Do not use Nutriflex Lipid 32\/64\/40 peripheral<\/h2>\n\n\n\n- if you are allergic to any of the active substances, to eggs, peanuts or soybeans or to any of the other ingredients of this medicine (listed in section 6).<\/li>
- This medicine should not be given to newborns, infants or children under two years of age.<\/li><\/ul>\n\n\n\n
You should also not use Nutriflex Lipid 32\/64\/40 peripheral if you have any of the following conditions:<\/p>\n\n\n\n
- life-threatening circulation problems that can occur e.g. in case of unconsciousness or shock<\/li>
- heart attack or stroke<\/li>
- severely impaired blood coagulation ability, risk of bleeding (severe coagulopathy , pronounced hemorrhagic diathesis)<\/li>
- blood or fat clots in the blood vessels (emboli)<\/li>
- severe liver failure<\/li>
- impaired bile flow (intrahepatic cholestasis)<\/li>
- severe renal failure that is not treated with any dialysis treatment<\/li>
- disturbances in the body’s salt level<\/li>
- dehydration or excess fluid in the body<\/li>
- fluid in the lungs ( pulmonary edema )<\/li>
- severe heart failure<\/li>
- certain disturbances in metabolism such as
- too much lipid er (fat) in the blood<\/li>
- congenital disorders of amino acid metabolism<\/li>
- abnormally high blood sugar levels that require more than 6 units of insulin per hour to be kept under control<\/li>
- abnormalities in metabolism that may occur after surgery or injury<\/li>
- coma of unknown cause<\/li>
- insufficient oxygen supply to the tissues<\/li>
- abnormally high acid level in the blood.<\/li><\/ul><\/li><\/ul>\n\n\n\n
Warnings and cautions<\/h2>\n\n\n\n
Talk to your doctor, pharmacist, or nurse before using Nutriflex\u00a0Lipid\u00a032\/64\/40\u00a0peripheral.<\/p>\n\n\n\n
Inform the doctor:<\/p>\n\n\n\n
- if you have heart, liver or kidney problems<\/li>
- if you have certain types of metabolic diseases such as diabetes , abnormal blood fat levels and disorders of the body’s fluid and salt balance or acid \u2011 base balance.<\/li><\/ul>\n\n\n\n
When you receive this medicine, you will be closely monitored to detect any early signs of an\u00a0allergic reaction\u00a0(eg fever, chills, rash, or shortness of breath).<\/p>\n\n\n\n
Continued monitoring and testing, such as various blood tests will be performed to ensure that your body is using the supplied nutrients properly.<\/p>\n\n\n\n
Healthcare professionals can also take steps to ensure that your fluid and electrolyte needs are met.\u00a0You can also get other nutritional solutions, in addition to Nutriflex\u00a0Lipid\u00a032\/64\/40\u00a0peripheral, to completely cover your nutritional needs.<\/p>\n\n\n\n
Children<\/h2>\n\n\n\n
This medicine must not be given to newborns, infants, or children under two years of age.<\/p>\n\n\n\n
Other medicines and Nutriflex Lipid 32\/64\/40 peripheral<\/h2>\n\n\n\n
Tell your doctor, pharmacist, or nurse if you are taking, have recently taken, or might take any other medicines.<\/p>\n\n\n\n
Nutriflex\u00a0Lipid\u00a032\/64\/40\u00a0peripheral\u00a0effects may affect or be affected by certain other medicines.\u00a0Tell your doctor, pharmacist, or nurse if you are taking or receiving any of the following:<\/p>\n\n\n\n
- insulin<\/li>
- heparin<\/li>
- drugs that inhibit the blood’s ability to coagulate such as warfarin or other coumarin derivatives<\/li>
- drugs that increase urinary excretion ( diuretics )<\/li>
- medicines used to treat high blood pressure (ACE inhibitors)<\/li>
- medicines to treat high blood pressure or heart problems ( angiotensin \u2011II \u2011 receptor antagonists)<\/li>
- drugs used in organ transplants such as ciclosporin and tacrolimus<\/li>
- drugs to treat inflammation ( corticosteroids , cortisone )<\/li>
- hormone preparations that affect fluid balance (adrenocorticotropic hormone or ACTH)<\/li><\/ul>\n\n\n\n
Pregnancy and breastfeeding<\/h2>\n\n\n\n
