{"id":19368,"date":"2022-03-08T15:33:26","date_gmt":"2022-03-08T15:33:26","guid":{"rendered":"https:\/\/zeepedia.com\/?p=19368"},"modified":"2022-03-09T11:24:54","modified_gmt":"2022-03-09T11:24:54","slug":"nutrineal","status":"publish","type":"post","link":"https:\/\/zeepedia.com\/medical\/medicines\/nutrineal\/","title":{"rendered":"Nutrineal &#8211; Peritoneal dialysis fluid uses, dose and side effects"},"content":{"rendered":"\n<p>PD4 1.1%\u00a0Amino acids,\u00a0peritoneal dialysis fluid<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What Nutrineal is and what it is used for<\/h2>\n\n\n\n<p>Nutrineal is a\u00a0peritoneal dialysis\u00a0fluid that is glucose-free.\u00a0The solution removes water and waste products from the blood and corrects imbalances in the blood components.<\/p>\n\n\n\n<p>Nutrineal can be prescribed to you:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you have&nbsp;kidney failure&nbsp;that requires treatment with&nbsp;peritoneal dialysis<\/li><li>especially if you are malnourished.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">What you need to know before you use Nutrineal<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">&#8211;<\/h2>\n\n\n\n<p>Your doctor will decide if Nutrineal is a suitable liquid for your peritoneal dialysis treatment.\u00a0Your doctor will take into account many factors in your medical history that may preclude the possibility of using peritoneal dialysis fluids.<\/p>\n\n\n\n<p><strong>Do not use Nutrineal:<\/strong><\/p>\n\n\n\n<p>You should NOT use Nutrineal<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>If you are allergic to any&nbsp;amino acid&nbsp;or any of the other ingredients of this medicine (listed in section 6).<\/li><li>If your urea level in the blood exceeds 38 mmol \/ l.<\/li><li>If you have a disease that affects the metabolism of&nbsp;amino acids&nbsp;.<\/li><li>If you have lowered your blood potassium level.<\/li><li>If you have uremic symptoms, e.g.&nbsp;decreased appetite, nausea or vomiting.<\/li><li>If you have too little&nbsp;bicarbonate&nbsp;in your blood.<\/li><li>If you have impaired liver function.<\/li><li>If you have problems that affect the abdominal wall or abdominal cavity and that cannot be operated on or if you have non-correctable problems that increase the risk of abdominal infections.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Warnings and cautions<\/h2>\n\n\n\n<p>Stop taking Nutrineal and contact a doctor immediately if you get any of the following symptoms (&nbsp;angioedema&nbsp;)<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>swelling of the face, tongue or throat<\/li><li>difficulty swallowing<\/li><li>hives&nbsp;and difficulty breathing.<\/li><\/ul>\n\n\n\n<p><strong>Talk to your doctor:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>if you suffer from loss of appetite, nausea or vomiting.&nbsp;Your doctor may need to reduce the number of changes of Nutrineal or discontinue treatment with Nutrineal.<\/li><li>if you experience stomach pain or find that the dialysate is cloudy, cloudy or contains particles.&nbsp;This may be a sign of peritonitis or&nbsp;infection&nbsp;.&nbsp;You should then contact your care team immediately.&nbsp;Make a note of the batch number and take it with you to the dialysate bag for your healthcare team.&nbsp;They will decide if the treatment should be stopped and if any other treatment is necessary.&nbsp;For example, if you have an&nbsp;infection&nbsp;, your doctor may perform tests to find out which&nbsp;antibiotic&nbsp;is best for you.&nbsp;Until your doctor knows what&nbsp;infection&nbsp;you have, you can get an&nbsp;antibioticwhich is effective against a large number of different bacteria.&nbsp;This is called a broad-spectrum antibiotic.<\/li><li>if you get a&nbsp;hypersensitivity reaction&nbsp;(an&nbsp;allergic reaction&nbsp;) &#8211; see also section 4. Doctors may need to stop taking Nutrineal.<\/li><li>During&nbsp;peritoneal dialysis&nbsp;, the body can lose&nbsp;protein&nbsp;,&nbsp;amino acids&nbsp;and&nbsp;vitamins&nbsp;.&nbsp;Your doctor knows if replacement therapy is needed.<\/li><li>if you have problems affecting the abdominal wall or abdominal cavity.&nbsp;For example, if you have a&nbsp;hernia&nbsp;or an&nbsp;infection&nbsp;or an&nbsp;inflammatory&nbsp;disease that affects your intestines.