TRAVASOL 4.25% IN DEXTROSE 20% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for TRAVASOL 4.25% IN DEXTROSE 20% IN PLASTIC CONTAINER (TRAVASOL 4.25% IN DEXTROSE 20% IN PLASTIC CONTAINER).
Travasol 4.25% in Dextrose 20% is a parenteral nutrition solution providing amino acids and carbohydrates. Amino acids serve as substrates for protein synthesis, while dextrose supplies calories to prevent catabolism and promote anabolism. The solution corrects nitrogen balance and provides energy.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle. Amino acids are deaminated and metabolized in the liver and peripheral tissues; carbon skeletons enter metabolic pathways, and nitrogen is excreted as urea. |
| Excretion | Renal excretion; amino acids are reabsorbed or metabolized, excess nitrogen excreted as urea (renal). Dextrose is metabolized to CO2 and water. No significant biliary/fecal elimination. |
| Half-life | Not applicable; components are endogenous nutrients. Dextrose half-life <15 min in normal renal function; amino acids have variable half-lives (minutes) due to rapid metabolism and incorporation. Clinical context: continuous infusion maintains steady state. |
| Protein binding | Amino acids: minimal binding (<10%) to albumin; dextrose: not protein-bound. |
| Volume of Distribution | Amino acids: approximately 0.3-0.4 L/kg (total body water); dextrose: approximately 0.2 L/kg (extracellular fluid). Clinical meaning: distributes to total body water and extracellular space. |
| Bioavailability | Intravenous: 100% (complete bioavailability). Not administered orally; oral bioavailability of components varies but not relevant for this formulation. |
| Onset of Action | Intravenous: immediate (within minutes); nutrients are available for metabolism as soon as infused. |
| Duration of Action | Intravenous: duration depends on infusion rate; continuous infusion provides sustained nutritive effect. After stopping infusion, effects diminish rapidly as components clear (minutes to <1 hour). |
| Molecular Weight | Amino acids: 75-240 Da (varies by individual amino acid); dextrose: 180.16 Da |
Intravenous administration via central line. Typical adult dose: 500-1000 mL/day of TRAVASOL 4.25% in dextrose 20% (providing 4.25 g amino acids and 20 g dextrose per 100 mL) as part of total parenteral nutrition. Infusion rate: not to exceed 0.8 g/kg/h of amino acids. Individualize based on metabolic needs.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR <50 mL/min/1.73m²: Reduce total daily amino acid dose by 30-50% and monitor serum urea and creatinine. For GFR <15 mL/min: Avoid or use with extreme caution; consider essential amino acid formulations. Adjust fluid and electrolyte content as needed. |
| Liver impairment | Child-Pugh Class A: No adjustment. Class B: Reduce amino acid dose by 25% and monitor ammonia. Class C: Avoid use; use hepatic failure-specific formulations. Prefer branched-chain amino acid-enriched solutions in severe hepatic impairment. |
| Pediatric use | Weight-based dosing: For neonates and infants: Start at 1-2 g/kg/day of amino acids, increase up to 3-4 g/kg/day. Provide 10-15 g/kg/day of dextrose (adjust concentration). For children: 1.5-3 g/kg/day of amino acids and 5-15 mg/kg/min of dextrose. Infuse via central line. Monitor serum electrolytes and glucose closely. |
| Geriatric use | Start at lower end of adult dose (e.g., 500 mL/day) and increase slowly. Monitor renal function (CrCl) and adjust fluid volume to avoid overload. Decrease amino acid dose if GFR <60 mL/min. Monitor serum electrolytes, glucose, and nutrition status frequently due to increased risk of metabolic complications. |
| 1st trimester | Amino acids 4.25% with dextrose 20% is a combination used for parenteral nutrition. There are no adequate and well-controlled studies in pregnant women. Use only if clearly needed and potential benefit justifies potential risk to the fetus. |
| 2nd trimester | Same as first trimester. Use only if clearly needed. |
| 3rd trimester | Same as first trimester. Use only if clearly needed. |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 4.25% IN DEXTROSE 20% IN PLASTIC CONTAINER (TRAVASOL 4.25% IN DEXTROSE 20% IN PLASTIC CONTAINER).
| Placental transfer | Amino acids and dextrose cross the placenta by passive diffusion and active transport; degree varies with maternal levels and placental function. |
| Breastfeeding | It is not known whether this combination is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when administered to a nursing woman. |
| Lactation Rating | L3 (Moderately Safe) |
| Teratogenic Risk | No specific teratogenic risk identified in animal studies; however, amino acid and dextrose solutions are essential nutrients and not known to be teratogenic when used at recommended doses. First trimester: no known risk. Second and third trimesters: no known risk. Use only if clearly needed. |
| Fetal Monitoring | Monitor maternal blood glucose, electrolytes, serum ammonia, and acid-base balance. Monitor for signs of fluid overload, hyperglycemia, or hyperosmolality. Fetal monitoring as clinically indicated. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. |
■ FDA Black Box Warning
This solution is indicated for intravenous use only. Do not use if solution is discolored or contains particulate matter. Risk of infections from catheter-related sepsis, fluid overload, electrolyte imbalances, hyperglycemia, and metabolic acidosis. Use in patients with renal failure, hepatic insufficiency, or severe metabolic disorders may require dosage adjustments.
| Serious Effects |
Hypersensitivity to any componentInborn errors of amino acid metabolismSevere hyperglycemiaSevere hypertriglyceridemiaSevere hepatic impairmentSevere renal failure without dialysis
| Precautions | Monitor fluid and electrolyte status, renal function, hepatic function, blood glucose, and acid-base balance. Caution in patients with congestive heart failure, renal impairment, hepatic disease, diabetes mellitus, or metabolic disorders. Use sterile technique for catheter care. Do not administer unless solution is clear and container undamaged. |
| Food/Dietary | No direct food interactions. However, this is total parenteral nutrition (TPN); oral intake is typically restricted. When transitioning to oral feeding, monitor for refeeding syndrome, especially in malnourished patients. |
| Clinical Pearls | TRAVASOL 4.25% IN DEXTROSE 20% is a high-osmolality parenteral nutrition solution (≈1500 mOsm/L) requiring central venous access. Monitor serum glucose closely due to 20% dextrose; insulin may be needed. Check electrolytes, renal function, and liver enzymes regularly. Avoid sudden discontinuation to prevent rebound hypoglycemia. Use with caution in renal impairment (risk of hyperkalemia, hyperphosphatemia). |
| Patient Advice | This solution is given through a central vein (large vein near the heart) and must be administered by a healthcare professional. · You will need regular blood tests to monitor blood sugar, electrolytes, and kidney/liver function. · Do not stop the infusion suddenly; sudden stop may cause low blood sugar. · Report any signs of infection (redness, swelling, pain at IV site) or shortness of breath. · Maintain good hydration as directed; report any unusual thirst or increased urination. |
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