If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.\u00a0If you are pregnant, you will only be given this medicine if your doctor thinks it is necessary for your recovery.\u00a0There are no data on the use of Nutriflex\u00a0Lipid\u00a032\/64\/40\u00a0peripheral\u00a0in pregnant women.<\/p>\n\n\n\n
Breast-feeding is not recommended for mothers receiving\u00a0parenteral\u00a0nutrition.<\/p>\n\n\n\n
Driving and using machines<\/h2>\n\n\n\n
This drug is normally given to bedridden patients e.g.\u00a0in a hospital or clinic, which excludes driving or using machines.\u00a0However, the drug itself does not affect the ability to drive or use machines.\u00a0<\/p>\n\n\n\n
You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or\u00a0side effects.\u00a0Descriptions of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Read all the information in this leaflet for guidance.\u00a0If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n
Nutriflex Lipid 32\/64\/40 peripheral contains sodium<\/h2>\n\n\n\n
This medicine contains 1150 mg of\u00a0sodium\u00a0(the main ingredient in table salt\/table salt) per 1250 ml bag.\u00a0This corresponds to 58% of the maximum recommended daily\u00a0sodium\u00a0intake for adults.<\/p>\n\n\n\n
Consult a doctor or pharmacist if your need is one or more bags daily for an extended period, especially if you have been prescribed a low-salt (sodium-poor) diet.<\/p>\n\n\n\n
How to use Nutriflex Lipid 32\/64\/40 peripheral<\/h2>\n\n\n\n
This medicine is given to you as an intravenous infusion (drip), ie. via a small hose directly into a friend. This drug can be given in a smaller ( peripheral ) or larger (central) vein.<\/p>\n\n\n\n
Your doctor will decide how much of this medicine you need and for how long you need to be treated.<\/p>\n\n\n\n
Use for children<\/h2>\n\n\n\n
This medicine should not be given to newborns, infants, or children under two years of age.<\/p>\n\n\n\n
If you use more Nutriflex Lipid 32\/64\/40 than you should<\/h2>\n\n\n\n
If you have ingested too much medicine or if e.g.\u00a0a child ingested the medicine by mistake, contact a doctor or hospital for risk assessment and advice.<\/p>\n\n\n\n
If you have been given too much of this medicine, it can lead to a so-called congestion syndrome and the following symptoms:<\/p>\n\n\n\n
- excess fluid and electrolyte disturbances<\/li>
- fluid in the lungs ( pulmonary edema )<\/li>
- loss of amino acids via the urine and disturbances in the amino acid balance<\/li>
- vomiting, nausea<\/li>
- overindulge<\/li>
- high blood sugar levels<\/li>
- glucose in the urine<\/li>
- dehydration<\/li>
- the blood becomes much more concentrated than normal (hyperosmolality)<\/li>
- impaired consciousness or unconsciousness due to extremely high blood sugar content<\/li>
- enlargement of the liver ( hepatomegaly ) with or without jaundice (jaundice)<\/li>
- enlargement of the spleen ( splenomegaly )<\/li>
- accumulation of fat in the internal organs<\/li>
- abnormal liver function values<\/li>
- decreased number of red blood cells ( anemia , anemia )<\/li>
- decreased white blood cell count ( leukopenia )<\/li>
- decreased platelet count ( thrombocytopenia )<\/li>
- increased amount of immature red blood cells (reticulocytosis)<\/li>
- decay of blood cells ( hemolysis )<\/li>
- bleeding or tendency to bleed<\/li>
- disturbance in the blood’s ability to coagulate (such as altered bleeding time, coagulation time, prothrombin time, etc.)<\/li>
- fever<\/li>
- high blood fat levels<\/li>
- unconsciousness.<\/li><\/ul>\n\n\n\n
If any of these symptoms occur, the infusion should be stopped immediately.<\/p>\n\n\n\n
If you have any further questions on the use of this product, ask your doctor, pharmacist, or nurse.<\/p>\n\n\n\n
Possible side effects<\/h2>\n\n\n\n
Like all medicines, this medicine can cause\u00a0side effects, although not everybody gets them.<\/p>\n\n\n\n
The following side effects can be serious. If you get any of the following symptoms, tell your doctor immediately if you stop taking this medicine:<\/strong><\/p>\n\n\n\nRare (may affect up to 1 in 1,000 people):<\/p>\n\n\n\n
