ASHP® Injectable Drug Informationn™

ASHP® Injectable Drug Informationn™

American Society of Health-System Pharmacists, ASHP®

This online database provides fast, well-arranged, and comprehensive Information about compatibility and stability of injectable drugs.

All relevant data on 406 drugs, including coss references to the standard work "AHFS Drug Information".

Detailed answers to frequently asked questions concerning manufacturing, storing, and application of injectible drugs.
Cumulative knowledge of 3,603 resources.

The databases Pediatric Injectable Drugs and Extended Stability for Parenteral Drugs for ASHP Injectable Drugs Information are not included in the offer.

Updates

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ASHP® Injectable Drug Informationn™

Manual

Userguide

How to Use ASHP® Injectable Drug Information™

• What Is ASHP® Injectable Drug Information™ ?

The ASHP® Injectable Drug Information™ is a collection of summaries of information from the published literature on the pharmaceutics of parenteral medications as applied to the clinical setting. ASHP® Injectable Drug Information™ is constructed from information derived from 3603 references with the information presented in the standardized structure described below. The purpose of this reference text is to facilitate the use of this clinical pharmaceutics research by knowledgeable health care professionals for the benefit of patients. The summary information from published research is supplemented with information from the labeling of each product and from other references.

The information base summarized in ASHP® Injectable Drug Information™ is large and highly complex, requiring thoughtful consideration for proper use. This reference text is not, nor should it be considered, elementary in nature or a primer. A single quick glance in a table is not adequate for proper interpretation of this highly complex information base. Proper interpretation includes the obvious need to consider and evaluate all relevant research information and results. Additionally, information on the formulation components (e.g., excipients), product attributes (especially pH), and the known stability behaviors of each parenteral drug, as well as the clinical situation of the patient, must be included in a thoughtful, reasoned evaluation of clinical pharmaceutics questions. Stability and sterility both must be considered in the assignment of beyond-use dates.

• Who Should Use ASHP® Injectable Drug Information™?

ASHP® Injectable Drug Information™ is designed for use as a professional reference and guide to the literature on the clinical pharmaceutics of parenteral medications. The intended audience consists of knowledgeable healthcare professionals, particularly pharmacists, who are well versed in the formulation and clinical use of parenteral medications and who have the highly specialized knowledge base, training, and skill set necessary to interpret and apply the information. Practitioners who are not well versed in the formulation, essential properties, and clinical application of parenteral drugs should seek the assistance of more knowledgeable and experienced healthcare professionals to ensure patient safety.

Users of ASHP® Injectable Drug Information™ must recognize that no reference work, including this one, can substitute for adequate decision-making by healthcare professionals. Proper clinical decisions must be made after considering all aspects of the patient’s condition and needs, with particular attention to the special demands imposed by parenteral medications. ASHP® Injectable Drug Information™ cannot make decisions for its users. However, in knowledgeable hands, it is a valuable tool for the proper use of parenteral medications.

• Organization of ASHP® Injectable Drug Information™

ASHP® Injectable Drug Information™ has been organized as a collection of monographs on each of the drugs. The monographs are arranged alphabetically by nonproprietary (generic) name. The nonproprietary names of the drugs are the United States Adopted Names (USAN) and other official names for drugs as described in the USP Dictionary of USAN and International Drug Names. Also included are some of the trade (proprietary, brand) names and manufacturers of the drug products; this listing is not necessarily comprehensive and should not be considered an endorsement of any product or manufacturer.

All of the information included in ASHP® Injectable Drug Information™ is referenced so that those who wish to study the original sources may find them. Efforts are ongoing to provide increased specificity of references to product labeling as individually cited references to the labeling for a drug product, including the proprietary name (if available), manufacturer, and revision date of the prescribing information; this will facilitate location of specific labeling that has been used as a reference. In addition, the full list of the AHFS® Pharmacologic-Therapeutic Classification© system and specific classification numbers within each individual monograph have been included to facilitate the location of therapeutic information on the drugs.

The monographs have been divided into the subheadings described below:

Products—lists many of the sizes, strengths, volumes, and forms in which the drug is supplied, along with other components of the formulation. Instructions for reconstitution (when applicable) are included in this section.

The products described do not necessarily comprise a comprehensive list of all available products. Rather, some common representative products are described. Furthermore, dosage forms, sizes, and container configurations of parenteral products may undergo important changes during the lifespan of this edition of ASHP® Injectable Drug Information™.

Following the product descriptions, the pH of the drug products, the osmotic value(s) of the drug and/or dilutions (when available), and other product information such as the sodium content and definition of units are presented.

Practitioners have not always recognized the value and importance of incorporating product formulation information into the thought process that leads to their decision on handling drug compatibility and stability questions. Excipients used in the formulation of commercially available products may vary among manufacturers and can influence drug compatibility and stability; specific product labeling should be consulted for additional formulation details. Consideration of the product information and formulation components, as well as the properties and attributes of the products (especially pH), is essential to proper interpretation of the information presented in ASHP® Injectable Drug Information™.

Administration—includes route(s) by which the drug can be given, rates of administration (when applicable), and other related administration details.

The administration information is a condensation derived principally from product labeling. For complete information, including dosage information sufficient for prescribing, the reader should refer to product labeling and therapeutically comprehensive references, such as the AHFS® Drug Information®.

Stability—describes the drug’s stability and storage requirements. The storage condition terminology of The United States Pharmacopeia, 42nd ed., is used in ASHP® Injectable Drug Information™.

The United States Pharmacopeia defines controlled room temperature as a temperature that encompasses the usual and customary working environment of 20–25°C and that results in a mean kinetic temperature no greater than 25°C.17 Temperature excursions between 15–30°C that are experienced in pharmacies, hospitals, warehouses, and during shipping are permitted.17 Transient temperature elevations up to 40°C also are permitted provided that they do not persist beyond 24 hours and that the mean kinetic temperature does not exceed 25°C.17 In contrast, room (ambient) temperature is defined simply as a temperature prevailing in a working environment.17

Protection from excessive heat is often required; excessive heat is defined as any temperature above 40°C.17 Similarly, protection from freezing may be required for products that are subject to loss of strength or potency or to destructive alteration of their characteristics, in addition to the risk of container breakage, upon exposure to freezing temperatures.17

Some products may require storage at a cool temperature, which is defined as any temperature between 8–15°C, or a cold temperature, which is defined as any temperature not exceeding 8°C.17 A refrigerator is defined as a cold place in which the temperature is controlled between 2–8°C.17 A freezer refers to a place in which the temperature is controlled between -25 and -10°C.17 Some products may have a recommended storage condition below -20°C, and in such cases, the temperature should be controlled to within 10°C of -20°C.17

In addition to storage requirements, aspects of drug stability related to pH, freezing, and exposure to light are presented in this section. Also presented is information on repackaging of the drugs or their dilutions in container/closure systems other than the original package (e.g., prefilling into syringes or in ambulatory pump reservoirs). Sorption and filtration characteristics of the drugs are provided as well when this information is available. The information is derived principally from the primary published research literature and is supplemented with information from other sources when available.

Compatibility Information—tabulates the compatibility results of the drug about which the monograph is written with infusion solutions and other drugs based on published reports from the primary research as well as the product labeling. The various entries are listed alphabetically by solution or drug name; the information is completely cross-referenced among the monographs.

Four types of tables are utilized to present the available information, depending on the kind of test being reported. The first type is for information on the compatibility of a drug in various infusion solutions and is depicted in Table 1. The second type of table presents information on two or more drugs in intravenous solutions and is shown in Table 2. The third type of table is used for tests of two or more drugs in syringes and is shown in Table 3. The fourth table format is used for reports of simulated or actual injection into Y-sites and manifolds of administration sets and is shown in Table 4.

Many published articles, especially older ones, do not include all of the information necessary to complete the tables. However, the tables have been completed as fully as possible from the original articles; in some cases, editorial staff have supplemented the published information based on direct communication with the authors of the published research.

Table 1. Solution Compatibility
Monograph drug name
Solution Mfr Mfr Conc/L or % Remarks Ref C/I
(1) (2) (3) (4) (5) (6) (7)
  1. Solution in which the test was conducted.
  2. Manufacturer of the solution.
  3. Manufacturer of the drug about which the monograph is written.
  4. Concentration of the drug about which the monograph is written. (See The Listing of Concentration.)
  5. Description of the results of the test.
  6. Reference to the original source of the information.
  7. Designation of the compatibility (C) or incompatibility (I) of the test result according to conventional guidelines.

 

Table 2. Additive Compatibility

Monograph drug name
Drug Mfr Conc/L or % Mfr Conc/L or % Test Soln Remarks Refs C/I
(1) (2) (3) (4) (5) (6) (7) (8) (9)
  1. Monograph title for the test drug.
  2. Manufacturer of the test drug.
  3. Concentration of the test drug.
  4. Manufacturer of the drug about which the monograph is written.
  5. Concentration of the drug about which the monograph is written. (See The Listing of Concentration.)
  6. Infusion solution in which the test was conducted.
  7. Description of the results of the test.
  8. Reference to the original source of the information.
  9. Designation of the compatibility (C) or incompatibility (I) of the test result according to conventional guidelines.

 

Table 3. Drugs in Syringe Compatibility

Monograph drug name
Drug (in syringe) Mfr Amt Mfr Amt Remarks Ref C/I
(1) (2) (3) (4) (5) (6) (7) (8)
  1. Monograph title for the test drug.
  2. Manufacturer of the test drug.
  3. Actual amount of the test drug.
  4. Manufacturer of the drug about which the monograph is written.
  5. Actual amount of the drug about which the monograph is written.
  6. Description of the results of the test.
  7. Reference to the original source of the information.
  8. Designation of the compatibility (C) or incompatibility (I) of the test result according to conventional guidelines.

 

Table 4. Y-Site Injection Compatibility (1:1 Mixture)

Monograph drug name
Drug Mfr Conc Mfr Conc Remarks Ref C/I
(1) (2) (3) (4) (5) (6) (7) (8)
  1. Monograph title for the test drug
  2. Manufacturer of the test drug.
  3. Concentration of the test drug prior to mixing at the Y-site.
  4. Manufacturer of the drug about which the monograph is written.
  5. Concentration of the drug about which the monograph is written prior to mixing at the Y-site.
  6. Description of the results of the test.
  7. Reference to the original source of the information.
  8. Designation of the compatibility (C) or incompatibility (I) of the test result according to conventional guidelines.

Additional Compatibility Information—provides additional information and discussions of compatibility presented largely in narrative form.

Other Information—contains any relevant auxiliary information concerning the drug that does not fall into the previous categories.

