TRAVASOL 2.75% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 25% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for TRAVASOL 2.75% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 25% IN PLASTIC CONTAINER (TRAVASOL 2.75% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 25% IN PLASTIC CONTAINER).
TRAVASOL 2.75% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 25% is a parenteral nutrition solution providing calories (dextrose), amino acids (for protein synthesis), and electrolytes for maintenance of acid-base balance and cellular function. Dextrose is metabolized to glucose, which undergoes glycolysis and oxidative phosphorylation. Amino acids are used for protein synthesis and as an energy source. Electrolytes correct or prevent deficiencies.
| Metabolism | Dextrose is metabolized via glycolysis and enters the citric acid cycle. Amino acids are deaminated and oxidized for energy or used in protein synthesis. Electrolytes are not metabolized but are excreted or utilized in physiological processes. |
| Excretion | Primarily renal (glomerular filtration). Dextrose is completely metabolized; electrolytes (sodium, chloride, potassium, calcium, magnesium, acetate) are excreted via kidneys. Acetate is metabolized to bicarbonate. No significant biliary/fecal elimination. |
| Half-life | Dextrose: rapid, minutes (insulin dependent); amino acids: 20-30 min for free pool turnover; electrolytes: distribution half-life 2-4 hours, elimination depends on renal function. Clinical: continuous infusion maintains steady state. |
| Protein binding | Minimal (<10%). Dextrose and electrolytes not significantly protein bound. Amino acids: low binding (albumin, variable by amino acid). |
| Volume of Distribution | Dextrose: ~0.2 L/kg (total body water). Amino acids: 0.5-1 L/kg (free amino acid pool). Electrolytes: distribute according to body water compartments (e.g., Na+ 0.6 L/kg, K+ 4 L/kg). Clinically: reflects distribution into extracellular and intracellular spaces. |
| Bioavailability | IV: 100% (complete bioavailability). Not administered via other routes; oral or enteral would result in variable absorption and first-pass metabolism (not applicable). |
| Onset of Action | IV: Immediate. Dextrose raises blood glucose within minutes; amino acids enter circulation immediately; electrolytes act within seconds to minutes. |
| Duration of Action | Continuous infusion: duration equals infusion time plus post-infusion equilibration (1-2 hours). No sustained effect after discontinuation. Clinical: requires continuous administration for nutritional support. |
| Molecular Weight | 198.17 |
Intravenous infusion only. Adult dose determined by nutritional requirements and metabolic tolerance. Typical dose: 500-2000 mL/day infused continuously or intermittently, with dextrose dosage not exceeding 0.5 g/kg/h. Final concentration of dextrose and amino acids must be monitored.
| Dosage form | INJECTABLE |
| Renal impairment | In acute kidney injury or chronic kidney disease (GFR <30 mL/min/1.73 m²): reduce total daily amino acid dose to 0.6-0.8 g/kg/day with close monitoring of serum electrolytes and acid-base balance. GFR 30-50 mL/min/1.73 m²: standard dosing may be used with caution. Avoid in patients with severe renal failure without appropriate electrolyte adjustment. |
| Liver impairment | Child-Pugh class B or C cirrhosis: reduce or avoid use. Initiate at 50% of standard dose, titrate slowly based on tolerance and serum ammonia levels. Monitor for signs of hepatic encephalopathy. |
| Pediatric use | Weight-based dosing: Neonates and infants: 2-3 g amino acids/kg/day. Children: 1-2 g amino acids/kg/day. Dextrose infusion rate should not exceed 12-14 mg/kg/min in neonates, 8-10 mg/kg/min in older children. Adjust electrolytes based on age and renal function. |
| Geriatric use | In elderly patients, start at low end of dosing range due to age-related decline in renal function. Monitor fluid balance, electrolytes, and renal function closely. Typical adult dose may be used if renal function is normal, but individualize based on comorbidities. |
| 1st trimester | Use only if clearly needed; no adequate studies in pregnant women. Dextrose may affect maternal/fetal glucose levels. Electrolytes should be monitored. |
| 2nd trimester | Use only if clearly needed; monitor maternal glucose and electrolytes. Risk of fluid/electrolyte imbalance. |
| 3rd trimester | Use with caution; may cause maternal hyperglycemia and fetal hyperinsulinemia. Monitor closely. |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 2.75% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 25% IN PLASTIC CONTAINER (TRAVASOL 2.75% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 25% IN PLASTIC CONTAINER).