- allergic reactions, e.g. skin reactions, shortness of breath, swelling of the lips, mouth and throat, difficulty breathing.<\/li><\/ul>\n\n\n\n
Other side effects include:<\/strong><\/p>\n\n\n\nCommon (may affect up to 1 in 10 people):<\/p>\n\n\n\n
- irritation or inflammation of the vein ( phlebitis , thrombophlebitis )<\/li><\/ul>\n\n\n\n
Uncommon (may affect up to 1 in 100 people):<\/p>\n\n\n\n
- nausea, vomiting, loss of appetite<\/li><\/ul>\n\n\n\n
Rare (may affect up to 1 in 1,000 people):<\/p>\n\n\n\n
- increased blood coagulation capacity<\/li>
- bluish discoloration of the skin<\/li>
- shortness of breath<\/li>
- headache<\/li>
- heat wave<\/li>
- redness ( erythema )<\/li>
- sweating<\/li>
- overindulge<\/li>
- feel cold<\/li>
- high body temperature<\/li>
- drowsiness<\/li>
- pain in the chest, back, skeletal bones or lumbar spine<\/li>
- decrease or increase in blood pressure et<\/li><\/ul>\n\n\n\n
Very rare (may affect up to 1 in 10,000 people):<\/p>\n\n\n\n
- abnormally high blood fats or blood sugar levels<\/li>
- high levels of acidic substances in the blood<\/li>
- Excess fat can lead to fat overload syndrome, for more information see “If you have used too much Nutriflex Lipid 32\/64\/40 peripheral” in section 3. Symptoms usually disappear when the infusion is stopped.<\/li><\/ul>\n\n\n\n
Has been reported (occurs in an unknown number of users):<\/p>\n\n\n\n
- decreased white blood cell count ( leukopenia )<\/li>
- decreased platelet count ( thrombocytopenia )<\/li>
- decreased bile flow (cholestasis)<\/li><\/ul>\n\n\n\n
How to store Nutriflex Lipid 32\/64\/40 peripheral<\/h2>\n\n\n\n
Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n
Do not store above 25 \u00b0 C.<\/p>\n\n\n\n
Do not freeze. If the packaging is accidentally frozen, it must be discarded.<\/p>\n\n\n\n
Store the bag in the protective packaging. Sensitive to light.<\/p>\n\n\n\n
Do not use this medicine after the expiry date which is stated on the label. The expiration date is the last day of the specified month.<\/p>\n\n\n\n
Contents of the pack and other information<\/h2>\n\n\n\nContent declaration<\/h2>\n\n\n\n
The active substances in the ready-to-use\u00a0mixture\u00a0are:<\/p>\n\n\n\nfrom the upper chamber
(glucose solution)<\/em><\/strong><\/td>and 1000 ml<\/td> and 1250 ml<\/td> in 1875 ml<\/td> and 2500 ml<\/td><\/tr> Glucose monohydratecorresponding to glucose<\/td> 70.40 g64.00 g<\/td> 88.00 g80.00 g<\/td> 132.0 g120.0 g<\/td> 176.0 g160.0 g<\/td><\/tr> Sodium dihydrogen phosphate dihydrate<\/td> 0.936 g<\/td> 1.170 g<\/td> 1.755 g<\/td> 2,340 g<\/td><\/tr> Zinc acetate dihydrate<\/td> 5,280 mg<\/td> 6,600 mg<\/td> 9,900 mg<\/td> 13.20 mg<\/td><\/tr> <\/td><\/tr> from the middle chamber
(fat emulsion)<\/em><\/strong><\/td>and 1000 ml<\/td> and 1250 ml<\/td> in 1875 ml<\/td> and 2500 ml<\/td><\/tr> Soybean oil, refined<\/td> 20.00 g<\/td> 25.00 g<\/td> 37.50 g<\/td> 50.00 g<\/td><\/tr> Medium chain triglycerides<\/td> 20.00 g<\/td> 25.00 g<\/td> 37.50 g<\/td> 50.00 g<\/td><\/tr> <\/td><\/tr> from the lower chamber
(amino acid solution)<\/em><\/strong><\/td>and 1000 ml<\/td> and 1250 ml<\/td> in 1875 ml<\/td> and 2500 ml<\/td><\/tr> Isoleucine<\/td> 1.872 g<\/td> 2,340 g<\/td> 3,510 g<\/td> 4,680 g<\/td><\/tr> Leucine<\/td> 2,504 g<\/td> 3.130 g<\/td> 4,695 g<\/td> 6,260 g<\/td><\/tr> Lysine hydrochloride corresponding to\u00a0lysine<\/td> 2,272 g1.818 g<\/td> 2,840 g2,273 g<\/td> 4,260 g3,410 g<\/td> 5,680 g4,546 g<\/td><\/tr> Methionine<\/td> 1,568 g<\/td> 1,960 g<\/td> 2,940 g<\/td> 3,920 g<\/td><\/tr> Phenylalanine<\/td> 2,808 g<\/td> 3,510 g<\/td> 5.265 g<\/td> 7,020 g<\/td><\/tr> Troponin<\/td> 1,456 g<\/td> 1,820 g<\/td> 2,730 g<\/td> 3,640 g<\/td><\/tr> Tryptophan<\/td> 0.456 g<\/td> 0.570 g<\/td> 0.855 g<\/td> 1,140 g<\/td><\/tr> Valin<\/td> 2,080 g<\/td> 2,600 g<\/td> 3,900 g<\/td> 5,200 g<\/td><\/tr> Arginine<\/td> 2,160 g<\/td> 2,700 g<\/td> 4,050 g<\/td> 5,400 g<\/td><\/tr> Histidine hydrochloride monohydratecorresponding to histidine<\/td> 1,352 g1,000 g<\/td> 1.690 g1,251 g<\/td> 2,535 g1.876 