TRAVASOL 4.25% IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for TRAVASOL 4.25% IN DEXTROSE 5% IN PLASTIC CONTAINER (TRAVASOL 4.25% IN DEXTROSE 5% IN PLASTIC CONTAINER).
Travasol 4.25% in dextrose 5% is a parenteral nutrition solution providing amino acids and carbohydrates. Amino acids serve as substrates for protein synthesis and other metabolic processes, while dextrose provides a source of glucose for energy. The combination supports tissue repair, growth, and maintenance.
| Metabolism | Amino acids undergo deamination, transamination, and catabolism primarily in the liver; dextrose is metabolized via glycolysis and the citric acid cycle throughout the body. |
| Excretion | Travasol 4.25% in dextrose 5% is a parenteral nutrition solution; the amino acids are metabolized and the nitrogen is excreted primarily in urine as urea (≥90%). Dextrose is metabolized to CO2 and water, with minimal biliary or fecal excretion. |
| Half-life | Not applicable as a combined product; amino acids have half-lives of minutes to hours depending on individual amino acid, and dextrose has a half-life of ~15-20 minutes under normal glucose homeostasis. |
| Protein binding | Amino acids: variable (<10% for most), primarily albumin; dextrose: negligible. |
| Volume of Distribution | Amino acids: approximately 0.2-0.4 L/kg (total body water); dextrose: 0.2 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100% (complete bioavailability). |
| Onset of Action | Intravenous: Metabolic effects begin within 15-30 minutes after infusion, with peak plasma amino acid levels reached during infusion. |
| Duration of Action | Duration of nutritional support is continuous while infusion is maintained; metabolic effects persist for 1-2 hours after discontinuation for amino acids and 15-30 minutes for dextrose. |
Intravenous infusion: 500-2000 mL per day as a source of amino acids and calories, adjusted based on metabolic needs and clinical response. Typical adult dose is 1.5-2.0 g/kg/day of amino acids (equivalent to 35-47 mL/kg/day of TRAVASOL 4.25% IN DEXTROSE 5%) administered via central or peripheral line.
| Dosage form | INJECTABLE |
| Renal impairment | In acute kidney injury or chronic kidney disease, restrict protein intake; GFR < 30 mL/min: limit to 0.6-0.8 g/kg/day of amino acids; GFR 30-60 mL/min: 0.8-1.0 g/kg/day; monitor serum electrolytes and fluid status. |
| Liver impairment | Child-Pugh Class A: standard dosing; Class B: reduce protein to 0.5-0.8 g/kg/day; Class C: avoid or use with extreme caution, limit protein to 0.5 g/kg/day and monitor for hepatic encephalopathy. |
| Pediatric use | Intravenous infusion: neonates and children: 2-3 g/kg/day of amino acids (0.5-0.7 mL/kg/min of TRAVASOL 4.25% IN DEXTROSE 5%) titrated to metabolic tolerance; adjust for age, weight, and clinical condition. |
| Geriatric use | Initiate at lower end of adult dosing (1.0-1.2 g/kg/day of amino acids) due to reduced renal function and increased frailty; monitor fluid and electrolyte balance closely. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 4.25% IN DEXTROSE 5% IN PLASTIC CONTAINER (TRAVASOL 4.25% IN DEXTROSE 5% IN PLASTIC CONTAINER).
| Breastfeeding | Excretion into breast milk is minimal due to rapid metabolism; unlikely to affect nursing infant. M/P ratio not established. Compatible with breastfeeding when indicated. |
| Teratogenic Risk | Amino acids and dextrose are endogenous substances; no teratogenicity anticipated at physiologic levels. However, intravenous administration during pregnancy may cause metabolic disturbances (e.g., hyperglycemia, electrolyte imbalances) that could adversely affect the fetus. Use only if clearly needed, with monitoring. |
■ FDA Black Box Warning
None.
| Serious Effects |
["Severe metabolic acidosis","Uncontrolled hyperglycemia","Hepatic coma or severe hepatic impairment","Known hypersensitivity to any component","Galactosemia (due to dextrose content)"]
| Precautions | ["Risk of fluid overload, especially in patients with renal or cardiac impairment","Hyperglycemia or hypoglycemia with abrupt discontinuation","Electrolyte imbalances, acid-base disturbances","Infections from catheter-related complications","Refeeding syndrome in severely malnourished patients"] |
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| Fetal Monitoring | Monitor maternal blood glucose, electrolytes, and fluid balance. Assess fetal heart rate during infusion in high-risk pregnancies. Monitor for signs of fluid overload or hyperosmolarity. |
| Fertility Effects | No known adverse effects on fertility. Intravenous administration of amino acids and dextrose is not associated with reproductive impairment. |