• The Listing of Concentration

The concentrations of all admixtures in intravenous solutions in the tables (Table 1 and Table 2) generally have been indicated in terms of concentration per liter (L) to facilitate comparison of the various studies. In some cases, this may result in amounts of the drug that are greater or lesser than those normally administered (as when the recommended dose is tested in 100 mL of vehicle), but the listings do accurately reflect the actual concentrations tested, expressed in standardized terms. Concentration may be expressed as a percentage for certain drugs or solutions (e.g., dextran, hetastarch, mannitol, fat emulsion) to reflect the style commonly used to express concentration for these products.

For studies involving syringes, the amounts actually used are indicated. The volumes are also listed if available.

For studies of actual or simulated Y-site injection of drugs, the concentrations are cited in terms of concentration per mL of each drug solution prior to mixing at the Y-site. Most published research reports have presented the drug concentrations in this manner, and ASHP® Injectable Drug Information™ follows this convention. For those few published reports that presented the drug concentrations after mixing at the Y-site, the concentrations have been recalculated to be consistent with the more common presentation style to maintain the consistency of presentation in ASHP® Injectable Drug Information™. Note that the Y-Site Injection Compatibility table is designed with the assumption of a 1:1 mixture of the subject drug and infusion solution or admixture. For citations reporting other than a 1:1 mixture, the actual amounts tested are specifically noted.

• Designating Compatibility or Incompatibility

Each summary of a published research report appearing in the Compatibility Information tables bears a compatibility indicator (CI, or ?). A report receives a designation of C when the study results indicate that compatibility of the test samples existed under the test conditions. If the study determined an incompatibility existed under the test conditions, then an I designation is assigned for the ASHP® Injectable Drug Information™ entry for that study result. A designation of ? indicates that the test result does not clearly fit either the compatibility or incompatibility definition. Specific standardized guidelines are used to assign these compatibility designations and are described below. The citation is designated as a report of compatibility when results of the original article indicated one or more of the following criteria were met:

  1. Physical or visual compatibility of the combination was reported (no visible or electronically detected indication of particulate formation, haze, precipitation, color change, or gas evolution).
  2. Stability of the components for at least 24 hours in an admixture under the specified conditions was reported (decomposition of 10% or less).
  3. Stability of the components for the entire test period, although in some cases it was less than 24 hours, was reported (time periods less than 24 hours have been noted).

 

The citation is designated as a report of incompatibility when the results of the original article indicated either or both of the following criteria were met:

  1. A physical or visual incompatibility was reported (visible or electronically detected particulate formation, haze, precipitation, color change, or gas evolution).
  2. Greater than 10% decomposition of one or more components in 24 hours or less under the specified conditions was reported (time periods of less than 24 hours have been noted in the table).

 

Reports of test results that do not clearly fit into the compatibility or incompatibility definitions cannot be designated as either. These are indicated with a question mark.

Although these criteria have become the conventional definitions of compatibility and incompatibility, the reader should recognize that the criteria may need to be tempered with professional judgment. Inflexible adherence to the compatibility designations should be avoided. Instead, they should be used as aids in the exercising of professional judgment.

Therapeutic incompatibilities or other drug interactions are not within the scope of ASHP® Injectable Drug Information™ and are therefore not addressed. Therapeutically comprehensive references and the product labeling should be consulted for such information.

• Interpreting Compatibility Information in ASHP® Injectable Drug Information™

As mentioned above, the body of information summarized in ASHP® Injectable Drug Information™ is large and complicated. With the possible exception of a report of immediate gross precipitation, it usually takes some degree of thoughtful consideration and judgment to properly evaluate and appropriately act on the research results that are summarized in this book.

Nowhere is the need for judgment more obvious than when apparently contradictory information appears in two or more published reports. The body of literature in drug-drug and drug-solution compatibility is replete with apparently contradictory results. Except for study results that have been documented later to be incorrect, the conflicting information has been included in ASHP® Injectable Drug Information™ to provide practitioners with all of the information for their consideration. The conflicting information will be readily apparent to the reader because of the content of the Remarks section as well as the CI, and ? designations following each citation.

Many or most of the apparently conflicting citations may be the result of differing conditions or materials used in the studies. A variety of factors that can influence the compatibility and stability of drugs must be considered in evaluating such conflicting results, and absolute statements are often difficult or impossible to make. Differences in concentrations, buffering systems, preservatives, vehicles, temperatures, and order of mixing all may play a role. By reviewing a variety of reports, the user of ASHP® Injectable Drug Information™ is better able to exercise professional judgment with regard to compatibility and stability.

The reader must guard against misinterpretation of research results, which may lead to inappropriate assumptions of compatibility and stability. As an example, a finding of precipitate formation two hours after two drugs are mixed does not imply nor should it be interpreted to mean that the combination is compatible until that time point, when a sudden precipitation occurs. Rather, it should be interpreted to mean that precipitation occurred at some point between mixing and the first observation point at two hours. Such a result would lead to a designation of incompatibility in ASHP® Injectable Drug Information™.

Precipitation reports can be particularly troublesome for practitioners to deal with because of the variability of the time frames in which they may occur. Apart from combinations that repeatedly result in immediate precipitation, the formation of a precipitate can be unpredictable to some degree. Numerous examples of variable precipitation time frames can be found in the literature, including paclitaxel, etoposide, and sulfamethoxazole-trimethoprim (co-trimoxazole) in infusion solutions and calcium and phosphates precipitation in parenteral nutrition mixtures (e.g., TNAs, TPNs). Differing drug concentrations also can play a role in creating variability in results. A good example of this occurs with co-administered vancomycin hydrochloride and beta-lactam antibiotics. Users of the information in ASHP® Injectable Drug Information™ must always be aware that a marginally incompatible combination might exhibit precipitation earlier or later than that reported in the literature. In many such cases, the precipitation is ultimately going to occur, it is just the timing that is in question. This is of particular importance for precipitate formation because of the potential for serious adverse clinical consequences, including death, that have occurred. Certainly, users of ASHP® Injectable Drug Information™ information should always keep in mind and anticipate the possibility of precipitation and its clinical ramifications. Furthermore, all injections and infusions should be inspected for particulate matter and discoloration prior to administration. If found, such injections and solutions should be discarded.

In addition, many research reports cite test solutions or concentrations that may not be appropriate for clinical use. An example would be a report of a drug’s stability in unsterile water. Although the ASHP® Injectable Drug Information™ summary will accurately reflect the test solutions and conditions that existed in a study, it is certainly inappropriate to misinterpret a stability report like this as being an authorization to use the product clinically. In such cases, the researchers may have used the clinically inappropriate diluent to evaluate the drug’s stability for extrapolation to a more suitable vehicle that is similar, or they may not have recognized that the diluent is clinically unsuitable. In either event, it is incumbent on the practitioner in the clinical setting to use professional judgment to apply the information in an appropriate manner and recognize what is not acceptable clinically.

Further, it should be noted that many of the citations designated incompatible are not absolute. While a particular admixture may incur more than 10% decomposition within 24 hours, the combination may be useful for a shorter time period. The concept of “utility time” or the time to 10% decomposition may be useful in these cases. Unfortunately, such information is often not available. Included in the Remarks columns of the tables are the amount of decomposition, the time period involved, and the temperature at which the study was conducted when this information is available.

Users of ASHP® Injectable Drug Information™ information should always keep in mind that the information contained in this reference text must be used as a tool and a guide to the research that has been conducted and published. It is not a replacement for thoughtfully considered professional judgment. It falls to the practitioner to interpret the information in light of the clinical situation, including the patient’s needs and status. What is certain is that relying solely on the C or I designation without the application of professional judgment is inappropriate.

• Limitations of the Literature

In addition to conflicting information, many of the published articles have provided only partial evaluations, not looking at all aspects of a drug’s stability and compatibility. This is not surprising considering the complexity, difficulty, and costs of conducting such research. There are, in fact, articles that do provide evaluations of both physical stability/compatibility and chemical stability. But some are devoted only to physical issues, while others examine only chemical stability. Although a finding of precipitation, haze, or other physical effects may constitute an incompatibility (unless transient), the lack of such changes does not rule out chemical deterioration. In some cases, drugs initially designated as compatible because of a lack of visual change were later shown to undergo chemical decomposition. Similarly, the determination of chemical stability does not rule out the presence of unacceptable levels of particulates and/or turbidity in the combination. In a classic case, the drugs leucovorin calcium and fluorouracil were determined to be chemically stable for extended periods by stability-indicating HPLC assays in several studies, but years later, repeated episodes of filter clogging led to the discovery of unacceptable quantities of particulates in combinations of these drugs. The reader must always bear in mind these possibilities when only partial information is available.

And, finally, contemporary practitioners have come to expect that the analytical methods used in reports on the chemical stability of drugs will be validated, stability-indicating methods. However, many early studies used methods that were not demonstrated to be stability indicating.

Biological drugs (therapeutic proteins [e.g., enzymes, monoclonal antibodies, immune globulins]) are particularly sensitive to environmental factors and undergo more complex and numerous degradation pathways than classical drugs.3207 3208 3212 In addition to physicochemical instability issues similar to those observed with classical drugs (e.g., precipitation, decomposition), such proteins are subject to other stability issues (e.g., protein conformation, biologic activity) that must be considered.3207 3208 3209 3212 Therefore, a single analytic method that only assesses protein concentration is insufficient to determine stability of biological products.3209 3210 Interpretation of the results of compatibility and stability studies of such proteins poses a challenge because both analytic methods and meaningful acceptance criteria should be specific to the biologic; official compendial standards (e.g., The United States Pharmacopeia monographs and analytic methods) should be consulted when available.3206 3209 3212 Although many experts agree that multiple complementary methods should be used to assess the physical and chemical stability as well as assessment of biologic activity, no clear guideline or recommendation for in-use stability studies for therapeutic proteins is available.3208 3210 3211 3212

• Literature Search for Updating ASHP® Injectable Drug Information™

To gather the bulk of the published compatibility and stability information for updating ASHP® Injectable Drug Information™, a literature search is performed using the International Pharmaceutical Abstracts (IPA) database and PubMed. By using key terms (e.g., stability), a listing of candidate articles for inclusion in ASHP® Injectable Drug Information™ is generated. From this list, relevant articles are critically evaluated and prioritized for inclusion. As a supplement to this automated literature searching, a manual search of the references of the articles is also conducted, and any articles not included previously are similarly evaluated for inclusion. In addition, pharmaceutical manufacturers may be contacted for additional in-house (unpublished) data.