g<\/td> 3.380 g2,502 g<\/td><\/tr> Alanine<\/td> 3,880 g<\/td> 4,850 g<\/td> 7.275 g<\/td> 9,700 g<\/td><\/tr> Aspartic acid<\/td> 1,200 g<\/td> 1,500 g<\/td> 2,250 g<\/td> 3,000 g<\/td><\/tr> Glutamic acid<\/td> 2,800 g<\/td> 3,500 g<\/td> 5,250 g<\/td> 7,000 g<\/td><\/tr> Glycine<\/td> 1,320 g<\/td> 1.650 g<\/td> 2.475 g<\/td> 3,300 g<\/td><\/tr> Proline<\/td> 2,720 g<\/td> 3,400 g<\/td> 5,100 g<\/td> 6,800 g<\/td><\/tr> Serine<\/td> 2,400 g<\/td> 3,000 g<\/td> 4,500 g<\/td> 6,000 g<\/td><\/tr> Sodium hydroxide<\/td> 0.640 g<\/td> 0.800 g<\/td> 1,200 g<\/td> 1,600 g<\/td><\/tr> Sodium chloride<\/td> 0.865 g<\/td> 1,081 g<\/td> 1.622 g<\/td> 2,162 g<\/td><\/tr> Sodium acetate trihydrate<\/td> 0.435 g<\/td> 0.544 g<\/td> 0.816 g<\/td> 1,088 g<\/td><\/tr> Potassium acetate<\/td> 2,354 g<\/td> 2,943 g<\/td> 4,415 g<\/td> 5,886 g<\/td><\/tr> Magnesium acetate tetrahydrate<\/td> 0.515 g<\/td> 0.644 g<\/td> 0.966 g<\/td> 1,288 g<\/td><\/tr> Calcium chloride dihydrate<\/td> 0.353 g<\/td> 0.441 g<\/td> 0.662 g<\/td> 0.882 g<\/td><\/tr> <\/td><\/tr> Electrolyte is<\/strong><\/td>and 1000 ml<\/td> and 1250 ml<\/td> in 1875 ml<\/td> and 2500 ml<\/td><\/tr> Sodium<\/td> 40 mmol<\/td> 50 mmol<\/td> 75 mmol<\/td> 100 mmol<\/td><\/tr> Potassium<\/td> 24 mmol<\/td> 30 mmol<\/td> 45 mmol<\/td> 60 mmol<\/td><\/tr> Magnesium<\/td> 2.4 mmol<\/td> 3.0 mmol<\/td> 4.5 mmol<\/td> 6.0 mmol<\/td><\/tr> Calcium<\/td> 2.4 mmol<\/td> 3.0 mmol<\/td> 4.5 mmol<\/td> 6.0 mmol<\/td><\/tr> Zinc<\/td> 0.024 mmol<\/td> 0.03 mmol<\/td> 0.045 mmol<\/td> 0.06 mmol<\/td><\/tr> Chloride<\/td> 38 mmol<\/td> 48 mmol<\/td> 72 mmol<\/td> 96 mmol<\/td><\/tr> Acetate<\/td> 32 mmol<\/td> 40 mmol<\/td> 60 mmol<\/td> 80 mmol<\/td><\/tr> Phosphate<\/td> 6.0 mmol<\/td> 7.5 mmol<\/td> 11.25 mmol<\/td> 15.0 mmol<\/td><\/tr> <\/td><\/tr> Amino acid content<\/td> 32 g<\/td> 40 g<\/td> 60 g<\/td> 80 g<\/td><\/tr> Nitrogen content<\/td> 4.6 g<\/td> 5.7 g<\/td> 8.6 g<\/td> 11.4 g<\/td><\/tr> Carbohydrate content<\/td> 64 g<\/td> 80 g<\/td> 120 g<\/td> 160 g<\/td><\/tr> Lipid content<\/td> 40 g<\/td> 50 g<\/td> 75 g<\/td> 100 g<\/td><\/tr> <\/td><\/tr> Lipid energy<\/td> 1590 kJ(380 kcal)<\/td> 1990 kJ(475 kcal)<\/td> 2985 kJ(715 kcal)<\/td> 3980 kJ(950 kcal)<\/td><\/tr> Carbohydrate energy<\/td> 1075 kJ(255 kcal)<\/td> 1340 kJ(320 kcal)<\/td> 2010 kJ(480 kcal)<\/td> 2680 kJ(640 kcal)<\/td><\/tr> Amino acid energy<\/td> 535 kJ(130 kcal)<\/td> 670 kJ(160 kcal)<\/td> 1005 kJ(240 kcal)<\/td> 1340 kJ(320 kcal)<\/td><\/tr> Non-protein energy<\/td> 2665 kJ(635 kcal)<\/td> 3330 kJ(795 kcal)<\/td> 4995 kJ(1195 kcal)<\/td> 6660 kJ(1590 kcal)<\/td><\/tr> Energy, total<\/td> 3200 kJ(765 kcal)<\/td> 4000 kJ(955 kcal)<\/td> 6000 kJ(1435 kcal)<\/td> 8000 kJ(1910 kcal)<\/td><\/tr> <\/td><\/tr> Osmolality<\/td> 950 mOsm \/ kg<\/td> 950 mOsm \/ kg<\/td> 950 mOsm \/ kg<\/td> 950 mOsm \/ kg<\/td><\/tr> Theoretical osmolarity<\/td> 840 mOsm \/ l<\/td> 840 mOsm \/ l<\/td> 840 mOsm \/ l<\/td> 840 mOsm \/ l<\/td><\/tr> pH<\/td> 5.0\u20136.0<\/td> 5.0\u20136.0<\/td> 5.0\u20136.0<\/td> 5.0\u20136.0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\nThe other ingredients are citric acid monohydrate (for\u00a0pH\u00a0adjustment), egg phospholipids for\u00a0injection,\u00a0glycerol\u00a0, sodium oleate, all \u2011 rac \u2011 alpha-tocopherol, and water for injections.<\/p>\n\n\n\n
What the medicine looks like and contents of the pack<\/h2>\n\n\n\n
The reconstituted drug is an\u00a0emulsion\u00a0for\u00a0infusion, ie.\u00a0it is given through a small tube into a vein.<\/p>\n\n\n\n
Nutriflex Lipid 32\/64\/40 peripheral is delivered in flexible multi-chamber bags that contain.<\/p>\n\n\n\n
- 1250 ml (500 ml amino acid solution + 250 ml fat emulsion + 500 ml glucose solution)<\/li>
- 1875 ml (750 ml amino acid solution + 375 ml fat emulsion + 750 ml glucose solution)<\/li>
- 2500 ml (1000 ml amino acid solution + 500 ml fat emulsion + 1000 ml glucose solution)<\/li><\/ul>\n\n\n\n
You should also not use Nutriflex Lipid 32\/64\/40 peripheral if you have any of the following conditions:<\/p>\n\n\n\n
