TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 15% IN PLASTIC CONTAINER

Clinical safety rating: caution

Comprehensive clinical and safety monograph for TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 15% IN PLASTIC CONTAINER (TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 15% IN PLASTIC CONTAINER).

How it works

TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 15% is a parenteral nutrition solution providing amino acids, dextrose, and electrolytes. The amino acids serve as substrates for protein synthesis; dextrose supplies caloric energy; electrolytes maintain acid-base balance and osmotic equilibrium.

What the body does with it

Metabolism	Amino acids undergo deamination and transamination in the liver; dextrose is metabolized via glycolysis and the Krebs cycle; electrolytes are excreted or reabsorbed by renal mechanisms.
Excretion	Renal: 100% (primarily as free water and electrolytes; dextrose is metabolized; amino acids are deaminated and urea is excreted renally)
Half-life	Not applicable as a single agent; components have varying half-lives: dextrose ~2 h (glucose), amino acids ~1-3 h (plasma clearance), electrolytes proportional to renal function
Protein binding	Negligible for most components; amino acids: <20% (primarily albumin); dextrose: none; electrolytes: variable, e.g., calcium ~50% (albumin), magnesium ~30% (albumin)
Volume of Distribution	Not applicable as a mixture; approximate Vd for dextrose = 0.2 L/kg (extracellular fluid); electrolytes distribute in total body water (~0.6 L/kg for sodium, ~0.5 L/kg for chloride); amino acids Vd ~0.3-0.5 L/kg
Bioavailability	I.V. only: 100%
Onset of Action	I.V. infusion: immediate (within minutes) for electrolyte and fluid effects; dextrose effect on blood glucose within 1-5 minutes
Duration of Action	Dependent on infusion rate and renal function; typically 4-6 h for metabolic effects; electrolyte and fluid effects persist as long as infusion continues

Classification & Brands

Dosing & administration

Intravenous infusion: 1-2 L/day as total parenteral nutrition; typical rate 100-125 mL/hour based on caloric and nitrogen needs.

Dosage form	INJECTABLE
Renal impairment	Contraindicated in severe renal impairment (CrCl <25 mL/min) without CRRT; for CrCl 25-50 mL/min reduce volume by 50% and monitor electrolytes; CrCl >50 mL/min no adjustment.
Liver impairment	Child-Pugh A: no adjustment; Child-Pugh B: reduce amino acid dose by 50% and monitor ammonia; Child-Pugh C: contraindicated due to risk of encephalopathy.
Pediatric use	Starting dose: 0.5-1 g amino acids/kg/day, titrated up to 2-3 g/kg/day based on weight; typical volume 100-150 mL/kg/day for infants; adjust dextrose to maintain euglycemia.
Geriatric use	Start at lower end of dosing range (e.g., 0.5-1 L/day) with slower infusion rate (e.g., 50-75 mL/hour) due to decreased renal clearance; monitor glucose and electrolytes closely.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Breastfeeding	Excretion into breast milk of components is minimal; no specific M/P ratio reported. Considered compatible with breastfeeding if maternal nutritional status is adequate. Monitor infant for metabolic or electrolyte disturbances only if maternal therapy prolonged.
Teratogenic Risk	Amino acids, dextrose, and electrolytes in parenteral nutrition are not directly teratogenic. However, the solution is used for maternal nutritional support; no human data on direct fetal risks. Use only if clearly needed. No known structural teratogenicity; potential for metabolic disturbances if maternal homeostasis not maintained.

Warnings & precautions

■ FDA Black Box Warning

Contains sulfites which may cause allergic-type reactions including anaphylactic symptoms and life-threatening asthmatic episodes in susceptible individuals. Sulfite sensitivity is more common in asthmatics.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Inborn errors of amino acid metabolism (e.g., maple syrup urine disease, phenylketonuria).","Severe electrolyte imbalance or acid-base disorder.","Severe hyperglycemia (>250 mg/dL) not controlled with insulin.","Hypersensitivity to any component (including sulfites).","Uncorrected fluid overload or pulmonary edema."]

Clinical Precautions

Precautions

["Risk of infection from catheter-related sepsis; strict aseptic technique required.","Fluid overload and electrolyte imbalances; monitor serum electrolytes, glucose, and fluid status.","Hyperglycemia may occur; insulin may be needed.","Refeeding syndrome in severely malnourished patients; initiate slowly and monitor phosphate, potassium, magnesium.","Hepatic cholestasis and steatosis with prolonged use; monitor liver function."]

Clinical Tips & Counseling

Drug interactions

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