• Abbreviations

AA Amino acids (percentage specified)
D Dextrose solution (percentage unspecified)
D5LR Dextrose 5% in Ringer’s injection, lactated
D5R Dextrose 5% in Ringer’s injection
D-S Dextrose-saline combinations
D2.5½S Dextrose 2.5% in sodium chloride 0.45%
D2.5S Dextrose 2.5% in sodium chloride 0.9%
D5¼S Dextrose 5% in sodium chloride 0.225%
D5½S Dextrose 5% in sodium chloride 0.45%
D5S Dextrose 5% in sodium chloride 0.9%
D10S Dextrose 10% in sodium chloride 0.9%
D5W Dextrose 5%
D10W Dextrose 10%
IM Isolyte M
IP Isolyte P
IS10 Invert sugar 10%
I.U.a International unit(s)
LR Ringer’s injection, lactated
NM Normosol M
NR Normosol R
NRD5W Normosol R in dextrose 5%
NS Sodium chloride 0.9%
R Ringer’s injections
REF Refrigeration
RT Room temperature
S Saline solution (percentage unspecified)
½S Sodium chloride 0.45%
SL Sodium lactate 1/6 M
TNA Total nutrient admixture (3-in-1)
TPN Total parenteral nutrition (2-in-1)
W Sterile water for injection

a It is well accepted that “IU” is not a preferred abbreviation for international units. There is some difference of opinion among medication safety stakeholders on whether such units should be referred to simply as “units” or as “International Units.” Throughout the text of this reference, we generally have used the term international units to describe such units; however, because of space limitations within the columns of the Compatibility Information tables, the term international units has been abbreviated as I.U. where necessary.

• Manufacturer and Compendium Abbreviations

AB Abbott
ABV AbbVie
ABX Abraxis
ACA Acacia
ACC American Critical Care
ACD Accord Healthcare
ACH Achaogen
ACT Actavis
AD Adria
AFT AFT
AGT Aguettant
AH Allen & Hanburys
AHP Ascot Hospital Pharmaceuticals
AKN Akorn
ALL Allergan
ALP Alpharma
ALT Altana Pharma
ALV Alveda Pharma
ALZ Alza
AM ASTA Medica
AMA AMAG
AMB Amneal Biosciences
AMD Amdipharm
AMG Amgen
AMP Amphastar
AMR American Regent
AMS Amerisource
AND Andromaco
ANT Antigen
AP Asta-Pharma
APC Apothecon
APN Aspen
APO Apotex
APP American Pharmaceutical Partners
APR Aspri
APT Aspen Triton
AQ American Quinine
AR Armour
ARC American Red Cross
ARD Ardeapharm
ARR Arrow
AS Arnar-Stone
ASC Ascot
ASP Astellas Pharma
AST Astra
ASZ AstraZeneca
AT Alpha Therapeutic
ATX Athenex
AUB Aurobindo
AUR Auromedics
AVD Avadel Legacy Pharmaceuticals
AVE Aventis
AVG Alvogen
AW Asta Werke
AY Ayerst
AZV Laboratórios Azevedos
BA Baxter
BB B & B Pharmaceuticals
BAN Banyu Pharmaceuticals
BAY Bayer
BC Bencard
BCT BioCryst Pharmaceuticals
BD Becton Dickinson
BE Beecham
BED Bedford
BEH Behring
BEL R. Bellon
BFM Bieffe Medital
BI Boehringer Ingelheim
BIO Bioniche Pharma
BK Berk
BKN Baker Norton
BM Boehringer Mannheim
BMS Bristol-Myers Squibb
BN Breon
BP British Pharmacopoeiaa
BPC British Pharmaceutical Codexa
BPI BPI Labs
BR Bristol
BRD Bracco Diagnostics
BRK Breckenridge
BRN B. Braun
BRT Britianna
BT Boots
BTK Biotika
BV Ben Venue
BW Burroughs Wellcome
BX Berlex
BXT Baxalta
CA Calmic
CAD Cadence Pharmaceuticals
CAR Cardinal Health
CBH CSL Behring
CDM CDM Lavoisier
CE Carlo Erba
CEL Celgene
CEN Centocor
CER Cerenex
CET Cetus
CH Lab. Choay Societe Anonyme
CHI Chiron
CHS Chiesi
CHU Chugai
CI Ciba
CIP Cipla
CIS CIS US
CL Clintec
CLA Claris Lifesciences
CLN Clinigen
CMB Cumberland
CMP CMP Pharma
CN Connaught
CNF Centrafarm
CO Cole
COM CommScope
COR COR Therapeutics
COV Covis
CP Continental Pharma
CPP CP Pharmaceuticals
CPR Cooper
CR Critikon
CRC Caraco
CSL CSL Ltd.
CTI Cell Therapeutics Inc.
CU Cutter
CUB Cubist
CUP Cura Pharmaceuticals
CUR Curomed
CY Cyanamid
DAK Dakota
DB David Bull Laboratories
DCC Dupont Critical Care
DGL Douglas
DI Dista
DIA Diamant
DM Dome
DME Dupont Merck Pharma
DMX Dumex
DRA Dr. Rentschler Arzneimittel
DRT Durata Therapeutics
DRX Draxis
DU DuPont
DUR Dura
DW Delta West
EA Eaton
EBE Ebewe
ECL Éclat
EGL Eagle
EI Eisai
ELN Elan
EN Endo
ENZ Enzon
ERF Erfa
ERM Erempharma
ES Elkins-Sinn
ESL ESI Lederle
ESP ESP Pharma
EST Esteve
EV Evans
EX Essex
EXL Exela
FA Farmitalia
FAC Facta Farmaceutical
FAN Fandre Laboratories
FAU Faulding
FC Frosst & Cie
FED Federa
FER Ferring
FI Fisons
FOR Forest Laboratories
FP Faro Pharma
FRE Fresenius
FRK Fresenius Kabi
FUJ Fujisawa
GEI Geistich Pharma
GEM Geneva-Marsam
GEN Genentech
GG Geigy
GH Generic Health
GIL Gilead
GIU Giulini
GL Glaxo
GLT Generics Limited
GNS Gensia-Sicor
GO Goedecke
GRI Grifols
GRP Gruppo
GRU Grunenthal
GSK GlaxoSmithKline
GVA Geneva
GW Glaxo Wellcome
GZ Genzyme
HAE Haemonetics
HB Hoechst-Biotika
HC Hillcross
HE Hengrui Medicine Co.
HEL Helsinn
HER Heritage
HIK Hikma
HMR Hoechst Marion Roussel
HO Hoechst-Roussel
HOS Hospira
HQS HQ Specialty Pharma
HR Horner
HRN Heron
HY Hyland
ICI ICI Pharmaceuticals
ICN ICN Pharmaceuticals
IMM Immunex
IMS IMS Ltd.
IN Intra
INT Intermune
IV Ives
IVX Ivex
IX Invenex
JAZ Jazz
JC Janssen-Cilag
JHP JHP Pharmaceuticals
JJ Johnson & Johnson
JN Janssen
JP Jones Pharma
KA Kabi
KED Kedrion
KEY Key Pharmaceuticals
KN Knoll
KP Kabi Pharmacia
KV Kabi-Vitrum
KY Kyowa
LA Lagap
LE Lederle
LEM Lemmon
LEO Leo Laboratories
LFB Laboratoire Français du Fractionnement et des Biotechnologies
LI Lilly
LIF Lifeshield
LJ La Jolla
LME Laboratoire Meram
LUN Lundbeck
LY Lyphomed
LZ Labaz Laboratories
MA Mallinckrodt
MAC Maco Pharma
MAR Marsam
MAY Mayne Pharma
MB May & Baker
MCD Merck Chibret Dohme
MDI Medimmune
MDX Medex
MDZ Medicianz
ME Merck
MEL Melinta Therapeutics
MER Merus Labs
MG McGaw
MGI MGI Pharma
MI Miles
MIL Millimed
MJ Mead Johnson
MM Merrimack
MMD Marion Merrell Dow
MMT Meridian Medical Technologies
MN McNeil
MON Monarch
MRD Merrell-Dow
MRN Merrell-National
MSD Merck Sharp & Dohme
MTN Marathon
MUN Mundi Pharma
MY Maney
MYL Mylan
MYR Mayrhofer Pharmazeutika
NA National
NAB Nabi
NAP NAPP Pharmaceuticals
NCI National Cancer Institute
NE Norwich-Eaton
NIN Ningbo Team
NF National Formularya
NO Nordic
NOP Novopharm
NOV Novo Pharm
NVA Novartis
NVN Novo Nordisk
NVP Nova Plus
NVX Novex Pharma
NYC Nycomed
OCT Octapharma
OHM Ohmeda
OM Omega
OMJ OMJ Pharmaceuticals
OMN Ortho-McNeil
ON Orion
OR Organon
ORC Orchid
ORP Orphan Medical
ORT Ortho
OTS Otsuka
OVA Ovation
PAD Paddock
PAL Paladin
PAN Panpharma Laboratory
PAR Par
PB Pohl-Boskamp
PD Parke-Davis
PE Pentagone
PF Pfizer
PFM Pfrimmer
PH Pharmacia
PHC Pharmachemie
PHM Pharmacosmos
PHS Pharmascience
PHT Pharma-Tek
PHU Pharmacia & Upjohn
PHX Phoenix
PNN Pantheon
PNT Parenta
PO Poulenc
PP Pharmaceutical Partners
PPC Pharmaceutical Partners of Canada
PPR Premier Pro Rx
PR Pasadena Research
PRF Pierre Fabre
PRK Parkfields
PRM Premier
PRP Premier Pro
PTK Paratek
PX Pharmax
QI Qilu
QLM Qualimed Labs
QU Quad
RB Robins
RBP Ribosepharm
RC Roche
REG Regeneron
REN Renaudin
RI Riker
RKB Reckitt & Benckhiser
RKC Reckitt & Colman
ROR Rorer
ROX Roxane
RP Rhone-Poulenc
RPR Rhone-Poulenc Rorer
RR Roerig
RS Roussel
RU Rugby
SA Sankyo
SAA Sanofi Aventis
SAG Sageant
SAN Sanofi
SB Sintetica Bioren
SC Schering
SCI Scios
SCN Schein
SCS SCS Pharmaceuticals
SE Searle
SEQ Sequus
SER Servier
SGS SangStat
SGT Sagent
SHI Shionogi
SIA Siam Pharmaceutical
SIC Sicor
SIG Sigma Tau
SKB SmithKline Beecham
SKF Smith Kline & French
SM Smith
SMX SteriMax
SN Smith + Nephew
SO SoloPak
SP Spectrum Pharmaceuticals
SQ Squibb
SRB Serb
SS Sanofi-Synthelabo
ST Sterilab
STP Sterop
STR Sterling
STS Steris
STU Stuart
SUN Sun
SV Savage
SW Sanofi Winthrop
SX Sabex
SY Syntex
SYN Synergen
SYO Synthelabo
SZ Sandoz
TAK Takeda
TAL Talon Therapeutics
TAP TAP Holdings
TAR Targanta Therapeutics
TAY Taylor
TE Teva
TEC Teclapharm
TEL Teligent
TES Tesaro
TET Tetraphase
TL Tillotts
TMC The Medicines Company
TO Torigian
TR Travenol
TRE Trevena
UCB UCB
UP Upjohn
USB US Bioscience
USP United States Pharmacopeiaa
USV USV Pharmaceuticals
UT United Therapeutics
VHA VHA Plus
VI Vitarine
VIC Vicuron Pharmaceuticals
VT Vitrum
WAS Wasserman
WAT Watson
WAY Wyeth-Ayerst
WB Winthrop-Breon
WC Warner-Chilcott
WED Weddel
WEL Wellcome
WI Winthrop
WG WG Critical Care
WL Warner Lambert
WOC Wockhardt
WW Westward
WY Wyeth
XGN X-Gen
XU Xudong Pharmaceutical Co.
YAM Yamanouchi
ZEN Zeneca
ZLB ZLB Biopharma
ZNS Zeneus Pharma
ZY ZyGenerics
ZYD Zydus

a While reference to a compendium does not indicate the specific manufacturer of a product, it does help to indicate the formulation that was used in the test.