- life-threatening circulation problems that can occur e.g. in case of unconsciousness or shock<\/li>
- heart attack or stroke<\/li>
- severely impaired blood coagulation ability, risk of bleeding (severe coagulopathy , pronounced hemorrhagic diathesis)<\/li>
- blood or fat clots in the blood vessels (emboli)<\/li>
- severe liver failure<\/li>
- impaired bile flow (intrahepatic cholestasis)<\/li>
- severe renal failure that is not treated with any dialysis treatment<\/li>
- disturbances in the body’s salt level<\/li>
- dehydration or excess fluid in the body<\/li>
- fluid in the lungs ( pulmonary edema )<\/li>
- severe heart failure<\/li>
- certain disturbances in metabolism such as
- too much lipid er (fat) in the blood<\/li>
- congenital disorders of amino acid metabolism<\/li>
- abnormally high blood sugar levels that require more than 6 units of insulin per hour to be kept under control<\/li>
- abnormalities in metabolism that may occur after surgery or injury<\/li>
- coma of unknown cause<\/li>
- insufficient oxygen supply to the tissues<\/li>
- abnormally high acid level in the blood.<\/li><\/ul><\/li><\/ul>\n\n\n\n
Warnings and cautions<\/h2>\n\n\n\n
Talk to your doctor, pharmacist, or nurse before using Nutriflex\u00a0Lipid\u00a032\/64\/40\u00a0peripheral.<\/p>\n\n\n\n
Inform the doctor:<\/p>\n\n\n\n
- if you have heart, liver or kidney problems<\/li>
- if you have certain types of metabolic diseases such as diabetes , abnormal blood fat levels and disorders of the body’s fluid and salt balance or acid \u2011 base balance.<\/li><\/ul>\n\n\n\n
When you receive this medicine, you will be closely monitored to detect any early signs of an\u00a0allergic reaction\u00a0(eg fever, chills, rash, or shortness of breath).<\/p>\n\n\n\n
Continued monitoring and testing, such as various blood tests will be performed to ensure that your body is using the supplied nutrients properly.<\/p>\n\n\n\n
Healthcare professionals can also take steps to ensure that your fluid and electrolyte needs are met.\u00a0You can also get other nutritional solutions, in addition to Nutriflex\u00a0Lipid\u00a032\/64\/40\u00a0peripheral, to completely cover your nutritional needs.<\/p>\n\n\n\n
Children<\/h2>\n\n\n\n
This medicine must not be given to newborns, infants, or children under two years of age.<\/p>\n\n\n\n
Other medicines and Nutriflex Lipid 32\/64\/40 peripheral<\/h2>\n\n\n\n
Tell your doctor, pharmacist, or nurse if you are taking, have recently taken, or might take any other medicines.<\/p>\n\n\n\n
Nutriflex\u00a0Lipid\u00a032\/64\/40\u00a0peripheral\u00a0effects may affect or be affected by certain other medicines.\u00a0Tell your doctor, pharmacist, or nurse if you are taking or receiving any of the following:<\/p>\n\n\n\n
- insulin<\/li>
- heparin<\/li>
- drugs that inhibit the blood’s ability to coagulate such as warfarin or other coumarin derivatives<\/li>
- drugs that increase urinary excretion ( diuretics )<\/li>
- medicines used to treat high blood pressure (ACE inhibitors)<\/li>
- medicines to treat high blood pressure or heart problems ( angiotensin \u2011II \u2011 receptor antagonists)<\/li>
- drugs used in organ transplants such as ciclosporin and tacrolimus<\/li>
- drugs to treat inflammation ( corticosteroids , cortisone )<\/li>
- hormone preparations that affect fluid balance (adrenocorticotropic hormone or ACTH)<\/li><\/ul>\n\n\n\n
Pregnancy and breastfeeding<\/h2>\n\n\n\n
If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine.\u00a0If you are pregnant, you will only be given this medicine if your doctor thinks it is necessary for your recovery.\u00a0There are no data on the use of Nutriflex\u00a0Lipid\u00a032\/64\/40\u00a0peripheral\u00a0in pregnant women.<\/p>\n\n\n\n
Breast-feeding is not recommended for mothers receiving\u00a0parenteral\u00a0nutrition.<\/p>\n\n\n\n
Driving and using machines<\/h2>\n\n\n\n
