TRAVASOL 4.25% IN DEXTROSE 10% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for TRAVASOL 4.25% IN DEXTROSE 10% IN PLASTIC CONTAINER (TRAVASOL 4.25% IN DEXTROSE 10% IN PLASTIC CONTAINER).
Provides parenteral nutrition with amino acids and dextrose to maintain nitrogen balance and provide caloric support in patients unable to tolerate oral or enteral feeding.
| Metabolism | Amino acids are metabolized via hepatic and extrahepatic tissues; dextrose undergoes glycolysis and oxidation via the Krebs cycle; no specific enzyme involvement. |
| Excretion | Amino acids are deaminated, with nitrogen excreted primarily as urea in urine (90-95%); small amounts excreted in feces (<5%) and bile (<1%). Dextrose is metabolized to CO2 and water. |
| Half-life | Not applicable as a single entity; amino acids have rapid clearance (minutes to hours), dextrose half-life <15 minutes under normal conditions. |
| Protein binding | Amino acids: minimal to moderate binding (e.g., tryptophan ~90% to albumin; others <20%). Dextrose: negligible. |
| Volume of Distribution | Amino acids: Vd ~0.2-0.5 L/kg (total body water). Dextrose: Vd ~0.2 L/kg (extracellular fluid, equilibrates with total body water). |
| Bioavailability | Intravenous: 100% (complete bioavailability). Not administered orally. |
| Onset of Action | Intravenous: nutritional support begins immediately upon infusion, with rise in plasma amino acids and glucose within minutes. |
| Duration of Action | Duration depends on infusion rate; after cessation, plasma levels decline rapidly (minutes to hours). Continuous infusion required for sustained effect. |
| Molecular Weight | TRAVASOL is a mixture of amino acids (average MW ~110-200 Da) and dextrose (MW 180.16 Da). The primary osmotically active component is dextrose with MW 180.16 Da. |
Intravenous infusion: 1.5 to 2.5 g amino acids/kg body weight per day (equivalent to 35-60 mL/kg per day of TRAVASOL 4.25% IN DEXTROSE 10%) as part of total parenteral nutrition. Infusion rate should not exceed 0.2 g amino acids/kg per hour.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-59 mL/min: reduce dose to 1.0-1.5 g amino acids/kg per day. For GFR 15-29 mL/min: 0.8-1.0 g/kg per day. For GFR <15 mL/min: 0.6-0.8 g/kg per day, with monitoring of serum electrolytes and acid-base balance. |
| Liver impairment | Child-Pugh Class A: standard dosing. Class B: reduce amino acid content to 1.0-1.2 g/kg per day and monitor ammonia levels. Class C: use with caution; consider branched-chain amino acid-enriched formulations; avoid if severe encephalopathy. |
| Pediatric use | Neonates: 1.0-3.0 g amino acids/kg per day; infants: 1.5-3.5 g/kg per day; children: 1.0-2.5 g/kg per day. Administer as continuous infusion. Adjust dextrose content to achieve desired caloric intake. |
| Geriatric use | No specific dose adjustment; initiate at lower end of dosing range (1.2-1.5 g amino acids/kg per day). Monitor renal function, fluid status, and electrolytes closely. Consider reduced metabolic reserve and comorbidities. |
| 1st trimester | TRAVASOL 4.25% IN DEXTROSE 10% is a parenteral nutrition solution. No adequate and well-controlled studies in pregnant women. Use only if clearly needed. |
| 2nd trimester | Same as T1. Parenteral nutrition may be used if oral/enteral intake is inadequate. Monitor for fluid and electrolyte imbalances. |
| 3rd trimester | Same as T1. Potential risks include electrolyte disturbances and fluid overload. Use with caution. |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 4.25% IN DEXTROSE 10% IN PLASTIC CONTAINER (TRAVASOL 4.25% IN DEXTROSE 10% IN PLASTIC CONTAINER).
| Placental transfer | Amino acids and glucose cross the placenta via active transport. Electrolytes also cross. The extent is regulated by maternal-fetal gradients. |
| Breastfeeding | TRAVASOL 4.25% IN DEXTROSE 10% components (amino acids, dextrose, electrolytes) are endogenous substances normally found in breast milk. No known adverse effects on infant. Use with caution if essential. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Amino acids and dextrose in balanced parenteral nutrition have no known teratogenic risk. As a standard component of total parenteral nutrition, no specific fetal risks have been identified in any trimester when used as clinically indicated. However, underlying maternal conditions requiring TPN may pose risks. |
| Fetal Monitoring | Monitor maternal serum electrolytes, blood glucose, acid-base status, and fluid balance. Fetal surveillance via ultrasound and nonstress test in high-risk pregnancies. Assess for signs of fluid overload or metabolic complications. |
| Fertility Effects | No known direct adverse effects on fertility. Correction of maternal nutritional deficiencies may improve fertility outcomes in malnourished patients. |
■ FDA Black Box Warning
Not for intravenous injection as a single solution; contains no electrolytes and may cause metabolic complications if used without appropriate additives.
| Serious Effects |
Hypersensitivity to any componentSevere electrolyte disorders before correctionSevere fluid overloadPulmonary edemaAnuriaUncontrolled hyperglycemia
| Precautions | Risk of hyperglycemia and hyperosmolar syndrome, especially in diabetic or stressed patients, Can cause electrolyte imbalances, fluid overload, and metabolic acidosis, Monitor renal and hepatic function, serum glucose, and electrolyte levels, Do not use if solution is discolored or contains particles |
| Food/Dietary | There are no direct food interactions as this is an intravenous solution. However, oral intake should be coordinated with parenteral nutrition to avoid overfeeding or electrolyte imbalances. Patients who resume oral intake may require adjustment of the parenteral nutrition formula. |
| Clinical Pearls | Travasol 4.25% in Dextrose 10% is a parenteral nutrition solution for central line administration. Monitor serum electrolytes, glucose, and liver function tests. Do not administer peripherally due to high osmolarity (~1170 mOsm/L). Use inline filter (0.22 micron) to prevent particulate matter infusion. Add multivitamins and trace elements per protocol. Check for incompatibilities with concurrent IV medications; do not add other drugs unless verified. Assess for signs of infection at catheter site. Taper infusion rate to avoid rebound hypoglycemia upon discontinuation. |
| Patient Advice | This solution is given through a central venous catheter (large vein in chest or neck) to provide nutrition when you cannot eat. · It is not for use at home unless under strict medical supervision; report any fever, redness, swelling, or drainage at catheter site immediately. · You may experience changes in blood sugar; symptoms of high blood sugar include increased thirst, urination, or confusion; low blood sugar includes sweating, dizziness, or hunger. · Do not stop the infusion suddenly; it will be tapered off to prevent low blood sugar. · Inform your healthcare provider about all medications and supplements you take. · Avoid taking any medications or supplements by mouth without doctor approval, as they may affect nutrition needs. |
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