TRAVASOL 4.25% IN DEXTROSE 25% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for TRAVASOL 4.25% IN DEXTROSE 25% IN PLASTIC CONTAINER (TRAVASOL 4.25% IN DEXTROSE 25% IN PLASTIC CONTAINER).
TRAVASOL 4.25% IN DEXTROSE 25% provides crystalline amino acids and dextrose for parenteral nutrition. Amino acids serve as substrates for protein synthesis, while dextrose provides a carbohydrate source for energy. The formulation supplies essential and nonessential amino acids to maintain nitrogen balance and support tissue repair and growth.
| Metabolism | Amino acids undergo deamination and transamination in the liver; dextrose is metabolized via glycolysis and the citric acid cycle; insulin secretion increases in response to dextrose. |
| Excretion | The amino acids and dextrose are completely metabolized; no significant renal or biliary excretion of intact product. |
| Half-life | Not applicable as TRAVASOL 4.25% IN DEXTROSE 25% is a nutrient solution, not a drug with a defined elimination half-life. |
| Protein binding | Not applicable; amino acids and dextrose do not bind to plasma proteins. |
| Volume of Distribution | Not applicable; distributes throughout total body water. |
| Bioavailability | Intravenous: 100% bioavailable. |
| Onset of Action | Intravenous: Immediate upon infusion; provides caloric and nitrogen substrate. |
| Duration of Action | Duration depends on infusion rate and metabolic demand; typically administered over 24 hours in parenteral nutrition. |
| Molecular Weight | Amino acids mixture average ~130 Da; dextrose 180.16 Da |
Intravenous infusion; usual adult dose provides 0.5-2.0 g amino acids/kg/day, with dextrose providing 2-5 mg/kg/min; rate adjusted according to metabolic and fluid needs; typically infused over 24 hours via central line.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment; GFR 10-50 mL/min: reduce dose by 50% or monitor BUN and creatinine; GFR <10 mL/min: avoid unless on dialysis; adjust based on nitrogen balance and fluid status. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B: reduce dose by 50% and monitor ammonia; Child-Pugh C: avoid use due to risk of encephalopathy from amino acid load. |
| Pediatric use | Neonates and infants: initial 0.5-1 g amino acids/kg/day, increase gradually to 2-3 g/kg/day; dextrose initial 4-6 mg/kg/min, titrate up to 12-15 mg/kg/min; continuous infusion via central vein. |
| Geriatric use | Start at lower end of dose range (0.5-1 g amino acids/kg/day); monitor fluid and electrolyte balance closely; adjust for renal function and comorbidities; rate reduction may be needed due to decreased metabolic reserve. |
| 1st trimester | Amino acid and dextrose solutions are standard components of parenteral nutrition; no evidence of teratogenicity in humans. Use only if clearly needed; monitor glucose and electrolytes. |
| 2nd trimester | Safe for maternal nutritional support; may require dose adjustment due to increased plasma volume and renal clearance. Monitor fluid and electrolyte balance. |
| 3rd trimester | Safe for maternal and fetal nutrition; use with caution in preeclampsia or gestational diabetes due to dextrose load. Adjust electrolyte composition as needed. |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 4.25% IN DEXTROSE 25% IN PLASTIC CONTAINER (TRAVASOL 4.25% IN DEXTROSE 25% IN PLASTIC CONTAINER).
| Placental transfer | Amino acids and dextrose cross the placenta via active transport and facilitated diffusion; considered physiological. No evidence of fetal harm. |
| Breastfeeding | Excretion into breast milk of amino acids and dextrose is negligible and poses no risk to nursing infant. Parenteral nutrition components are normal blood constituents. Use with standard monitoring. |
| Lactation Rating | L1 - Safest |
| Teratogenic Risk | Travasol 4.25% in Dextrose 25% is a parenteral nutrition solution. No specific teratogenic effects are documented; risks are related to underlying maternal malnutrition. Dextrose may cause fetal hyperinsulinemia and hypoglycemia if maternal glucose levels are high. Use only if clearly needed. |
| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, liver function, acid-base status, and fluid balance. Monitor fetal growth and well-being if used long-term. |
| Fertility Effects | No known adverse effects on fertility; correction of malnutrition may improve fertility. |
■ FDA Black Box Warning
None (not FDA-approved, but similar parenteral nutrition products carry warnings for metabolic complications, including hyperglycemia, hyperosmolar coma, and electrolyte imbalances; use in patients with severe renal or hepatic disease may require dose adjustments).
| Serious Effects |
Severe hypersensitivity to any componentInborn errors of amino acid metabolism (e.g., maple syrup urine disease)Severe hyperglycemia or hyperosmolar statesSevere electrolyte imbalances uncorrected
| Precautions | Risk of hyperglycemia, hyperosmolar hyperglycemic state, and rebound hypoglycemia if infusion is stopped abruptly, Monitor serum electrolytes, blood urea nitrogen (BUN), glucose, and liver function tests regularly, Use with caution in patients with renal insufficiency (may require protein restriction), hepatic failure, or metabolic disorders (e.g., maple syrup urine disease), Potential for infection and thrombophlebitis with central venous access, Do not administer if solution is discolored or contains particulate matter |
| Food/Dietary | None; parenteral nutrition bypasses the gastrointestinal tract. However, monitor blood glucose if patient is on oral hypoglycemics or insulin. |
| Clinical Pearls | This is a hypertonic solution (4.25% amino acids + 25% dextrose) used for peripheral parenteral nutrition; monitor for phlebitis due to high osmolality (>1000 mOsm/L); requires central venous access for long-term use; check serum electrolytes, glucose, and renal function daily; avoid abrupt discontinuation to prevent rebound hypoglycemia; contraindicated in patients with severe hyperglycemia, azotemia, or lipid metabolism disorders. |
| Patient Advice | This solution is given through a vein to provide nutrition when you cannot eat normally. · Report any pain, redness, or swelling at the infusion site immediately. · You may need regular blood tests to monitor your blood sugar, kidney function, and electrolytes. · Do not stop the infusion suddenly without medical advice, as this may cause low blood sugar. · Inform your healthcare provider if you have diabetes, kidney disease, or any allergies. |
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