 

ASHP® Injectable Drug Information. © Copyright, 1977-2021. American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
Original Publication Date: October 1, 1977.
Selected Revisions: December 23, 2020.
Database Extraction: 02/10/2021 18:22:15 -0500+

 

 

References

For a list of references cited in the text of this monograph, search the monograph titled References.

Supplementary information

Appendix I

The following tables summarize the composition of the total parenteral nutrition mixtures that are referenced throughout the Handbook on Injectable Drugs. Each unique formula that has been tested for stability and/or compatibility characteristics, alone or in combination with other drugs, is described and assigned a code number. These code numbers are used in the drug monographs to denote the TNA (3-in-1) or TPN (2-in-1) formulation being discussed (i.e., TPN #183, TPN #184, etc.). The TNA and TPN formulations are described as completely as possible from the original published sources.

The consolidation of the formulations into a single appendix is designed to avoid unnecessary repetition and to facilitate comparisons among different mixtures.

  Concentration per Liter
Component Mfr #21 #22 #23 #24
Amino acids MG 200 mL      
Amino acids 8.5% with electrolytes TR   500 mL 500 mL 500 mL
Dextrose 50%   400 mL   500 mL 500 mL
Dextrose 33.3% in water     500 mL    
Phosphate   15 mEqa 30 mEq   30 mEqa
Acetate   15 mEqa 67.5 mEq    
Calcium gluconate   2 g 9 mEq 1 g  
Calcium chloride     7.2 mEq    
Potassium chloride     70 mEq   20 mEq
Sodium chloride   40 mEq 55 mEq   60 mEq
Magnesium sulfate   8.1 mEq      
Multivitamins   10 mL      
Multivitamin concentrate       5 mL  
Water for injection   qs 1000 mL      
Trace elements     present    


a Potassium salt.

  Concentration per Liter
Component Mfr #25 #26 #27 #28 #29 #30
Amino acids (Aminosyn) AB 3.5%     1%    
Amino acids (FreAmine III) MG   4.25%     1%  
Amino acids (Travasol) TR     4.25%     1%
Dextrose   25% 25% 25% 25% 25% 25%
Sodium phosphate AB 10 mmol 10 mmol 10 mmol 10 mmol 10 mmol 10 mmol
Multivitamins (M.V.I.-12) USV 10 mL 10 mL 10 mL 10 mL 10 mL 10 mL
Multielectrolyte concentratea SE 25 mL 25 mL 25 mL 25 mL 25 mL 25 mL
Trace mineral injectionb   3.5 mL 3.5 mL 3.5 mL 3.5 mL 3.5 mL 3.5 mL

 

 


a Each 25 mL provides: sodium, 25 mEq; potassium, 40.5 mEq; calcium, 5 mEq; magnesium, 8 mEq; chloride, 33.5 mEq; acetate, 40.6 mEq; and gluconate, 5 mEq.
b Each 3.5 mL provides: zinc, 2 mg; copper, 1 mg; manganese, 0.5 mg; and chromium, 10 mcg.

  Concentration per Liter
Component   #31 #32 #33 #34 #35 #36 #37
Amino acids TR 4.2% 4.2% 4.2% 4.2% 4.2% 4.2% 4.2%
Dextrose   25% 25% 25% 25% 25% 25% 25%
Sodium   29 mEq 29 mEq 29 mEq 29 mEq 69 mEq 69 mEq 69 mEq
Potassium   25 mEq 25 mEq 25 mEq 25 mEq 46 mEq 46 mEq 46 mEq
Calcium   9 mEq 9 mEq 9 mEq 4.5 mEq 9.5 mEq 9.5 mEq 9.5 mEq
Magnesium   4 mEq 4 mEq 4 mEq 4 mEq 12 mEq 12 mEq 12 mEq
Phosphorus   388 mg 388 mg 388 mg 388 mg 388 mg 388 mg 388 mg
Chloride   29 mEq 29 mEq 29 mEq 29 mEq 103 mEq 103 mEq 103 mEq
Acetate   63 mEq 63 mEq 63 mEq 63 mEq 63 mEq 63 mEq 63 mEq
Trace elements     a b a   a b a b a b
Multivitamins USV     10 mL     5 mL 5 mL
Vitamin B complex with C plus folic acid (Soluzyme) UP     5 mL       5 mL

 

 


a Trace elements: selenium, 120 mcg; chromium, 2 mcg; zinc, 3 mg; and manganese, 0.7 mg.
b Trace elements: iodine, 120 mcg; and copper, 1 mg.

 

 

    Concentration per Liter
Component   #48 #49 #50 #51
Amino acids   5% 5% 5% 5%
Dextrose   5% 5% 25% 25%
Vitamins   present   present  
Trace elements     present   present
  Concentration per Liter
Component Mfr #52 #53 #54 #55 #56
Amino acids VT 7% 2.3%      
Amino acids AB     1.5%    
Amino acids (FreAmine III) MG       3% 3%
Dextrose     6.5% 15% 25% 25%
Fructose   10% 3.2%      
Sodium   50 mmol 16.2 mmol a 35 mEq 35 mEq
Potassium   20 mmol 18.4 mmol a    
Calcium   2.5 mmol 4.9 mmol 300 mg 5 mEqb 5 mEqb
Magnesium   1.5 mmol 2.1 mmol   8 mEq 8 mEq
Phosphorus       155 mg    
Phosphate     12.1 mmolc   40 mEqd 40 mEqd
Chloride   55 mmol 17.8 mmol e 35 mEq 35 mEq
Laevulate calcium     9.8 mmol      
Folic acid       0.5 mg    
Cyanocobalamin       f    
Phytonadione       0.2 mg    
Multivitamins     present 4 mL   10 mL
Vitamin B complex with C (Berocca-C)       0.2 mL    

 


a Adjusted to provide 2.5 mEq/kg/day.
b Present as the gluconate.
c Anion not specified.
d Present as the potassium salt.
e Adjusted to provide 5 mEq/kg/day.
f Present but concentration not specified.

  Concentration per Liter
Component Mfr #57 #58a #59 #60 #61
Amino acids MG 2.125% 4.25%      
Amino acids TR     2.125%  
Amino acids AB       3%
Amino acids with electrolytes TR     4.25%    
Dextrose   10% 25% 25% 25% 20%
Sodium   40 mEq 100 mmol 50 mEq 50 mEq 30 mEq
Potassium   30 mEq 60 to 80 mmol     25 mEq
Calcium   15 mEq 5 mmol 5 mEq 5 mEq 15 mEq
Magnesium   12.5 mEq 5 mmol 5 mEq 5 mEq 10 mEq
Phosphorus   6 mmol 10 mmol 465 mg 465 mg 15 mmol
Chloride   40 mEq 100 mmol 50 mEq 50 mEq  
Heparin sodium     1000 units 500 units 500 units  
Phytonadione       1 mg 1 mg  
Multivitamins     10 mL 10 mL 10 mL 2 mL
Multivitamin concentrate   2 mL        
Iron     1 mg      
Trace elements   present present present present present

 

 


a Concentration per 1200 mL.

  Component Amounts
Component Mfr #62 #63 #64 #65 #66 #67 #68
Amino acids 8.5% (FreAmine III) MG 500 mL 500 mL     500 mL    
Amino acids 5.4% (Nephramine) MG     500 mL     500 mL  
Amino acids 5.2% (Aminosyn RF) AB       500 mL     500 mL
Dextrose 50% MG 500 mL 500 mL 500 mL 500 mL 500 mL 500 mL 500 mL
Hyperlyte (electrolyte) concentrate MG   25 mL          
Fat emulsion 10%, intravenous CU         500 mL 500 mL 500 mL
Multivitamins (M.V.I.-12) USV a a a a a a a

 


a Tested both with and without multivitamins.

  Component Amounts
Component Mfr #69 #70 #71
Amino acids 8.5% (FreAmine II) MG 1000 mL    
Amino acids 8.5% with electrolytes TR     1500 mLa
Amino acids 7% AB   500 mL  
Dextrose 50%   500 mL 500 mL 1500 mL
Dextrose 20% with electrolyte pattern A TR 500 mLb    
Dextrose 20%   500 mL    
Sodium chloride 0.9%   500 mL    
Potassium chloride   20 mmol    
Calcium gluconate 10%       30 mL
Multivitamins   1 ampul   10 mL
Multivitamin concentrate     5 mL  
Folic acid   1 mg 0.25, 0.5, 0.75, 1 mg  
Trace elements       present

 

 


a Each 1500 mL provides: sodium, 105 mEq; potassium, 90 mEq; magnesium, 15 mEq; chloride, 105 mEq; acetate, 203 mEq; and phosphate, 45 mmol.
b Each 500 mL provides: magnesium, 14 mmol; calcium, 13 mmol; chloride, 54 mmol; acetate, 0.08 mmol; zinc, 0.04 mmol; and manganese, 0.02 mmol.

