion: 500 mL to 1000 mL over 24 hours, titrated to provide 2.75% amino acids and 20% dextrose as part of parenteral nutrition. Rate based on glucose tolerance and metabolic needs.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <50 mL/min: Reduce total nitrogen intake by 50% and monitor serum urea and electrolytes. GFR <20 mL/min: Use with caution; consider alternative amino acid formulations. No specific dose adjustment for dextrose component. |
| Liver impairment | Child-Pugh Class B or C: Reduce amino acid component to 1-2 g/kg/day, use branched-chain enriched formula if available. Dextrose may require reduction if hyperglycemia present. |
| Pediatric use | Weight-based: Amino acids 0.5-2 g/kg/day; dextrose 5-20 mg/kg/min. Begin at lower end and titrate to metabolic parameters. Infuse via central line for concentrations >10% dextrose. |
| Geriatric use | Start at lower infusion rates (0.5-1 mL/kg/h) due to increased risk of fluid overload and hyperglycemia. Monitor renal function and electrolytes closely. Use with caution in heart failure or renal impairment. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 2.75% IN DEXTROSE 20% IN PLASTIC CONTAINER (TRAVASOL 2.75% IN DEXTROSE 20% IN PLASTIC CONTAINER).
| Breastfeeding | No data on excretion in human milk. The components (amino acids, dextrose) are normal constituents of milk. Intravenous infusion may affect milk composition; M/P ratio unknown. Use with caution in breastfeeding mothers. |
| Teratogenic Risk | TRAVASOL 2.75% IN DEXTROSE 20% is a combination of amino acids and dextrose for parenteral nutrition. Dextrose at high doses may cause fetal hyperglycemia and hyperinsulinemia, but no direct teratogenic effects are established. Amino acids are essential nutrients and not known to be teratogenic. However, the components are at high concentrations; use in pregnancy only if clearly needed. |
■ FDA Black Box Warning
Not intended for use in patients with severe hepatic disease, uremia, or metabolic disorders involving amino acid metabolism.
| Serious Effects |
["Severe hepatic disease","Severe uremia","Inborn errors of amino acid metabolism","Hyperglycemia or hyperosmolar nonketotic coma","Patients with known hypersensitivity to any component"]
| Precautions | ["Monitor serum electrolyte concentrations, fluid balance, and acid-base status","Risk of hyperglycemia, especially in patients with diabetes mellitus","Hepatic and renal function should be assessed before and during therapy","Intravenous administration requires strict aseptic technique"] |
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| Fetal Monitoring | Monitor maternal blood glucose, electrolytes, fluid balance, and liver function. Fetal monitoring for signs of hyperglycemia or growth disturbances. Assess maternal weight gain and nutritional status. |
| Fertility Effects | No known adverse effects on fertility from components. Dextrose and amino acids are essential for normal reproductive function. Inadequate nutrition may impair fertility; supplementation may aid. |