This drug is normally given to bedridden patients e.g.\u00a0in a hospital or clinic, which excludes driving or using machines.\u00a0However, the drug itself does not affect the ability to drive or use machines.\u00a0<\/p>\n\n\n\n
You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention.\u00a0One of the factors that can affect your ability in these respects is the use of drugs due to their effects and\/or\u00a0side effects.\u00a0Descriptions of these effects and\u00a0side effects\u00a0can be found in other sections.\u00a0Read all the information in this leaflet for guidance.\u00a0If you are not sure, talk to your doctor or pharmacist.<\/p>\n\n\n\n
Nutriflex Lipid 32\/64\/40 peripheral contains sodium<\/h2>\n\n\n\n
This medicine contains 1150 mg of\u00a0sodium\u00a0(the main ingredient in table salt\/table salt) per 1250 ml bag.\u00a0This corresponds to 58% of the maximum recommended daily\u00a0sodium\u00a0intake for adults.<\/p>\n\n\n\n
Consult a doctor or pharmacist if your need is one or more bags daily for an extended period, especially if you have been prescribed a low-salt (sodium-poor) diet.<\/p>\n\n\n\n
How to use Nutriflex Lipid 32\/64\/40 peripheral<\/h2>\n\n\n\n
This medicine is given to you as an intravenous infusion (drip), ie. via a small hose directly into a friend. This drug can be given in a smaller ( peripheral ) or larger (central) vein.<\/p>\n\n\n\n
Your doctor will decide how much of this medicine you need and for how long you need to be treated.<\/p>\n\n\n\n
Use for children<\/h2>\n\n\n\n
This medicine should not be given to newborns, infants, or children under two years of age.<\/p>\n\n\n\n
If you use more Nutriflex Lipid 32\/64\/40 than you should<\/h2>\n\n\n\n
If you have ingested too much medicine or if e.g.\u00a0a child ingested the medicine by mistake, contact a doctor or hospital for risk assessment and advice.<\/p>\n\n\n\n
If you have been given too much of this medicine, it can lead to a so-called congestion syndrome and the following symptoms:<\/p>\n\n\n\n
- excess fluid and electrolyte disturbances<\/li>
- fluid in the lungs ( pulmonary edema )<\/li>
- loss of amino acids via the urine and disturbances in the amino acid balance<\/li>
- vomiting, nausea<\/li>
- overindulge<\/li>
- high blood sugar levels<\/li>
- glucose in the urine<\/li>
- dehydration<\/li>
- the blood becomes much more concentrated than normal (hyperosmolality)<\/li>
- impaired consciousness or unconsciousness due to extremely high blood sugar content<\/li>
- enlargement of the liver ( hepatomegaly ) with or without jaundice (jaundice)<\/li>
- enlargement of the spleen ( splenomegaly )<\/li>
- accumulation of fat in the internal organs<\/li>
- abnormal liver function values<\/li>
- decreased number of red blood cells ( anemia , anemia )<\/li>
- decreased white blood cell count ( leukopenia )<\/li>
- decreased platelet count ( thrombocytopenia )<\/li>
- increased amount of immature red blood cells (reticulocytosis)<\/li>
- decay of blood cells ( hemolysis )<\/li>
- bleeding or tendency to bleed<\/li>
- disturbance in the blood’s ability to coagulate (such as altered bleeding time, coagulation time, prothrombin time, etc.)<\/li>
- fever<\/li>
- high blood fat levels<\/li>
- unconsciousness.<\/li><\/ul>\n\n\n\n
If any of these symptoms occur, the infusion should be stopped immediately.<\/p>\n\n\n\n
If you have any further questions on the use of this product, ask your doctor, pharmacist, or nurse.<\/p>\n\n\n\n
Possible side effects<\/h2>\n\n\n\n
Like all medicines, this medicine can cause\u00a0side effects, although not everybody gets them.<\/p>\n\n\n\n
The following side effects can be serious. If you get any of the following symptoms, tell your doctor immediately if you stop taking this medicine:<\/strong><\/p>\n\n\n\n
Rare (may affect up to 1 in 1,000 people):<\/p>\n\n\n\n
- allergic reactions, e.g. skin reactions, shortness of breath, swelling of the lips, mouth and throat, difficulty breathing.<\/li><\/ul>\n\n\n\n
Other side effects include:<\/strong><\/p>\n\n\n\n
Common (may affect up to 1 in 10 people):<\/p>\n\n\n\n