 

 

  Component Amounts
Component Mfr #72 #73 #74 #75
Amino acids 10% TR 750 mL 750 mL    
Amino acids 8.5% TR     500 mL  
Amino acids 8.5% MG       500 mL
Dextrose 70%   429 mL 429 mL   300 mL
Dextrose 50%       500 mL  
Fat emulsion 20%, intravenous TR 225 mL 225 mL    
Sterile water for injection   24.2 mL 15 mL   300 mL
Calcium gluconate 10%   20 mL 20 mL    
Calcium gluceptate         8 mEq
Sodium phosphate     15 mmol    
Potassium phosphate   20 mmol   30 mEq 18 mEq
Potassium chloride   30 mEq 40 mEq 20 mEq 20 mEq
Magnesium sulfate 50%   2 mL 2 mL   8 mEq
Sodium chloride   60 mEq 60 mEq 40 mEq 60 mEq
Sodium acetate         5 mEq
Heparin sodium     6000 units    
Multivitamins   10 mL 10 mL    
Trace elements   present present    
  Concentration per Liter
Component Mfr #86 #87 #88
Amino acids (Aminosyn) AB 2.5% 4.25% 5%
Dextrose   10% 25% 35%
Calcium   4.5 mEq 4.5 mEq 4.5 mEq
Magnesium   5 mEq 5 mEq 5 mEq
Potassium   23 mEq 40 mEq 40 mEq
Sodium   47 mEq 35 mEq 35 mEq
Acetate   82 mEq 74.5 mEq 74.5 mEq
Chloride   35 mEq 52.5 mEq 52.5 mEq
Phosphorus   9 mmol 12 mmol 12 mmol
Heparin sodium   1000 units 1000 units 1000 units
Insulin   a a a

 


a Insulin 10 to 40 units/L.

 

 

    Concentration per Liter
Component   #89 #90
Amino acids (Travasol)   4.25%  
Amino acids with electrolytes (Travasol with electrolytes)     4.25%
Dextrose   25% 25%
    Concentration per 100 mL Concentration per 2 L
Component Mfr #91 #92
Amino acids 10%   1.6 mL  
Nitrogen (from amino acids) PFM   14 g
Dextrose 5%   15 mL  
Dextrose 50%     500 mL
Fat emulsion 20%, intravenous KA   500 mL
Sodium   3 mEq 150 mEq
Potassium   2.2 mEq 120 mEq
Calcium   1 mEq 15 mEq
Magnesium   0.3 mEq 30 mEq
Phosphate   0.5 mmol 30 mmol
Chloride   2.5 mEq 150 mEq
Sulfate     30 mEq
Acetate     90 mEq
Pediatric multivitamins   5 mL  
Multivitamins     present
Trace elements   a present
Heparin sodium   100 units  
Water for injection     qs 2000 mL

 


a Trace elements: zinc, 600 mcg; copper, 40 mcg; manganese, 10 mcg; and chromium, 0.4 mcg.

 

 

  Concentration per Liter
Component Mfr #93 #94 #95 #96
Amino acids TR 4.25% 4.25%    
Amino acids AB     3% 3%
Dextrose   25% 25% 20% 20%
Potassium chloride   15 mEq 15 mEq 25 mEq 25 mEq
Sodium chloride   15 mEq 15 mEq 30 mEq 30 mEq
Calcium gluconate   4.7 mEq 4.7 mEq 15 mEq 15 mEq
Magnesium sulfate   4.05 mEq 4.05 mEq 10 mEq 10 mEq
Potassium phosphate   5 mEq 5 mEq 15 mmol 15 mmol
Sodium phosphate   10 mEq 10 mEq    
Zinc   1.5 mg 1.5 mg 3 mg 3 mg
Manganese   150 mcg 150 mcg 50 mcg 50 mcg
Chromium   6 mcg 6 mcg 2 mcg 2 mcg
Selenium   30 mcg 30 mcg    
Copper     600 mcg 200 mcg 200 mcg
Multivitamins LY     2 mL 2 mL
Heparin sodium IX     1000 units  
  Milliliters per Container
Component Mfr #97 #98 #99 #100 #101 #102 #103 #104
Amino acids 8.5% (FreAmine III) MG 10 10 10 10 75 75 75 75
Dextrose 70%   89 36 89 36 89 36 89 36
Fat emulsion 20%, intravenous (Intralipid) KV 5 5 75 75 5 5 50 50
Sterile water qs ad   250 250 250 250 250 250 250 250
Other components   a a a a a a a a

 


a Each TNA admixture also contained: sodium, 25 mEq; potassium, 25 mEq; calcium, 5 mEq; magnesium, 25 mEq; chloride, 30 mEq; acetate, 7.5 mEq; lactate, 10.5 mEq; phosphate, 1.5 mmol; multivitamins (M.V.I. Pediatric), 2.5 mL; trace elements; and heparin sodium, 250 units.

 

 

  Concentration per Liter
Component Mfr #105 #106 #107 #108
Amino acids TR 1.65% 4.25% 1.5% 1.5%
Dextrose   10% 10% 15% 15%
Sodium   21 mEq 35 mEq    
Potassium   18 mEq 30 mEq    
Magnesium   3 mEq 5 mEq    
Calcium   15 mEq 10 mEq    
Phosphate   10 mmol 15 mmol    
Chloride   21 mEq 35 mEq    
Acetate   30 mEq 68 mEq    
Pediatric multivitamins   1 mL 1 mL    
Trace elements   0.1 mL 0.1 mL    
Unspecified electrolytes and vitamins       present present
  Concentration per Liter
Component Mfr #109 #110 #111 #112 #113
Amino acids (FreAmine III) MG 4.25% 2% 4.25% 2.125%  
Amino acids (Travasol) TR         4.25%
Fat emulsion 20%, intravenous (Intralipid) KV     200 mL 125 mL  
Dextrose   25% 25% 20% 25% 25%
Sodium   50 mEq 50 mEq 50 mEq 50 mEq 35 mEq
Potassium   40 mEq 40 mEq 40 mEq 40 mEq 30 mEq
Chloride   40 mEq 40 mEq a a 35 mEq
Phosphorus   13 mmol 13 mmol 6 mmol 6 mmol 15 mmol
Acetate   31 mEq 31 mEq a a 70.5 mEq
Calcium   16.7 mEq 16.7 mEq 10 mEq 10 mEq 4.7 mEq
Magnesium   10 mEq 10 mEq 5 mEq 5 mEq 5 mEq
Multivitamins   4 mL 4 mL 3.33 mL 3.33 mL  
Trace elements   present present present present present
Heparin sodium   1000 units 1000 units 1000 units 1000 units  
Sterile water   qs qs qs qs  

 


a Not cited.

    Concentration per Liter
Component   #114 #115 #116 #117 #118
Nitrogen (from amino acids)   7 g        
Amino acids (Travasol)     4.2% 4.2% 4.5% 3.7%
Dextrose   12.5% 4.2% 21% 22.7% 18.5%
Fat emulsion, intravenous   50 ga       3.7%
Sodium   75 mEq 66.7 mmol 66.7 mmol 40.9 mEq 45 mEq
Potassium   60 mEq 50 mmol 50 mmol 36.4 mEq 40 mEq
Magnesium   15 mEq 4.16 mmol 4.16 mmol 7.3 mEq 8 mEq
Calcium   7.5 mEq 4.16 mmol 4.16 mmol 4.5 mEq 5 mEq
Chloride   75 mEq 66.7 mmol 66.7 mmol 48.2 mEq 53 mEq
Phosphorus   15 mmol 8.3 mmol 8.3 mmol 13.6 mmol 15 mmol
Sulfate   15 mEq        
Acetate   45 mEq 90.8 mmol 90.8 mmol 76.4 mEq 84 mEq
Trace elements   present present present    
Multivitamins   present 8.3 mL 8.3 mL    
Sterile water for injection   qs        
Iron     833 mcg 833 mcg    
Heparin sodium     1000 units 1000 units    

 


a Both Intralipid (long-chain triglycerides) and MCT/LCT (medium- and long-chain triglycerides) tested.

 

 

  Concentration per Liter
Component Mfr #119 #120 #121 #122 #123 #124 #125
Amino acids   4.25% 4.25% 5% 5% 1% 2%  
Amino acids (TrophAmine) MG             2%
Dextrose   35% 35% 20% 14.3% 10% 10% 10%
Fat emulsion         5.7%      
Sodium chloride   50 mEq 50 mEq 20 mEq 4 mEq 16 mEq 16 mEq 16 mEq
Potassium chloride       20 mEq 30 mEq 5 mEq 5 mEq 5 mEq
Potassium phosphate   30 mEq 30 mEq   3 mmol 10 to 40 mmol 10 to 40 mmol 10 to 40 mmol
Magnesium sulfate   10 mEq 10 mEq 8 mEq 12 mEq 4 mEq 4 mEq 4 mEq
Calcium gluconate   4.7 mEq 4.7 mEq 4.8 mEq 4 mEq 10 to 40 mEq 10 to 40 mEq 10 to 40 mEq
Sodium phosphates       20 mEq        
Sodium acetate         20 mEq 10 mEq 10 mEq 10 mEq
Cysteine HCl               1 g
Mixed electrolytes LY       27 mL      
Trace Elements   1 mL 1 mL present 3 mL      
Heparin sodium     1000 units          
Multivitamins       10 mL 10 mL      
Phytonadione         1 mg      
Cimetidine HCl         1 g      

 

 

  Concentration per Liter
Component Mfr #126 #127 #128 #129 #130 #131 #132 #133
Amino acids (Aminosyn II) AB 2% 3.3% 3.6% 3.6% 5% 3.5% 3.5%  
Amino acids (Travasol) TR               4.25%
Dextrose   14.8% 3.3% 23.3% 20.8% 10% 25% 25% 25%
Fat emulsion, intravenous (Liposyn II) AB 1.2% 3.3% 3.3% 2% 7.1%      
Sodium   39.5 mEq 51.7 mEq 48.4 mEq 96.3 mEq 49.4 mEq 33.6 mEq 33.6 mEq 75 mEq
Potassium   27 mEq 13.3 mEq 21.4 mEq 60 mEq 78.6 mEq 35.6 mEq 35.6 mEq 20 mEq
Calcium   6.6 mEq 3 mEq 6.7 mEq 10 mEq 13.4 mEq 4.5 mEq 4.5 mEq 9.6 mEq
Magnesium   3.2 mEq 3.3 mEq 10 mEq 12 mEq 14.5 mEq 5 mEq 5 mEq 10 mEq
Phosphate   5.5 mmol 10 mmol 10 mmol 15 mmol 21.4 mmol 12 mmol 12 mmol 10 mEq
Chloride   57.9 mEq 23.3 mEq 40 mEq 80 mEq 73.9 mEq 35 mEq 35 mEq 85 mEq
Acetate   21.9 mEq 43.6 mEq 23.9 mEq 65.8 mEq 35.9 mEq 35.7 mEq 35.7 mEq  
Trace elements   present present present present present   present 3 mL
Multivitamins (M.V.I.-12)               present 10 mL

 

 