| Placental transfer | Dextrose and electrolytes cross the placenta. Dextrose is actively transported; electrolytes equilibrate. |
| Breastfeeding | Excretion into breast milk unknown. Dextrose and electrolytes are normal constituents of milk. Use with caution, especially in mothers with glucose intolerance. |
| Lactation Rating | L3 (Moderately Safe) |
| Teratogenic Risk | No adequate studies in pregnant women. Animal reproduction studies not conducted. This formulation contains dextrose and electrolytes used for parenteral nutrition; teratogenic risk is considered low based on essential nutrient requirements. However, intravenous infusions during pregnancy should be administered with caution to avoid fluid overload and electrolyte imbalances that could affect the fetus. No specific fetal risks for first, second, or third trimester are identified beyond those associated with maternal metabolic disturbances. |
| Fetal Monitoring | Monitor maternal serum glucose, electrolytes, fluid balance, and renal function regularly during infusion. Assess for signs of hyperglycemia, electrolyte abnormalities, or fluid overload (e.g., edema, pulmonary congestion). Fetal monitoring (e.g., nonstress test or biophysical profile) is recommended if maternal metabolic instability occurs. In prolonged parenteral nutrition, monitor intrauterine growth and amniotic fluid volume. |
| Fertility Effects | No known adverse effects on fertility from dextrose or electrolyte components. However, parenteral nutrition may be used in conditions that themselves affect fertility (e.g., malnutrition, malabsorption). No specific data on impact of this formulation on fertility. |
■ FDA Black Box Warning
Contains sulfites that may cause allergic-type reactions including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in susceptible individuals. Sulfite sensitivity is seen more frequently in asthmatic patients. Solutions with dextrose concentrations of 25% are hypertonic and may cause phlebitis or thrombosis when administered via peripheral vein.
| Serious Effects |
Hypersensitivity to any componentHyperglycemia or hyperosmolar statesSevere electrolyte disordersRenal failure with anuriaPulmonary edemaCirrhosis with ascites
| Precautions | Risk of infection due to catheter placement and maintenance, Monitor for metabolic complications such as hyperglycemia, hypoglycemia, hyperosmolarity, electrolyte imbalances, acid-base disturbances, and azotemia, Use with caution in patients with renal insufficiency, hepatic failure, or cardiac failure due to fluid and electrolyte load, Sulfite sensitivity may cause allergic reactions, Extravasation may cause tissue necrosis, Do not administer simultaneously with blood through the same infusion set due to risk of agglutination |
| Food/Dietary | No direct food interactions; however, because this is a parenteral nutrition solution, oral intake may be restricted per clinical condition. Monitor blood glucose and adjust insulin as needed. |
| Clinical Pearls | TRAVASOL 2.75% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 25% is a high-concentration dextrose (25%) solution for parenteral nutrition, typically administered via central line due to high osmolarity (~2000 mOsm/L). Monitor for hyperglycemia, especially in diabetic or stressed patients; insulin may be required. Sulfite-free formulation reduces risk of allergic reactions in sulfite-sensitive individuals, but still contains electrolytes; assess renal function before use to avoid electrolyte imbalances. Rapid infusion can cause osmotic diuresis and dehydration. Use within 24 hours after opening; discard unused portion. |
| Patient Advice | This medication is used to provide nutrition and fluids when you cannot eat or drink. · It is given through a large vein in your chest (central line) and must be administered slowly. · Report any signs of allergic reaction: rash, itching, difficulty breathing. · Monitor for symptoms of high blood sugar: increased thirst, frequent urination, confusion. · Avoid self-adjusting the infusion rate; follow your healthcare provider's instructions exactly. · Report any pain, redness, or swelling at the IV site. |
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