<\/li><li>if you have had an aortic graft.<\/li><li>if you have severe lung disease, e.g.&nbsp;emphysema&nbsp;.<\/li><li>if you have difficulty breathing.<\/li><li>if you are&nbsp;taking insulin&nbsp;or other medicines for&nbsp;hyperglycaemia&nbsp;(high blood sugar).&nbsp;Your doctor may need to adjust the&nbsp;dose&nbsp;of one of these medicines.<\/li><li>If you are being treated for secondary&nbsp;hyperparathyroidism&nbsp;, your doctor will decide if you can use a low-calcium dialysis fluid.<\/li><\/ul>\n\n\n\n<p>You should also note that:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>The disease sclerosing&nbsp;peritonitis&nbsp;(EPS) is a known, rare complication of treatment with&nbsp;peritoneal dialysis&nbsp;.&nbsp;You should, possibly in consultation with your doctor, be aware of this possible complication.&nbsp;EPS causes:<ul><li>inflammation&nbsp;of the abdomen (stomach)<\/li><li>growth of layers of fibrous&nbsp;tissue&nbsp;that cover and bind the organs and affect their normal movement.&nbsp;It is rarely fatal<\/li><\/ul><\/li><\/ul>\n\n\n\n<p>Your doctor will check your potassium levels regularly.&nbsp;If the potassium content is too low, your doctor may give you potassium chloride to compensate.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Your doctor will tell you if you need to take special precautions.&nbsp;Your doctor will check your blood parameters regularly and ensure that the values \u200b\u200bare adequate during treatment.<\/li><li>You should, possibly in consultation with your doctor, keep a record of protein intake via diet, fluid balance and body weight.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Other medicines and Nutrineal<\/h2>\n\n\n\n<ul class=\"wp-block-list\"><li>Tell your doctor or pharmacist if you are taking, have recently taken or might take any other medicines.<\/li><li>If you are taking other medicines, your doctor may need to increase the&nbsp;dose&nbsp;of one of these.&nbsp;This is because treatment with&nbsp;peritoneal dialysis&nbsp;increases the secretion of certain drugs.<\/li><li>Be careful if you use cardiac glycosides (eg&nbsp;digoxin&nbsp;).&nbsp;Cardiac drugs may be less effective and their&nbsp;toxicity&nbsp;may increase.&nbsp;You can:<\/li><li>need&nbsp;potassium&nbsp;and calcium supplements.<\/li><li>develop irregular heartbeats (an&nbsp;arrhythmia&nbsp;).<br>Your doctor will monitor you closely during treatment, especially your&nbsp;potassium&nbsp;,&nbsp;calcium&nbsp;and magnesium levels.<\/li><\/ul>\n\n\n\n<h2 class=\"wp-block-heading\">Pregnancy and breastfeeding<\/h2>\n\n\n\n<p>Nutrineal is not recommended during pregnancy or breastfeeding unless your doctor considers it necessary.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Driving and using machines<\/h2>\n\n\n\n<p>This treatment may cause weakness, malaise, or decreased body fluid volume (\u00a0hypovolemia\u00a0).\u00a0Do not drive or use machines if you are affected.<\/p>\n\n\n\n<p>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<h2 class=\"wp-block-heading\">How to use Nutrineal<\/h2>\n\n\n\n<p>Nutrineal should be administered intraperitoneally, ie in the abdomen (stomach) between the skin and the peritoneum.&nbsp;The peritoneum is the&nbsp;membrane&nbsp;that surrounds the internal organs, e.g.&nbsp;the intestines and liver.<\/p>\n\n\n\n<p>Nutrineal should not be given\u00a0intravenously.<\/p>\n\n\n\n<p>Always use this medicine exactly according to the instructions of the care team that specializes in\u00a0peritoneal dialysis.\u00a0Consult them if you are unsure.<\/p>\n\n\n\n<p>Discard the bag if it has been damaged.<\/p>\n\n\n\n<p><strong>How much and how often<\/strong><\/p>\n\n\n\n<p>Your doctor will prescribe the appropriate number of bags for you.\u00a0It usually varies between a 2.0-liter bag and a 2.5-liter bag daily.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Use for children and adolescents<\/h2>\n\n\n\n<p>If you are under 18 years of age, your doctor will, after careful evaluation, determine the&nbsp;dosage&nbsp;of Nutrineal.<\/p>\n\n\n\n<p>After 3 months, your doctor will re-evaluate your treatment if your nutritional status has not improved.<\/p>\n\n\n\n<p><strong>Method of use<\/strong><\/p>\n\n\n\n<p>Before use:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Heat the bag to 37 \u00b0 C.&nbsp;Use a hot plate designed for this purpose.