- irritation or inflammation of the vein ( phlebitis , thrombophlebitis )<\/li><\/ul>\n\n\n\n
Uncommon (may affect up to 1 in 100 people):<\/p>\n\n\n\n
- nausea, vomiting, loss of appetite<\/li><\/ul>\n\n\n\n
Rare (may affect up to 1 in 1,000 people):<\/p>\n\n\n\n
- increased blood coagulation capacity<\/li>
- bluish discoloration of the skin<\/li>
- shortness of breath<\/li>
- headache<\/li>
- heat wave<\/li>
- redness ( erythema )<\/li>
- sweating<\/li>
- overindulge<\/li>
- feel cold<\/li>
- high body temperature<\/li>
- drowsiness<\/li>
- pain in the chest, back, skeletal bones or lumbar spine<\/li>
- decrease or increase in blood pressure et<\/li><\/ul>\n\n\n\n
Very rare (may affect up to 1 in 10,000 people):<\/p>\n\n\n\n
- abnormally high blood fats or blood sugar levels<\/li>
- high levels of acidic substances in the blood<\/li>
- Excess fat can lead to fat overload syndrome, for more information see “If you have used too much Nutriflex Lipid 32\/64\/40 peripheral” in section 3. Symptoms usually disappear when the infusion is stopped.<\/li><\/ul>\n\n\n\n
Has been reported (occurs in an unknown number of users):<\/p>\n\n\n\n
- decreased white blood cell count ( leukopenia )<\/li>
- decreased platelet count ( thrombocytopenia )<\/li>
- decreased bile flow (cholestasis)<\/li><\/ul>\n\n\n\n
How to store Nutriflex Lipid 32\/64\/40 peripheral<\/h2>\n\n\n\n
Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n
Do not store above 25 \u00b0 C.<\/p>\n\n\n\n
Do not freeze. If the packaging is accidentally frozen, it must be discarded.<\/p>\n\n\n\n
Store the bag in the protective packaging. Sensitive to light.<\/p>\n\n\n\n
Do not use this medicine after the expiry date which is stated on the label. The expiration date is the last day of the specified month.<\/p>\n\n\n\n
Contents of the pack and other information<\/h2>\n\n\n\n
Content declaration<\/h2>\n\n\n\n
The active substances in the ready-to-use\u00a0mixture\u00a0are:<\/p>\n\n\n\n
from the upper chamber
(glucose solution)<\/em><\/strong><\/td>and 1000 ml<\/td> and 1250 ml<\/td> in 1875 ml<\/td> and 2500 ml<\/td><\/tr> Glucose monohydratecorresponding to glucose<\/td> 70.40 g64.00 g<\/td> 88.00 g80.00 g<\/td> 132.0 g120.0 g<\/td> 176.0 g160.0 g<\/td><\/tr> Sodium dihydrogen phosphate dihydrate<\/td> 0.936 g<\/td> 1.170 g<\/td> 1.755 g<\/td> 2,340 g<\/td><\/tr> Zinc acetate dihydrate<\/td> 5,280 mg<\/td> 6,600 mg<\/td> 9,900 mg<\/td> 13.20 mg<\/td><\/tr> <\/td><\/tr> from the middle chamber
(fat emulsion)<\/em><\/strong><\/td>and 1000 ml<\/td> and 1250 ml<\/td> in 1875 ml<\/td> and 2500 ml<\/td><\/tr> Soybean oil, refined<\/td> 20.00 g<\/td> 25.00 g<\/td> 37.50 g<\/td> 50.00 g<\/td><\/tr> Medium chain triglycerides<\/td> 20.00 g<\/td> 25.00 g<\/td> 37.50 g<\/td> 50.00 g<\/td><\/tr> <\/td><\/tr> from the lower chamber
(amino acid solution)<\/em><\/strong><\/td>and 1000 ml<\/td> and 1250 ml<\/td> in 1875 ml<\/td> and 2500 ml<\/td><\/tr> Isoleucine<\/td> 1.872 g<\/td> 2,340 g<\/td> 3,510 g<\/td> 4,680 g<\/td><\/tr> Leucine<\/td> 2,504 g<\/td> 3.130 g<\/td> 4,695 g<\/td> 6,260 g<\/td><\/tr> Lysine hydrochloride corresponding to\u00a0lysine<\/td> 2,272 g1.818 g<\/td> 2,840 g2,273 g<\/td> 4,260 g3,410 g<\/td> 5,680 g4,546 g<\/td><\/tr> Methionine<\/td> 1,568 g<\/td> 1,960 g<\/td> 2,940 g<\/td> 3,920 g<\/td><\/tr> Phenylalanine<\/td> 2,808 g<\/td> 3,510 g<\/td> 5.265 g<\/td> 7,020 g<\/td><\/tr> Troponin<\/td> 1,456 g<\/td> 1,820 g<\/td> 2,730 g<\/td> 3,640 g<\/td><\/tr> Tryptophan<\/td> 0.456 g<\/td> 0.570 g<\/td> 0.855 g<\/td> 1,140 g<\/td><\/tr> Valin<\/td> 2,080 g<\/td> 2,600 g<\/td> 3,900 g<\/td> 5,200 g<\/td><\/tr> Arginine<\/td> 2,160 g<\/td> 2,700 g<\/td> 4,050 g<\/td> 5,400 g<\/td><\/tr> Histidine hydrochloride monohydratecorresponding to histidine<\/td> 1,352 g1,000 g<\/td> 1.690 g1,251 g<\/td> 2,535 g1.876 g<\/td> 3.380 g2,502 g<\/td><\/tr> Alanine<\/td> 3,880 g<\/td> 4,850 g<\/td> 7.275 g<\/td> 9,700 g<\/td><\/tr> Aspartic acid<\/td> 1,200 g<\/td> 1,500 g<\/td> 2,250 g<\/td> 3,000 g<\/td><\/tr> Glutamic acid<\/td> 2,800 g<\/td> 3,500 