TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 20% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 20% IN PLASTIC CONTAINER (TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 20% IN PLASTIC CONTAINER).
TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 20% is a combination of amino acids, electrolytes, and dextrose used for parenteral nutrition. Amino acids provide substrates for protein synthesis; electrolytes maintain acid-base balance and cellular function; dextrose provides caloric energy. Sulfite-free formulation reduces risk of allergic reactions.
| Metabolism | Amino acids are metabolized via transamination and deamination pathways; dextrose is metabolized via glycolysis and oxidative phosphorylation; electrolytes are not metabolized but are eliminated via renal excretion. |
| Excretion | Renal excretion of amino acids and dextrose metabolites; virtually 100% renal elimination of infused water and electrolytes. |
| Half-life | Amino acids: 0.5-2 hours; dextrose: 1-2 hours; clinical context: rapid elimination necessitates continuous infusion to maintain nutrient levels. |
| Protein binding | Amino acids: minimal (<10%); dextrose: negligible; no significant binding. |
| Volume of Distribution | Amino acids: 0.3-0.5 L/kg; dextrose: 0.2 L/kg; reflects distribution in total body water. |
| Bioavailability | Intravenous: 100%; not administered via enteral routes. |
| Onset of Action | Intravenous: immediate (within minutes) elevation of plasma amino acid and glucose levels. |
| Duration of Action | Duration: 2-4 hours post-infusion; clinical notes: continuous infusion required for sustained nutritional support. |
| Molecular Weight | Twelve amino acids range from 75 (glycine) to 204 (tryptophan) Da; dextrose 180 Da; electrolytes < 100 Da. |
Intravenous infusion; dose determined by individual protein and caloric requirements, typically 1.5 to 2.5 g/kg/day of amino acids (equivalent to 35-59 mL/kg/day of TRAVASOL 4.25%) for adults.
| Dosage form | INJECTABLE |
| Renal impairment | In patients with GFR <50 mL/min: reduce amino acid dose to 0.6-1.0 g/kg/day; monitor BUN and electrolyte levels; avoid in severe renal impairment unless on renal replacement therapy. |
| Liver impairment | In Child-Pugh B or C: avoid use due to risk of hepatic encephalopathy from amino acid load; use specialized hepatic formulations if necessary. |
| Pediatric use | Dose based on protein and caloric needs: infants and children typically 2.0-3.0 g/kg/day of amino acids (equivalent to 47-71 mL/kg/day of TRAVASOL 4.25%); adjust for age and clinical condition. |
| Geriatric use | No specific dosage adjustment except based on renal and hepatic function; monitor fluid and electrolyte balance closely due to decreased physiological reserve and higher risk of volume overload. |
| 1st trimester | Amino acids and dextrose are generally safe when used for maternal indications; no known teratogenic effects. |
| 2nd trimester | No increased fetal risk reported; use only if clearly needed. |
| 3rd trimester | Use with caution; monitor maternal glucose and electrolytes during labor to avoid neonatal hypoglycemia. |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 20% IN PLASTIC CONTAINER (TRAVASOL 4.25% SULFITE FREE W/ ELECTROLYTES IN DEXTROSE 20% IN PLASTIC CONTAINER).
| Placental transfer | Amino acids and glucose cross placenta via active transport; electrolytes cross via passive diffusion. Extensively transferred. |
| Breastfeeding | Travasol components (amino acids, dextrose, electrolytes) are endogenous substances; dextrose may increase maternal blood glucose but levels in milk are negligible. Clinical monitoring of infant is not required. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | No teratogenic effects reported in humans. Travasol (amino acids) and dextrose are essential nutrients; no fetal risk is anticipated when used appropriately. No specific trimester risks identified. |
| Fetal Monitoring | Monitor maternal electrolytes, glucose, acid-base status, and renal function. Monitor fetal growth if prolonged administration. Ensure proper IV access and infusion rate. |
| Fertility Effects | No known adverse effects on fertility. Amino acids and dextrose are physiological nutrients; reproductive impact not expected. |
■ FDA Black Box Warning
None
| Serious Effects |
Severe electrolyte disorders (e.g., hyperkalemia, hypernatremia)Anuria or oliguria not due to dehydrationHepatic coma or severe hepatic insufficiencyInborn errors of amino acid metabolismFructose or sorbitol intolerance (dextrose is safe but container may contain trace sorbitol)Uncontrolled hyperglycemia or diabetic ketoacidosis
| Precautions | Risk of hyperglycemia, particularly in diabetic patients; monitor blood glucose, Electrolyte imbalances; monitor serum electrolytes regularly, Fluid overload; use with caution in patients with heart failure or renal impairment, Sulfite sensitivity; contraindicated in patients with known sulfite allergy (though labeled as sulfite-free), Infection risk from intravenous catheter, Hepatic steatosis with prolonged use |
| Food/Dietary | No oral food interactions as this is parenteral nutrition. However, if patient is also eating, manage total caloric and electrolyte intake. Avoid grapefruit products (affects CYP450 metabolism of some additives). |
| Clinical Pearls | Contains 4.25% amino acids and 20% dextrose, providing approximately 0.96 kcal/mL. Not for peripheral administration due to high osmolarity (~2000 mOsm/L). Must be administered via central line. Contains no sulfite; safe for sulfite-allergic patients. Electrolytes included; monitor serum electrolyte levels. Do not use if solution is cloudy or precipitate present. |
| Patient Advice | This medication provides nutrition through a central vein. · Report any signs of infection at the catheter site (redness, swelling, pain, fever). · Do not stop the infusion without medical guidance. · Monitor for symptoms of high blood sugar (excessive thirst, frequent urination). · Keep all follow-up appointments for blood tests. |
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