&nbsp;The bag must not be heated in a water bath.&nbsp;The bag must not be heated in the microwave.<\/li><li>Remove the outer bag and use immediately.<\/li><li>Use the bag only if the solution is ready and if the container is undamaged.<\/li><li>Each bag may only be used once.<\/li><li>Discard any remaining solution.<\/li><\/ul>\n\n\n\n<p>Aseptic technique should be applied throughout the use of the solution as you have learned.<\/p>\n\n\n\n<p><strong>Miscibility with other drugs<\/strong><\/p>\n\n\n\n<p>Your doctor may&nbsp;prescribe&nbsp;other medicines for&nbsp;injection&nbsp;to be added directly to the Nutrineal bag.&nbsp;In such cases, the drug should be added via the injection port.&nbsp;Use the product immediately after the drug has been added.&nbsp;Ask your doctor if you are unsure.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you use more than one bag of Nutrineal for 24 hours<\/h2>\n\n\n\n<p>If you infuse too much Nutrineal, you may get:<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>stretched abdomen<\/li><li>a feeling of satiety<\/li><\/ul>\n\n\n\n<p>Contact your doctor immediately.&nbsp;The doctor decides on any measures.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">If you stop using Nutrineal<\/h2>\n\n\n\n<p>Do not end treatment with&nbsp;peritoneal dialysis&nbsp;without your doctor&#8217;s consent.&nbsp;Discontinuation of treatment may have life-threatening consequences.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Possible side effects<\/h2>\n\n\n\n<p>Like all medicines, this medicine can cause\u00a0side effects, although not everybody gets them.<\/p>\n\n\n\n<p>If you get any of the following symptoms, tell your doctor or peritoneal dialysis clinic immediately.<\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Swelling of the face, tongue or throat;&nbsp;difficulty swallowing;&nbsp;hives&nbsp;and difficulty breathing (&nbsp;angioedema&nbsp;,&nbsp;<em>has been reported &#8211; occurs in an unknown number of patients treated with Nutrineal<\/em>&nbsp;).<\/li><li>Abdominal pain (&nbsp;<em>common&nbsp;side effect&nbsp;&#8211; occurs in more than 1 in 100 patients treated with Nutrineal<\/em>&nbsp;).<\/li><\/ul>\n\n\n\n<p><strong>Other&nbsp;side effects&nbsp;ar<\/strong><\/p>\n\n\n\n<p><em>Very common&nbsp;side effects&nbsp;(affects more than 1 user in 10 patients treated with Nutrineal):<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Nausea, vomiting<\/li><li>Loss of appetite<\/li><li>Gastritis&nbsp;(gastritis)<\/li><li>Increased fluid volume in the body (&nbsp;hypervolemia&nbsp;)<\/li><li>Feeling weak<\/li><li>High content of acidic substances in the body (&nbsp;acidosis&nbsp;)<\/li><\/ul>\n\n\n\n<p><em>Common&nbsp;side effects&nbsp;(affects more than 1 user in 100 patients treated with Nutrineal):<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Anemia<\/li><li>Depression<\/li><li>Shortness of breath<\/li><li>Decreased fluid volume in the body (&nbsp;hypovolemia&nbsp;)<\/li><li>Decreased level of potassium salt in the blood (&nbsp;hypokalaemia&nbsp;)<\/li><li>Infection<\/li><\/ul>\n\n\n\n<p><em>Adverse reactions&nbsp;that have been reported (occurs in an unknown number of patients treated with Nutrineal):<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Peritonitis<\/li><li>Cloudy dialysate from the abdominal cavity<\/li><li>Discomfort from the abdomen<\/li><li>Fever<\/li><li>Feeling sick<\/li><li>Itching<\/li><li>Hypersensitivity reaction (an&nbsp;allergic reaction&nbsp;)<\/li><\/ul>\n\n\n\n<p><em>Other&nbsp;side effects&nbsp;are related to peritoneal dialysis:<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>Infection&nbsp;at the catheter starting point<\/li><li>Complications due to the catheter<\/li><li>Decreased calcium content in the blood (&nbsp;hypocalcaemia&nbsp;)<\/li><\/ul>\n\n\n\n<p>If any of the&nbsp;side effects&nbsp;gets serious, or if you notice any&nbsp;side effects&nbsp;not listed in this leaflet, please tell your doctor or pharmacist.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">How to store Nutrineal<\/h2>\n\n\n\n<p>Keep this medicine out of the sight and reach of children.<\/p>\n\n\n\n<p>Store at a maximum of 30 \u00b0 C in the outer carton.&nbsp;Sensitive to light.<\/p>\n\n\n\n<p>Do not use this medicine after the expiry date which is stated on the label after &#8220;EXP&#8221;.