g<\/td> 5,250 g<\/td> 7,000 g<\/td><\/tr> Glycine<\/td> 1,320 g<\/td> 1.650 g<\/td> 2.475 g<\/td> 3,300 g<\/td><\/tr> Proline<\/td> 2,720 g<\/td> 3,400 g<\/td> 5,100 g<\/td> 6,800 g<\/td><\/tr> Serine<\/td> 2,400 g<\/td> 3,000 g<\/td> 4,500 g<\/td> 6,000 g<\/td><\/tr> Sodium hydroxide<\/td> 0.640 g<\/td> 0.800 g<\/td> 1,200 g<\/td> 1,600 g<\/td><\/tr> Sodium chloride<\/td> 0.865 g<\/td> 1,081 g<\/td> 1.622 g<\/td> 2,162 g<\/td><\/tr> Sodium acetate trihydrate<\/td> 0.435 g<\/td> 0.544 g<\/td> 0.816 g<\/td> 1,088 g<\/td><\/tr> Potassium acetate<\/td> 2,354 g<\/td> 2,943 g<\/td> 4,415 g<\/td> 5,886 g<\/td><\/tr> Magnesium acetate tetrahydrate<\/td> 0.515 g<\/td> 0.644 g<\/td> 0.966 g<\/td> 1,288 g<\/td><\/tr> Calcium chloride dihydrate<\/td> 0.353 g<\/td> 0.441 g<\/td> 0.662 g<\/td> 0.882 g<\/td><\/tr> <\/td><\/tr> Electrolyte is<\/strong><\/td> and 1000 ml<\/td> and 1250 ml<\/td> in 1875 ml<\/td> and 2500 ml<\/td><\/tr> Sodium<\/td> 40 mmol<\/td> 50 mmol<\/td> 75 mmol<\/td> 100 mmol<\/td><\/tr> Potassium<\/td> 24 mmol<\/td> 30 mmol<\/td> 45 mmol<\/td> 60 mmol<\/td><\/tr> Magnesium<\/td> 2.4 mmol<\/td> 3.0 mmol<\/td> 4.5 mmol<\/td> 6.0 mmol<\/td><\/tr> Calcium<\/td> 2.4 mmol<\/td> 3.0 mmol<\/td> 4.5 mmol<\/td> 6.0 mmol<\/td><\/tr> Zinc<\/td> 0.024 mmol<\/td> 0.03 mmol<\/td> 0.045 mmol<\/td> 0.06 mmol<\/td><\/tr> Chloride<\/td> 38 mmol<\/td> 48 mmol<\/td> 72 mmol<\/td> 96 mmol<\/td><\/tr> Acetate<\/td> 32 mmol<\/td> 40 mmol<\/td> 60 mmol<\/td> 80 mmol<\/td><\/tr> Phosphate<\/td> 6.0 mmol<\/td> 7.5 mmol<\/td> 11.25 mmol<\/td> 15.0 mmol<\/td><\/tr> <\/td><\/tr> Amino acid content<\/td> 32 g<\/td> 40 g<\/td> 60 g<\/td> 80 g<\/td><\/tr> Nitrogen content<\/td> 4.6 g<\/td> 5.7 g<\/td> 8.6 g<\/td> 11.4 g<\/td><\/tr> Carbohydrate content<\/td> 64 g<\/td> 80 g<\/td> 120 g<\/td> 160 g<\/td><\/tr> Lipid content<\/td> 40 g<\/td> 50 g<\/td> 75 g<\/td> 100 g<\/td><\/tr> <\/td><\/tr> Lipid energy<\/td> 1590 kJ(380 kcal)<\/td> 1990 kJ(475 kcal)<\/td> 2985 kJ(715 kcal)<\/td> 3980 kJ(950 kcal)<\/td><\/tr> Carbohydrate energy<\/td> 1075 kJ(255 kcal)<\/td> 1340 kJ(320 kcal)<\/td> 2010 kJ(480 kcal)<\/td> 2680 kJ(640 kcal)<\/td><\/tr> Amino acid energy<\/td> 535 kJ(130 kcal)<\/td> 670 kJ(160 kcal)<\/td> 1005 kJ(240 kcal)<\/td> 1340 kJ(320 kcal)<\/td><\/tr> Non-protein energy<\/td> 2665 kJ(635 kcal)<\/td> 3330 kJ(795 kcal)<\/td> 4995 kJ(1195 kcal)<\/td> 6660 kJ(1590 kcal)<\/td><\/tr> Energy, total<\/td> 3200 kJ(765 kcal)<\/td> 4000 kJ(955 kcal)<\/td> 6000 kJ(1435 kcal)<\/td> 8000 kJ(1910 kcal)<\/td><\/tr> <\/td><\/tr> Osmolality<\/td> 950 mOsm \/ kg<\/td> 950 mOsm \/ kg<\/td> 950 mOsm \/ kg<\/td> 950 mOsm \/ kg<\/td><\/tr> Theoretical osmolarity<\/td> 840 mOsm \/ l<\/td> 840 mOsm \/ l<\/td> 840 mOsm \/ l<\/td> 840 mOsm \/ l<\/td><\/tr> pH<\/td> 5.0\u20136.0<\/td> 5.0\u20136.0<\/td> 5.0\u20136.0<\/td> 5.0\u20136.0<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n The other ingredients are citric acid monohydrate (for\u00a0pH\u00a0adjustment), egg phospholipids for\u00a0injection,\u00a0glycerol\u00a0, sodium oleate, all \u2011 rac \u2011 alpha-tocopherol, and water for injections.<\/p>\n\n\n\n
What the medicine looks like and contents of the pack<\/h2>\n\n\n\n
The reconstituted drug is an\u00a0emulsion\u00a0for\u00a0infusion, ie.\u00a0it is given through a small tube into a vein.<\/p>\n\n\n\n
Nutriflex Lipid 32\/64\/40 peripheral is delivered in flexible multi-chamber bags that contain.<\/p>\n\n\n\n
- 1250 ml (500 ml amino acid solution + 250 ml fat emulsion + 500 ml glucose solution)<\/li>
- 1875 ml (750 ml amino acid solution + 375 ml fat emulsion + 750 ml glucose solution)<\/li>
- 2500 ml (1000 ml amino acid solution + 500 ml fat emulsion + 1000 ml glucose solution)<\/li><\/ul>\n\n\n\n
- nausea, vomiting, loss of appetite<\/li><\/ul>\n\n\n\n
- irritation or inflammation of the vein ( phlebitis , thrombophlebitis )<\/li><\/ul>\n\n\n\n
- allergic reactions, e.g. skin reactions, shortness of breath, swelling of the lips, mouth and throat, difficulty breathing.<\/li><\/ul>\n\n\n\n