TRAVASOL 8.5% W/ ELECTROLYTES
Clinical safety rating: caution
Comprehensive clinical and safety monograph for TRAVASOL 8.5% W/ ELECTROLYTES (TRAVASOL 8.5% W/ ELECTROLYTES).
Travasol 8.5% with Electrolytes is a parenteral nutrition solution providing amino acids for protein synthesis, electrolytes for maintenance of acid-base balance and osmotic pressure, and calories to prevent protein catabolism and promote anabolism.
| Metabolism | Amino acids are metabolized via transamination, deamination, and incorporation into proteins; electrolytes are not metabolized and are excreted primarily by the kidneys. |
| Excretion | Components are eliminated via metabolic pathways (e.g., amino acids undergo deamination, protein synthesis) and renal excretion of waste products (urea, creatinine). 100% of nitrogenous waste is renally excreted; electrolytes are excreted renally proportional to intake and renal function. |
| Half-life | Variable; amino acids have rapid distribution (minutes) and metabolic elimination (half-life ~1-2 hours for most). Clinical context: continuous infusion maintains steady state; half-life not typically used for dosing but reflects rapid clearance. |
| Protein binding | Amino acids: minimal protein binding (<10%), primarily albumin. Electrolytes: not protein bound (free ions). |
| Volume of Distribution | Amino acids: Vd ~0.2-0.4 L/kg, reflecting distribution primarily to extracellular fluid and tissues. Electrolytes: distributed according to body water compartments (e.g., sodium Vd ~0.2 L/kg, potassium Vd ~0.4 L/kg). |
| Bioavailability | Oral: not applicable (parenteral only). Intravenous: 100%. |
| Onset of Action | Intravenous infusion: immediate increase in plasma amino acid and electrolyte concentrations within minutes. Nutritional support effects (e.g., nitrogen balance) occur over hours to days. |
| Duration of Action | Intravenous infusion: effects persist only during infusion and shortly after. Nutritional benefits (e.g., improved nitrogen balance) require continuous or daily administration over days to weeks. |
Intravenous infusion via central vein: 500 mL to 2000 mL per day, infused at a rate not exceeding 0.2 g/kg/hour of amino acids. Dosing individualized based on caloric and protein requirements.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-59 mL/min: Reduce amino acid dose to 0.6-0.8 g/kg/day. GFR 15-29 mL/min: 0.5 g/kg/day. GFR <15 mL/min: 0.4 g/kg/day; consider supplementation with essential amino acids. Monitor electrolytes closely; adjust potassium, magnesium, and phosphate based on serum levels. |
| Liver impairment | Child-Pugh class A: No adjustment. Child-Pugh class B: Reduce dose by 50% and use branched-chain amino acid enriched solution. Child-Pugh class C: Avoid use or use with extreme caution; restrict amino acids to 0.5-0.6 g/kg/day with high BCAAs. |
| Pediatric use | Neonates and children: Intravenous infusion via central vein: Initial dose 2-2.5 g amino acids/kg/day (24 mL/kg/day of 8.5% solution), titrated to tolerance up to 3.5 g/kg/day depending on age and clinical condition. Infusion rate not to exceed 0.1-0.15 g/kg/hour. Monitor blood glucose, electrolytes, and acid-base balance. |
| Geriatric use | Start at lower end of adult dosing (e.g., 0.8 g/kg/day) and titrate slowly based on renal and hepatic function, fluid status, and metabolic tolerance. Monitor for fluid overload, electrolyte imbalances, and hyperglycemia. Use with caution in patients with cardiac or renal impairment. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for TRAVASOL 8.5% W/ ELECTROLYTES (TRAVASOL 8.5% W/ ELECTROLYTES).
| Breastfeeding | Excreted into breast milk in small amounts; considered safe during lactation. M/P ratio not established. |
| Teratogenic Risk | No evidence of teratogenicity. Amino acid solutions are essential nutrients; no direct fetal risk identified when used as indicated for maternal nutrition. |
| Fetal Monitoring | Monitor maternal electrolytes, acid-base balance, fluid status, and renal function. Fetal growth and well-being assessed if prolonged use. |
■ FDA Black Box Warning
This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.
| Serious Effects |
["Anuria","Severe electrolyte imbalances","Hepatic coma","Inborn errors of amino acid metabolism","Hypersensitivity to any component"]
| Precautions | ["Monitor serum electrolytes, fluid balance, acid-base status, and renal function","Risk of aluminum toxicity, especially in patients with renal impairment and long-term use","Risk of infection from catheter-related complications","Hepatic abnormalities including cholestasis may occur with prolonged use","Monitor for hyperglycemia or hypoglycemia requiring insulin adjustment"] |
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| Fertility Effects | No known adverse effects on fertility. Used to correct malnutrition which may improve fertility. |