<\/p>\n\n\n\n<p>The expiration date is the last day of the specified month.<\/p>\n\n\n\n<p>The product should be used immediately after opening the outer bag.<\/p>\n\n\n\n<p>Only use the solution if it is ready and the bag is undamaged.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Contents of the pack and other information<\/h2>\n\n\n\n<h2 class=\"wp-block-heading\">Content declaration<\/h2>\n\n\n\n<p>The active substances are:<\/p>\n\n\n\n<figure class=\"wp-block-table\"><table><tbody><tr><td>&nbsp;<\/td><td><strong>mg \/ l<\/strong><\/td><\/tr><tr><td>Mixture&nbsp;of amino acids:AlanineArginineGlycineHistidineIsoleucineLeucineLysine hydrochlorideMethioninePhenylalanineProlinSerineTreoninTryptophanTyrosineValin<\/td><td><br>951107151071485010209558505705955106462703001393<\/td><\/tr><tr><td>Sodium chloride<\/td><td>5380<\/td><\/tr><tr><td>Calcium chloride dihydrate<\/td><td>184<\/td><\/tr><tr><td>Magnesium chloride hexahydrate<\/td><td>51<\/td><\/tr><tr><td>Sodium lactate<\/td><td>4480<\/td><\/tr><tr><td><br><strong>Composition in mmol \/ l<\/strong><\/td><\/tr><tr><td>&nbsp;<\/td><td><strong>mmol \/ l<\/strong><\/td><\/tr><tr><td>Amino acids<\/td><td>87.16<\/td><\/tr><tr><td>Sodium<\/td><td>132<\/td><\/tr><tr><td>Calcium<\/td><td>1.25<\/td><\/tr><tr><td>Magnesium<\/td><td>0.25<\/td><\/tr><tr><td>Lactate<\/td><td>40<\/td><\/tr><tr><td>Chloride<\/td><td>105<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n<p>The other ingredients are: Water for injections, concentrated&nbsp;hydrochloric acid<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">What the medicine looks like and contents of the pack<\/h2>\n\n\n\n<p>Nutrineal is a\u00a0sterile, clear, colorless to slightly yellow solution.<\/p>\n\n\n\n<p><em>Pack size:<\/em><\/p>\n\n\n\n<ul class=\"wp-block-list\"><li>5 x 2000 ml Duo bag with screw coupling<\/li><li>5 x 2000 ml Duo bag with Lineo coupling<\/li><li>6 x 2000 ml Duo bag with screw coupling<\/li><li>8 x 2000 ml Duo bag with screw coupling<\/li><li>4 x 2500 ml single bag with screw coupling<\/li><li>4 x 2500 ml Duo bag with screw coupling<\/li><li>4 x 2500 ml Duo bag with Lineo coupling<\/li><\/ul>\n\n\n\n<p>Duo bag can be delivered with Lineo coupling, which contains an ointment with 10.5% povidone-iodine.<\/p>\n\n\n\n<p>Not all pack sizes may be marketed.<\/p>\n\n\n\n<h2 class=\"wp-block-heading\">Marketing Authorisation Holder<\/h2>\n\n\n\n<p>Baxter Medical AB<br>Box 63<br>SE-164 94 Chest<\/p>\n\n\n\n<p><strong>Manufacturer<\/strong><\/p>\n\n\n\n<p>Baxter Healthcare SA<\/p>\n\n\n\n<p>Moneen Road<\/p>\n\n\n\n<p>Castlebar<\/p>\n\n\n\n<p>County Mayo- Ireland.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Nutrineal is a peritoneal dialysis fluid that is glucose free. The solution removes water and waste products from the blood and corrects imbalances in the blood components.<\/p>\n","protected":false},"author":2,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"cybocfi_hide_featured_image":"","footnotes":""},"categories":[2200,15581],"tags":[19407,19402,19403,19406,3276,3279,19404,8834,19405,8835],"class_list":["post-19368","post","type-post","status-publish","format-standard","hentry","category-medicines","category-n","tag-benefits-of-nutrineal","tag-benefits-of-peritoneal-dialysis-fluid","tag-nutrineal","tag-nutrineal-side-effects","tag-peritoneal-dialysis-fluid","tag-peritoneal-dialysis-fluid-side-effects","tag-what-is-nutrineal","tag-what-is-peritoneal-dialysis-fluid","tag-what-nutrineal-is-used-for","tag-what-peritoneal-dialysis-fluid-is-used-for"],"_links":{"self":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/19368","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/users\/2"}],"replies":[{"embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/comments?post=19368"}],"version-history":[{"count":4,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/19368\/revisions"}],"predecessor-version":[{"id":19397,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/posts\/19368\/revisions\/19397"}],"wp:attachment":[{"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/media?parent=19368"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/categories?post=19368"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/zeepedia.com\/medical\/wp-json\/wp\/v2\/tags?post=19368"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}