TRAVASOL 5.5% W/O ELECTROLYTES
Clinical safety rating: caution
Comprehensive clinical and safety monograph for TRAVASOL 5.5% W/O ELECTROLYTES (TRAVASOL 5.5% W/O ELECTROLYTES).
TRAVASOL 5.5% W/O ELECTROLYTES is a crystalline amino acid solution that provides essential and non-essential amino acids for protein synthesis, tissue repair, and nitrogen balance in patients unable to tolerate enteral nutrition. It serves as a substrate for gluconeogenesis and other metabolic processes.
| Metabolism | Amino acids are metabolized primarily in the liver via deamination, transamination, and decarboxylation. Carbon skeletons enter the citric acid cycle or are used for gluconeogenesis. Nitrogen is converted to urea via the urea cycle. |
| Excretion | Primarily renal excretion of amino acids and metabolites; approximately 70-80% of infused amino acids are converted to urea and excreted in urine, with the remainder undergoing metabolism or incorporation into body proteins. Biliary/fecal excretion is negligible. |
| Half-life | Not applicable as a fixed drug; the clearance of infused amino acids follows saturable kinetics with a functional half-life of approximately 30-60 minutes for free amino acids in plasma, reflecting rapid uptake and metabolism. Clinical context: continuous infusion maintains steady-state levels. |
| Protein binding | Minimal to negligible (<5%); amino acids are extensively bound to plasma proteins only in pathological conditions. No specific binding proteins. |
| Volume of Distribution | Approximately 0.3-0.5 L/kg, reflecting distribution into extracellular water and rapid cellular uptake. Clinical meaning: indicates wide distribution into body tissues. |
| Bioavailability | Intravenous: 100% (only route). Oral: not applicable due to formulation. |
| Onset of Action | Intravenous: immediate (within minutes) as amino acids enter the systemic circulation and are available for protein synthesis and metabolic processes. |
| Duration of Action | Duration of infusion is continuous; metabolic effects persist for 2-4 hours after cessation as plasma amino acid levels decline. Clinical note: used for parenteral nutrition support. |
Intravenous infusion, 500 mL to 2000 mL per day as a component of total parenteral nutrition (TPN), providing 5.5% amino acids. Rate should be individualized based on metabolic requirements and tolerance.
| Dosage form | INJECTABLE |
| Renal impairment | In acute kidney injury or chronic kidney disease with GFR < 30 mL/min, reduce total daily amino acid dose to 0.6-0.8 g/kg/day to avoid azotemia. Monitor BUN and creatinine closely. |
| Liver impairment | In hepatic encephalopathy (Child-Pugh class C), avoid or use with extreme caution. For Child-Pugh A or B, provide branched-chain amino acid (BCAA)-enriched formulations; standard TRAVASOL may require dose reduction to 0.5-0.8 g/kg/day. |
| Pediatric use | Infants and children: 2-3 g/kg/day of amino acids via intravenous infusion as part of TPN. Initiate at 1 g/kg/day and increase gradually based on metabolic tolerance. Monitor serum amino acids and ammonia. |
| Geriatric use | Elderly patients may have reduced renal function; use lower initial doses (e.g., 0.8-1.2 g/kg/day), assess fluid and electrolyte balance carefully, and monitor for fluid overload and azotemia. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 5.5% W/O ELECTROLYTES (TRAVASOL 5.5% W/O ELECTROLYTES).
| Breastfeeding | Excretion into breast milk is unknown. Caution is advised due to potential for metabolic effects on the infant. M/P ratio not available. Weigh benefits of breastfeeding against potential risks. |
| Teratogenic Risk | TRAVASOL 5.5% W/O ELECTROLYTES is an amino acid solution used for parenteral nutrition. There are no well-controlled studies in pregnant women. Animal reproduction studies have not been conducted. Use during pregnancy only if clearly needed. Fetal risks are not well defined, but theoretical risks include metabolic disturbances due to improper administration. First trimester: unknown; second and third trimesters: no specific reported teratogenic effects, but monitor maternal and fetal status. |
■ FDA Black Box Warning
None.
| Serious Effects |
["Absolute: Hypersensitivity to any component, inborn errors of amino acid metabolism, severe hepatic failure, severe renal failure without dialysis.","Relative: Metabolic acidosis, hyperammonemia, fluid overload, electrolyte imbalances."]
| Precautions | ["Risk of metabolic acidosis, hyperammonemia, and azotemia, especially in patients with hepatic or renal impairment.","Monitor serum electrolytes, blood urea nitrogen, ammonia, and acid-base balance regularly.","Pulmonary embolism due to pulmonary vascular precipitates if mixed with calcium and phosphate improperly.","Hepatobiliary disorders including cholestasis and steatosis with prolonged use."] |
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| Fetal Monitoring | Monitor maternal serum electrolytes, acid-base balance, blood glucose, liver and renal function, and periodic complete blood counts. Fetal monitoring via ultrasound may be considered if maternal metabolic instability occurs. |
| Fertility Effects | No specific studies on fertility effects. As a nutritional supplement, it may support normal reproductive function in malnourished individuals; no direct adverse effects on fertility are expected. |