  Concentration per Liter
Component Mfr #134 #135 #136 #137 #138 #139 #140
Amino acids (Travasol)   5.8% 5.8% 5.8% 5.8% 5.8% 4.26% 6%
Dextrose BA 23.7% 23.7% 23.7% 23.7% 23.7% 17.5% 25%
Fat emulsion, intravenous (Intralipid) KV   3% 5%     3%  
Fat emulsion, intravenous (Liposyn II) AB       3% 5%    
Potassium chloride   54.2 mEq 54.2 mEq 54.2 mEq 54.2 mEq 54.2 mEq 40.2 mEq 30 mEq
Sodium chloride   108 mEq 108 mEq 108 mEq 108 mEq 108 mEq 80.5 mEq 110 mEq
Calcium gluconate 10%   13.6 mL 13.6 mL 13.6 mL 13.6 mL 13.6 mL 4.65 mEq 10 mL
Magnesium sulfate 50%   1.4 mL 1.4 mL 1.4 mL 1.4 mL 1.4 mL 4 mEq 4 mL
Potassium phosphate   20.3 mmol 20.3 mmol 20.3 mmol 20.3 mmol 20.3 mmol 45 mmol  
Multivitamins   6.8 mL 6.8 mL 6.8 mL 6.8 mL 6.8 mL 5 mL 1 vial
Trace elements   present present present present present present present
Phytonadione               1 mg

 

 

  Concentration per Liter
Component Mfr #141 #142 #143 #144
Amino acids AB   2.5% 5%  
Amino acids (Travasol) TR       4.25%
Dextrose   25% 25% 25% 25%
Sodium       50 mEq 22.5 mEq
Potassium     40 mEq 40 mEq 20 mEq
Magnesium     5 mEq 5 mEq 2.85 mEq
Calcium     5 mEq 5 mEq 4.25 mEq
Phosphorus     15 mmol 15 mmol 15.75 mmol
Chloride     58 mEq 58 mEq 17 mEq
Acetate         58 mEq
Multivitamins     10 mL 10 mL  
Trace elements     1 mL 1 mL present
Heparin sodium UP   500 units 500 units  
Sterile water for injection         qs

 

 

  Concentration per Liter
Component Mfr #145 #146 #147 #148
Amino acids (Travasol) BA 5%      
Amino acids AB   5% 2.5% 1%
Dextrose   15% 25% 25% 25%
Sodium   45 mEq 35 mEq 35 mEq 35 mEq
Potassium   15 mEq 40 mEq 40 mEq 40 mEq
Chloride   20 mEq 35 mEq 35 mEq 35 mEq
Phosphorus   16 mmol 12 mmol 12 mmol 12 mmol
Acetate   81 mEq 82 mEq 82 mEq 82 mEq
Calcium   20 mEq 9 mEq 9 mEq 9 mEq
Magnesium     5 mEq 5 mEq 5 mEq
    Component Amounts
Component   #149 #150 #151 #152 #153 #154 #155 #156 #157 #158
Amino acids 10% (TrophAmine)   50 mL 50 mL 50 mL 50 mL 350 mL 350 mL 350 mL 350 mL 50 mL 350 mL
Dextrose   10% 10% 10% 10% 25% 25% 25% 25% 25% 25%
Fat emulsion 20%, intravenousa   25 mL 25 mL 70 mL 70 mL 25 mL 25 mL 70 mL 70 mL 100 mL 100 mL
Sodium   25 mEq 100 mEq 25 mEq 100 mEq 25 mEq 100 mEq 25 mEq 100 mEq 100 mEq 100 mEq
Potassium   15 mEq 80 mEq 15 mEq 80 mEq 15 mEq 80 mEq 15 mEq 80 mEq 80 mEq 80 mEq
Chloride   25 mEq 100 mEq 25 mEq 100 mEq 25 mEq 100 mEq 25 mEq 100 mEq 100 mEq 100 mEq
Calcium   7 mEq 18 mEq 7 mEq 18 mEq 7 mEq 18 mEq 7 mEq 18 mEq 18 mEq 18 mEq
Magnesium   2.5 mEq 13 mEq 2.5 mEq 13 mEq 2.5 mEq 13 mEq 2.5 mEq 13 mEq 13 mEq 13 mEq
Phosphate   3.4 mmol 9 mmol 3.4 mmol 9 mmol 3.4 mmol 9 mmol 3.4 mmol 9 mmol 9 mmol 9 mmol
Trace elements   present present present present present present present present present present
Multivitamins (M.V.I. Pediatric)   5 mL 5 mL 5 mL 5 mL 5 mL 5 mL 5 mL 5 mL 5 mL 5 mL
Heparin   1000 units 1000 units 1000 units 1000 units 1000 units 1000 units 1000 units 1000 units 1000 units 1000 units

 


a Intralipid 20%, Liposyn II 20%, and Nutrilipid 20% were each tested.

 

 

  Component Amounts
Component Mfr #159 #160 #161 #162 #163 #164 #165 #166
Amino acids 5.5% with electrolytes (Travasol) BA 100 mL 100 mL 400 mL 400 mL 400 mL 400 mL 100 mL 100 mL
Fat emulsion 20%, intravenous (Intralipid) KV 100 mL   200 mL   100 mL   200 mL  
Fat emulsion 20%, intravenous (Liposyn II) AB   100 mL   200 mL   100 mL   200 mL
Heparin sodium 1000 units/mL ES 5 mL 5 mL 5 mL 5 mL 5 mL 5 mL 5 mL 5 mL
Dextrose 10%   795 mL 795 mL         695 mL 695 mL
Dextrose 20%       395 mL 395 mL 495 mL 495 mL    

 

 

    Component Amounts
Component   #167 #168 #169 #170 #171 #172 #173
Aminoplex 12       500 mL   1000 mL    
Aminoplex 24   500 mL 500 mL 500 mL 500 mL      
Vamin glucose               1000 mL
Lipofundin S 20%   500 mL 500 mL 500 mL 500 mL 500 mL    
Fat emulsion 10%, intravenous (Intralipid)             300 mL  
Glucoplex 1000   1000 mL            
Glucoplex 1600     1000 mL 1000 mL   500 mL    
Dextrose 5%           1000 mL    
Dextrose 50%         500 mL     1000 mL
Potassium chloride 15%     37.5 mL   10 mL      
Potassium phosphate 17%   20 mL 20 mL 20 mL 20 mL 10 mL    
Sodium chloride 30%     27 mL   15 mL      
Addamel   10 mL 10 mL 10 mL 10 mL 10 mL   10 mL
Soluvit             7.5 mL  
Vitalipid infant             15 mL  
Pancebrin               10 mL

 

 

  Concentration per Liter
Component Mfr #174 #175 #176 #177 #178 #179
Amino acids AB 25 g 50 g 15 g      
Amino acids TR       3%    
Nitrogen           7.9 g 7 g
Dextrose   125 g 250 g 100 g 5% 100 g 125 g
Fat emulsion, intravenous (Intralipid) KV         50 g 5 g
TPN II electrolytes AB 20 mL 20 mL        
Sodium   26.3 mEq 37.5 mEq 40 mEq 46 mEq 24 mmol 75 mEq
Potassium   35.5 mEq 40 mEq 50 mEq 40 mEq 12.5 mmol 60 mEq
Magnesium   5 mEq 5 mEq 10 mEq 8 mEq 2.5 mmol 15 mEq
Calcium   9 mEq 4.5 mEq 10 mEq 5 mEq   7.5 mEq
Phosphorus   12 mmol 45 mmol 5 mmol 12 mmol 4.5 mmol 15 mmol
Chloride   35 mEq 35 mEq 47.6 mEq 57 mEq 7 mmol 75 mEq
Acetate   25 mEq 43 mEq 31.8 mEq 61 mEq 40.5 mmol 45 mEq
Gluconate       10 mEq      
Sulfate       10 mEq     15 mEq
Trace elements     present present present present present
Multivitamins (M.V.I. Pediatric)   3 mL   3 mL      
Multivitamins (M.V.I. 9+3)     10 mL        
Multivitamins         10 mL present present
Vitamin K     5 mg        
Heparin sodium   1000 units 1000 units 1000 units 1000 units    
Sterile water qs ad   1000 mL 1000 mL 1000 mL   1000 mL 1000 mL

 

 

    Component Amounts
Component   #180 #181
Amino acids 10%   1000 mL 400 mL
Dextrose 50%   500 mL 500 mL
Fat emulsion 20%, intravenous (Intralipid)   500 mL  
Sodium   40 mmol 41 mEq
Potassium   70 mmol 22.7 mEq
Calcium   4.6 mmol 5 mEq
Magnesium   5 mmol 5 mEq
Phosphorus   17.5 mmol 12 mmol
Chloride   120 mmol 30 mEq
Acetate   45 mmol 89 mEq
Trace elements     present
Multivitamins     10 mL

 

 

    Concentration per Liter
Component Mfr #182
Amino acids KV 5%
Dextrose   25%
Fat emulsion, intravenous (Intralipid) KV 2.25%
Potassium phosphate   10 mmol
Potassium chloride   45 mEq
Sodium chloride   75 mEq
Magnesium sulfate   8 mEq
Calcium gluconate   47 mg
Trace elements   present
Multivitamins   5 mL
Sterile water qs ad   1000 mL
  Component Amounts
Component Mfr #183 #184 #185 #186a #187b #188c #189
Amino acids (Aminosyn II) AB 1% 2.5% 5%        
Amino acids (Aminosyn) AB       15 g 25 g 50 g  
Amino acids 10% with electrolytes               500 mL
(Synthamin 17 with electrolytes)                
Dextrose AB 10% 10% 25% 125 g 125 g 250 g  
Dextrose 50%               500 mL
TPN II electrolytes           1 mL 1 mL  
Calcium   9 mEq 4.4 mEq 5 mEq 1 mEq 9 mEq 4.5 mEq 2.2 mmol
Magnesium   5 mEq 5 mEq 5 mEq 1 mEq 5 mEq 5 mEq 2.5 mmol
Potassium   27 mEq 18 mEq 40 mEq 5 mEq 30 mEq 40 mEq 42.5 mmol
Sodium   24 mEq 38 mEq 42 mEq 4 mEq 35 mEq 37.65 mEq 45 mmol
Phosphorus   6 mmol 9 mmol 15 mmol 2 mmol 6 mmol 12 mmol 15 mmol
Chloride   35 mEq 35 mEq 43 mEq 5.7 mEq 46.9 mEq 39.4 mEq 55.65 mmol
Acetate   22 mEq 25 mEq 38 mEq 11.1 mEq 25.6 mEq 43.5 mEq 81.25 mmol
Gluconate         1.1 mEq 2.5 mEq 0.05 mEq  
Sulfate         1.1 mEq      
Trace elements   1 mL 1 mL 1 mL 0.6 mL 1 mL 1 mL present
Multivitamins (M.V.I. Pediatric) AST       3 mL 3 mL    
Multivitamins (M.V.I. 9+3) AST           10 mL  
Heparin sodium ES       1000 units 1000 units 1000 units  
Sterile water         qs qs qs  

 


a Neonatal formula.
b Pediatric formula.
c Adult formula.

