TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 10% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 10% IN PLASTIC CONTAINER (TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 10% IN PLASTIC CONTAINER).
This combination product provides parenteral nutrition. Dextrose supplies calories and energy. Electrolytes (sodium, potassium, magnesium, calcium, chloride, acetate) maintain fluid and electrolyte balance. Amino acids provide nitrogen for protein synthesis.
| Metabolism | Dextrose is metabolized via glycolysis and oxidative phosphorylation. Amino acids undergo hepatic metabolism. Electrolytes are excreted renally. |
| Excretion | Renal: >95% as unchanged amino acids, dextrose (metabolized to CO2 and water), and electrolytes. Fecal/biliary: negligible (<1%). |
| Half-life | Not applicable as a single entity; components have independent kinetics: amino acids ~0.5-2 h (endogenous turnover), dextrose ~2 h (glucose), electrolytes follow renal clearance. |
| Protein binding | Minimal (<5%) for amino acids and dextrose; electrolytes largely unbound. |
| Volume of Distribution | 0.2-0.3 L/kg for glucose; amino acids distribute similarly to total body water (0.5-0.7 L/kg); electrolytes vary (e.g., Na+ 0.2-0.4 L/kg). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: immediate upon infusion; provides calories and amino acids as soon as infused. |
| Duration of Action | Intravenous: 4-6 h for metabolic effects (glucose elevation, amino acid provision); clinical effects persist as long as infusion continues. |
| Molecular Weight | Travasol is a mixture; amino acids have MW 75–204 Da, dextrose 180.16 Da, electrolytes as ions. Not a single compound. |
Intravenous infusion: 500 mL to 2 L per day, typically at 42 mL/hour, providing 4.25% amino acids and 10% dextrose for parenteral nutrition.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <50 mL/min: reduce total fluid and electrolyte content; monitor serum electrolytes and avoid excessive phosphate and potassium. GFR <30 mL/min: use with caution; may require specialized renal replacement formula. No specific dose reduction for amino acids, but volume adjustment needed. |
| Liver impairment | Child-Pugh B or C: reduce amino acid content; consider specialized hepatic formulation. Monitor for hyperammonemia. Use with caution due to reduced clearance of amino acids. |
| Pediatric use | Initial dose: 0.5-1 g/kg/day amino acids (11.8-23.5 mL/kg/day of this solution) and 2.5-5 g/kg/day dextrose; increase gradually. Typical infusion rate: 0.1-0.2 mL/kg/hour initially, advancing as tolerated. Monitor for hyperglycemia and electrolyte imbalances. |
| Geriatric use | Start at lower end of adult dose: 500 mL/day; monitor for fluid overload and hyperglycemia. Adjust electrolytes based on renal function. Use with caution due to altered body composition and reduced renal reserve. |
| 1st trimester | Use only if clearly needed. Dextrose and amino acids are essential nutrients; however, electrolyte imbalances may occur. No known teratogenicity. |
| 2nd trimester | Monitor maternal glucose and electrolytes. Safe when administered for appropriate indications. |
| 3rd trimester | Monitor for fluid overload and electrolyte disturbances. Safe when used as required. |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 10% IN PLASTIC CONTAINER (TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 10% IN PLASTIC CONTAINER).
| Placental transfer | Amino acids and dextrose cross the placenta via active transport and facilitated diffusion, respectively. Electrolytes freely cross. No specific data on this formulation, but components are endogenous. |
| Breastfeeding | Travasol is composed of amino acids, dextrose, and electrolytes, which are normal components of breast milk. Excretion into milk is minimal and not expected to cause adverse effects in the infant. Use with caution if the mother requires parenteral nutrition. |
| Lactation Rating | L2 - Safer |
| Teratogenic Risk | TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 10% is a parenteral nutrition solution. Dextrose and amino acids in standard doses are not associated with teratogenicity. However, caution is warranted due to possible electrolyte imbalances and hyperglycemia, which may affect fetal development (e.g., macrosomia, congenital anomalies with poor glycemic control). There are no adequate studies in pregnant women; use only if clearly needed. Trimesters: First trimester - low risk, but hyperglycemia may be teratogenic; second and third trimesters - risk of fetal hyperinsulinemia, hypoglycemia, and electrolyte disturbances. |
| Fetal Monitoring | Monitor maternal blood glucose, serum electrolytes, renal function, and liver function. Monitor fetal growth and well-being via ultrasound and non-stress tests if prolonged use in pregnancy. |
| Fertility Effects | No known adverse effects on fertility. Malnutrition correction may improve fertility in malnourished women. |
■ FDA Black Box Warning
Not for use in patients with known hypersensitivity to any component. Contains sulfites (may cause allergic reactions including anaphylaxis) though labeled 'sulfite-free'? Verify formulation. For sulfite-free formulation, no sulfite warning.
| Serious Effects |
Severe electrolyte disorders uncorrectedSevere fluid overloadAnuria or severe oliguriaInborn errors of amino acid metabolismSevere hyperglycemia or hyperosmolar stateAllergy to any component
| Precautions | Fluid overload, Electrolyte imbalances, Hyperglycemia, Metabolic acidosis, Phlebitis, Infection risk |
| Food/Dietary | No direct food interactions, but parenteral nutrition bypasses the GI tract. Patients should not consume oral food or fluids unless prescribed, as this may cause aspiration or electrolyte imbalances. Dextrose content may affect glycemic control; adjust insulin or oral hypoglycemics accordingly. |
| Clinical Pearls | TRAVASOL 4.25% with electrolytes and dextrose 10% is a hypertonic solution (approx. 900 mOsm/L) for central venous administration only; peripheral infusion risks thrombophlebitis. Contains sulfite-free amino acids, reducing hypersensitivity risk. Monitor serum electrolytes, blood glucose, and fluid balance closely due to dextrose load. Use with caution in renal impairment, hepatic failure, or metabolic acidosis. |
| Patient Advice | This solution is given through a large vein (central line) to provide nutrition. · Report any signs of infection at the catheter site (redness, swelling, pain) or fever. · Monitor blood sugar levels regularly if diabetic; dextrose may cause hyperglycemia. · Do not stop the infusion abruptly without medical advice. · Inform your healthcare provider about all medications and supplements you take. |
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