 

 

  Component Amounts
Component Mfr #190 #191 #192
Amino acids (Aminosyn II 15%) AB 333 mL    
Amino acids (Azonutril 25)     500 mL  
Amino acids       17 g
Dextrose 70%   500 mL    
Dextrose 50%     250 mL  
Dextrose 30%     750 mL  
Dextrose       42.4 g
Fat emulsion 20%, intravenous (Intralipid)     500 mL 24.2 g
Fat emulsion 20%, intravenous (Liposyn II) AB 400 mL    
Sterile water   133 mL    
Sodium       55.7 mmol
Potassium       19.4 mmol
Magnesium       2.3 mmol
Calcium       1.5 to 150 mmol
Phosphate       21 to 300 mmol
Unspecified electrolytes   present    
Vitamins   present   present
Trace elements     present present

 

 

    Component Amounts
Component Mfr #193
Amino acids 10% CL 1000 mL
Dextrose 50% CL 750 mL
Sodium chloride AB 140 mEq
Potassium phosphates AB 20 mmol
Calcium gluconate   4.8 mEq
Magnesium sulfate   40 mEq
Multivitamins AST 10 mL
Trace elements LY 3 mL
Famotidine   40 mg

 

 

    Concentration per Liter
Component   #194 #195
Amino acids   2.2% 2.2%
Dextrose   12.5% 20%
Sodium chloride   26 mEq 26 mEq
Potassium phosphates   15 mmol 15 mmol
Calcium gluconate   25 mEq 25 mEq
Magnesium sulfate   8 mEq 8 mEq
Potassium chloride   2 mEq 2 mEq
Heparin sodium   1000 units 1000 units
Cysteine   660 mg 660 mg
Trace elements   present present
Multivitamins   20 mL 20 mL

 

 

  Concentration per Liter
Component Mfr #196 #197 #198 #199 #200
Amino acids BA 6% 6% 6% 6% 6%
Dextrose BA 24% 24% 24% 24% 24%
Intralipid KV   3% 5%    
Liposyn II AB       3% 5%
Sodium chloride LY 108 mEq 108 mEq 108 mEq 108 mEq 108 mEq
Potassium phosphates AB 20 mmol 20 mmol 20 mmol 20 mmol 20 mmol
Calcium gluconate LY 6.3 mEq 6.3 mEq 6.3 mEq 6.3 mEq 6.3 mEq
Magnesium sulfate AST 5.6 mEq 5.6 mEq 5.6 mEq 5.6 mEq 5.6 mEq
Potassium chloride AB 54 mEq 54 mEq 54 mEq 54 mEq 54 mEq
Trace elements SO present present present present present
Multivitamins AR 6.8 mL 6.8 mL 6.8 mL 6.8 mL 6.8 mL
  Concentration per Liter
Component Mfr #201 #202 #203a #204b
Amino acids BA 4.25%      
Amino acids AB   4.25%    
Amino acids (TrophAmine) MG     2% 3%
Dextrose   25% 25% 10% 20%
Sodium   35 mEq 35 mEq 38 mEq 77 mEq
Potassium   30 mEq 30 mEq 20 mEq 40 mEq
Calcium   5 mEq 9.4 mEq 600 mg 600 mg
Magnesium   3 mEq 10 mEq 2.5 mEq 2.5 mEq
Chloride   47 mEq c 38 mEq 77 mEq
Phosphate   14.3 mEq 15 mmol 400 mg 400 mg
Acetate   67 mEq 50 mEq 29 mEq 58 mEq
l-Cysteine       200 mg 300 mg
Trace elements     present present present
Multivitamins     present present present
Heparin         500 units

 


a Calculated quantities from a pediatric peripheral line formula.
b Calculated quantities from a pediatric central line formula.
c Unspecified.

 

 

  Concentration per Liter
Component Mfr #205 #206
Amino acids BA 5%  
Aminosyn AB   2.125%
Dextrose   25% 20%
Intralipid KA    
Liposyn II AB    
Sodium chloride   75 mEq 30 mEq
Potassium chloride   60 mEq 30 mEq
Potassium phosphates   20 mmol  
Sodium phosphates     15 mmol
Calcium gluconate   10 mEq 14 mEq
Magnesium sulfate   10 mEq 50 mg
Trace elements   present present
Multivitamins      
Heparin sodium   3000 to 20,000 units  
  Concentration per Liter
Component Mfr #207 #208 #209 #210 #211
Amino acids (TrophAmine) MG 0.5% 1% 1.5% 2% 2.5%
Dextrose   10% 10% 10% 10% 10%
Sodium chloride   20 mEq 20 mEq 20 mEq 20 mEq 20 mEq
Sodium acetate   10 mEq 10 mEq 10 mEq 10 mEq 10 mEq
Potassium acetate   5 mEq 5 mEq 5 mEq 5 mEq 5 mEq
Potassium phosphates   10 mmol 10 mmol 10 mmol 10 mmol 10 mmol
Calcium gluconate   20 mEq 20 mEq 20 mEq 20 mEq 20 mEq
Magnesium sulfate   4 mEq 4 mEq 4 mEq 4 mEq 4 mEq
Trace elements FUJ a a a a a
Multivitamins AST b b b b b
Heparin sodium   1000 units 1000 units 1000 units 1000 units 1000 units
l-Cysteinec   200 mg 400 mg 600 mg 800 mg 1 g

 


a Tested with and without trace elements (Neotrace, Fujisawa).
b Tested with and without multivitamins (M.V.I. Pediatric, Astra) 3.5 mL/L.
c 40 mg/g of protein.

  Concentration per Liter
Component Mfr #212 #213 #214 #215 #216a
Amino acids (Aminosyn II) AB 3.5%   4.25%    
Amino acids (FreAmine III) MG   3.5%   4.25%  
Amino acids (Travasol) BA         0.5 to 5%
Dextrose   5% 5% 25% 25% 10 to 20%
Sterile water for injection   516.8 mL 516.75 mL 161 mL 158.6 mL q.s.
Potassium phosphates   3.5 mmol b 15 mmol 5.75 mmolc 0 to 20 mEq Kd
Sodium chloride   25 mEq 37.5 mEq 25 mEq 40 mEq 0 to 44 mEq
Sodium acetate           0 to 40 mEq
Potassium chloride   35 mEq 40 mEq 18 mEq 25 mEq 0 to 20 mEq
Magnesium sulfate   8 mEq 8 mEq 8 mEq 8 mEq 4 mEq
Calcium gluconate   9.3 mEq 5 mEq 9.15 mEq 7.5 mEq 19.2 to 28.8 mEq
Multivitamins AST 10 mL 10 mL 10 mL 10 mL 14 mL
Trace elements   present present present present present
Heparin sodium ES         500 units
Ranitidine (as HCl) GL         0 to 84 mg

 


a Forty parenteral nutrition formulations within the ranges cited were tested. Specific formulations were not reported.
b No phosphates added. Phosphates from FreAmine III formulation yielded 3.5 mmol/L.
c Added phosphates indicated. All phosphates from addition plus FreAmine III formulation totaled 10 mmol/L.
d Reported as potassium concentration.

 

 

  Concentration per Liter
Component Mfr #217 #218 #219 #220
Amino acids   5%      
Amino acids MG   3% 3%  
Amino acids AB       3%
Dextrose   25% 5% 5% 5%
Intralipid KA   2%    
Liposyn II AB     2%  
Liposyn III AB       2%
Sodium   50 mEq 43 mEq 43 mEq 41.6 mEq
Potassium   40 mEq 40 mEq 40 mEq 40 mEq
Chloride   58 mEq 45 mEq 45 mEq 35 mEq
Phosphorus   15 mmol 7.5 mmol 7.5 mmol 15 mmol
Calcium   5 mEq 5 mEq 5 mEq 9.15 mEq
Magnesium   8 mEq 8 mEq 8 mEq 8 mEq
Acetate     51.7 mEq 51.7 mEq 42 mEq
Heparin sodium   1000 units      
Multivitamins   10 mL 10 mL 10 mL 10 mL
Phytonadione   1 mg      
Trace elements   2 mL 1 mL 1 mL 1 mL
Sterile water for injection     qs qs qs

 

 

  Concentration per Liter
Component Mfr #221 #222 #223 #224 #225 #226
Amino acids MG 4.9% 4.9%     6% 6%
Amino acids AB     4.9% 6%    
Dextrose   20% 20% 20% 11% 10.7% 10.7%
Intralipid KA   3.5%       4%
Liposyn II AB 3.5%       4%  
Liposyn III AB     3.5% 4%    
Sodium   39.8 mEq 39.8 mEq 39.7 mEq 45 mEq 45 mEq 45 mEq
Potassium   40 mEq 40 mEq 40 mEq 40 mEq 40.2 mEq 40.2 mEq
Calcium   7.5 mEq 7.5 mEq 9.15 mEq 9.15 mEq 7.5 mEq 7.5 mEq
Magnesium   8 mEq 8 mEq 8 mEq 8 mEq 8 mEq 8 mEq
Chloride   45 mEq 45 mEq 35 mEq 35 mEq 51 mEq 51 mEq
Acetate   67.7 mEq 67.7 mEq 45 mEq 53.2 mEq 78.4 mEq 78.4 mEq
Phosphate   10 mmol 10 mmol 15 mmol 15 mmol 10 mmol 10 mmol
Multivitamins   10 mL 10 mL 10 mL 10 mL 10 mL 10 mL
Trace elements   1 mL 1 mL 1 mL 1 mL 1 mL 1 mL

 

 

  Concentration per Liter
Component Mfr #227 #228 #229 #230 #231
Aminosyn II AB 2% 3.5% 4.25% 4.25% 5%
Dextrose AB 10% 10% 15% 25% 25%
Sodium (as chloride) AB 40 mEq 40 mEq 70 mEq 70 mEq 70 mEq
Potassium (as chloride) AB 20 mEq 20 mEq 50 mEq 50 mEq 50 mEq
Magnesium (as sulfate) AB 8 mEq 8 mEq 12 mEq 12 mEq 12 mEq
Phosphates (as potassium) AB up to 40 mmol up to 40 mmol up to 40 mmol up to 40 mmol up to 40 mmol
Calcium (as acetate) AB up to 40 mEq up to 40 mEq up to 40 mEq up to 40 mEq up to 40 mEq

 

 

  Component Amounts
Component Mfr #232 #233 #234 #235 #236 #237
Synthamin 17   500 mL 500 mL 500 mL 500 mL    
Vaminolact FRE         150 mL 150 mL
Dextrose 50%   500 mL 500 mL 500 mL 500 mL 180 mL 154 mL
Sterile water for injection   500 mL 500 mL 500 mL 500 mL    
Intralipid 20%   500 mL 500 mL 500 mL 500 mL    
Medialipide BRN           50 mL
Albumin, human   100 mL 100 mL 200 mL 200 mL    
Sodium chloride 10%           6.08 mL 6.08 mL
Potassium chloride 10%           18.66 mL 18.66 mL
Calcium chloride     7 mmol   7 mmol    
Calcium gluconate/glucoheptonate           16.1 mL 16.1 mL
Magnesium sulfate     10 mmol   10 mmol    
Magnesium sulfate 15%           1.64 mL 1.64 mL
Phosphorus (Phocytan)           14.56 mL 14.56 mL
Vitamins (Soluvit)           5 mL 5 mL
Trace elements, pediatric (OEP)           10 mL 10 mL

 

 

  Component Amounts
Component Mfr #238 #239 #240
Aminoplex 12 GEI 200 mL    
FreAmine III FRE   200 mL  
Vamin 14 PH     200 mL
Dextrose 20% BA 300 mL 300 mL 300 mL
Addiphos PH 4 mL 4 mL 4 mL
Additrace PH 2 mL 2 mL 2 mL

 

 

  Concentration per Liter
Component Mfr #241 #242
Aminosyn AB 4.25% 5%
Dextrose   25% 25%
Calcium   4.5 mEq 4.5 mEq
Magnesium   5 mEq 5 mEq
Potassium   40 mEq 40 mEq
Sodium   35 mEq 35 mEq
Acetate   74.5 mEq 74.5 mEq
Chloride   52.5 mEq 52.5 mEq
Phosphorus   12 mmol 12 mmol
Heparin sodium   1000 units 1000 units

 

 

    Concentration per Liter
Component   #243 #244 #245
Amino acids (Aminosyn)   4%    
Amino acids (TrophAmine)     3%  
Nitrogen       0.8%
Dextrose   20% 20% 12.5%
Fat emulsion       5%
Sodium chloride   93 mEq 48 mEq 20 mEq
Potassium (from acetate and phosphate)   60 mEq 40 mEq 35 mEq
Calcium (as gluconate)   330 mg 600 mg 4.6 mEq
Chloride       60 mEq
Acetate       22.5 mEq
Magnesium sulfate   8 mEq 4.3 mEq 5 mEq
Trace elements (pediatric)   3 mL 3 mL  
l-Cysteine HCl (40 mg/g amino acids)     1.2 g  
Multivitamin injection (M.V.I. Pediatric)   5 mL 5 mL present
Heparin sodium   500 units 500 units  

 

    Concentration per Liter
Component   #246 #247
Amino acids (Aminoplasmal L10)   1000 mL 1000 mL
Dextrose 37.5% with electrolytes   500 mL 500 mL
Dextrose 10%   500 mL 500 mL
Fat emulsion (Lipofundin-S 20%)   500 mL  
Sterile water for injection     500 mL
Calcium gluconate   2.5 mmol 2.5 mmol
Magnesium sulfate   2 mmol 2 mmol
Addamel   10 mL 10 mL
Potassium phosphate   20 mLa 20 mLa
Sodium chloride 30%   8 mL 8 mL
Folic acid   15 mg 15 mg
Multivitamins   present present
Trace elements   present present


a Provided potassium 20 mEq and phosphate 10 mmol.

 

 

    Concentration per Liter
Component   #248 #249
Amino acids (Aminotripa 2)   3.3%  
Amino Acids (Unicaliq N)     3%
Dextrose   19.4% 17.5%
Sodium   38.9 mEq 40 mEq
Potassium   30 mEq 27 mEq
Magnesium   5.6 mEq 6 mEq
Calcium   5.6 mEq 6 mEq
Chloride   38.9 mEq 59 mEq
Sulfate   5.6 mEq  
Acetate   60 mEq 10 mEq
Gluconate   5.6 mEq 6 mEq
Citrate   12.2 mEq  
l-Malate     17 mEq
l-Lactate     35 mEq
Phosphorus   206.7 mg 250 mg
Zinc   11.1 mcmol 20 mcmol

 

 

    Concentration per Liter
Component   #250 #251 #252 #253 #254 #255 #256 #257
Aminosyn II   4% 4% 3.7% 3.7% 2.8% 2.8% 2.5% 2.5%
Dextrose   17.6% 17.6% 16.1% 16.1% 17.6% 17.6% 16.1% 16.1%
Liposyn II   6.0%   5.5%   6.0%   5.5%  
Intralipid     6.0%   5.5%   6.0%   5.5%
Sodium chloride       104 mEq 104 mEq     109 mEq 109 mEq
Potassium chloride       47 mEq 47 mEq     47 mEq 47 mEq
Potassium acetate       43 mEq 43 mEq     43 mEq 43 mEq
Sodium phosphates       11 mmol 11 mmol     11 mmol 11 mmol
Magnesium sulfate       6 mEq 6 mEq     6 mEq 6 mEq
Calcium gluconate       5.1 mEq 5.1 mEq     5 mEq 5 mEq
Sterile water for injection   qs qs qs qs qs qs qs qs

 

 

    Concentration per Liter
Component   #258 #259 #260 #261 #262
FreAmine III   1% 2% 3% 4% 5%
Dextrose   15% 15% 25% 25% 25%
Cysteine HCl   250 mg 500 mg 750 mg 1 g 1.25 g
Sodium chloride   40 mEq 40 mEq 40 mEq 70 mEq 70 mEq
Potassium chloride   20 mEq 20 mEq 20 mEq 50 mEq 50 mEq
Magnesium sulfate   8 mEq 8 mEq 8 mEq 12 mEq 12 mEq
Sterile water for injection   qs qs qs qs qs

 

 

    Concentration per Liter
Component   #263 #264 #265 #266 #267
Travasol 10%   267 mL        
Fravasol 10%     250 mL      
Livaframine 10%       250 mL    
Synthamin 10%         500 mL  
Amino acids 17%           1000 mL
Dextrose 70%   347 mL        
Dextrose 50%         500 mL 500 mL
Dextrose 10%     250 mL 250 mL    
Sterile water for injection   367 mL        
Fat emulsion 20%           500 mL
Sodium   36.6 mEq   5 mmoL    
Potassium   26.6 mEq        
Calcium   5 mEq        
Chloride   50 mEq 20 mmoL 4.5 mmoL    
Acetate     41 mmoL 31 mmoL    
Phosphate   9 mmoL   5 mmoL    
Trace elements   present        

 

 

  Concentration per Liter
Component #268
Aminosyn 15% 29.75 mL
Dextrose 70% 37.5 mL
Sterile water for injection 33.65 mL
Sodium chloride 4.7 mEq
Potassium chloride 2.1 mEq
Potassium phosphates 1.05 mmol
Magnesium sulfate 80 mg
Calcium gluconate 137 mg

 

 

    Concentration per Liter
Component   #269 #270 #271 #272 #273
Amino acids (Aminoplasmal 16%)   7.12% 7.34% 7.49% 7.6% 7.68%
Dextrose 70%   19.69% 20.35% 20.82% 21.0% 21.32%
Fat emulsion 20% (Lipofundin MCT)   2.49% 2.54% 2.58% 2.68% 2.69%
Sodium   118.6 mEq 97.8 mEq 83.3 mEq 72.4 mEq 64 mEq
Potassium   71.2 mEq 58.7 mEq 49.9 mEq 43.5 mEq 38.4 mEq
Calcium   11.9 mEq 9.8 mEq 8.3 mEq 7.2 mEq 6.4 mEq
Magnesium   11.9 mEq 9.8 mEq 8.3 mEq 7.2 mEq 6.4 mEq
Phosphate   28.5 mmol 23.5 mmol 19.9 mmol 17.4 mmol 15.4 mmol
Chloride   118.6 mEq 97.8 mEq 83.3 mmol 72.4 mEq 64.0 mEq
Trace elements   3.6 mL 2.9 mL 2.5 mL 2.2 mL 1.9 mL
Multivitamins   11.9 mL 9.8 mL 8.3 mL 7.2 mL 6.4 mL

 

 

    Concentration per Liter
Component   #274 #275
TrophAmine   3.75%  
Amino acids     3.6%
Dextrose   17.5% 10.6%
Sodium   25 mEq 36 mEq
Potassium   19 mEq 25.5 mEq
Calcium   19 mEq 6.4 mEq
Magnesium   3.8 mEq 6.4 mEq
Phosphates   12.5 mEq 5.5 mmol
Acetate   25 mEq 70 mEq
M.V.I.-Pediatric   52 mL  
Trace elements (pediatric)   2.5 mL  
Ranitidine HCl   73 mL  

 

 

  Concentration per Liter
Component #276
Aminosyn 4.25%
Dextrose 25%
Sterile water for injection 97.68 mL
Sodium chloride 50 mEq
Potassium chloride 40 mEq
Potassium phosphates 10 mmol
Magnesium sulfate 8 mEq
Calcium chloride and gluconate 10 mEq
    Component Amounts
Component Mfr #277 #278
Amino acids (Neonutrin 15%) FRK 500 mL 500 mL
Dextrose 40% (Ardeanutrisol) ARD 500 mL 500 mL
Fat emulsion 20% (Smoflipid) FRK 250 mL  
Fat emulsion 20% (Lipoplus) BRN   250 mL
Sodium chloride 10% ARD 10 mL 10 mL
Potassium chloride 7.45% ARD 10 mL 10 mL
Calcium gluconate 10% HB 10–40 mL 10–40 mL
Magnesium sulfate 10% HB 10–40 mL 10–40 mL
Potassium phosphate 13.6%   10–40 mL 10–40 mL
Trace elements (Addamel N) FRK 10 mL 10 mL

 


a Trace elements: chromium, copper, iron, manganese, iodine, fluorine, molybdenum, selenium, and zinc.

  Component Amounts
Component #279a #280b
Amino acids 14% 250 mL  
Amino acids 14.36%   250 mL
Dextrose 39.6% 250 mL 250 mL
Fat emulsion 20% 125 mL 125 mL
Sodium 33.5 mmol 33.5 mmol
Potassium 23.5 mmol 23.5 mmol
Magnesium 2.65 mmol 2.65 mmol
Calcium 2.65 mmol 2.65 mmol
Zinc 0.02 mmol 0.02 mmol
Chloride 30 mmol 30 mmol
Acetate 30 mmol 30 mmol
Phosphate 10 mmol 10 mmol

 


a Available as a 3-chamber bag of NuTRIflex Lipid Special (Braun) in a fixed volume and concentration with no additional additives.
b Available as a 3-chamber bag of NuTRIflex Omega Special (Braun) in a fixed volume and concentration with no additional additives.

 

ASHP® Handbook on Injectable Drugs®. © Copyright, 1977-2020. American Society of Health-System Pharmacists®, 4500 East-West Highway, Suite 900, Bethesda, Maryland 20814.
Original Publication Date: October 1, 2006.
Selected Revisions: September 30, 2019.
Database Extraction: 02/05/2020 15:45:21 -0500+