Nutriflex peri – Amino acids and salts uses, dose and side effects

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infusion solution

What Nutriflex peri is and what it is used for

This medicine contains substances (nutrients) called amino acids and salts ( electrolytes ) that are necessary for the body’s growth or recovery. It also contains energy in the form of carbohydrates ( glucose ).

You get Nutriflex peri when you can not eat food in the usual way. There are many occasions when this can happen, e.g. when you recover from surgery, injuries, or burns, or when food cannot be absorbed from the stomach or intestines.

Nutriflex peri is intended for adults and children aged 2–17 years with normal or moderately elevated protein requirements.

What you need to know before using Nutriflex peri

Do not use Nutriflex peri

  • if you are allergic to any of the active substances or any of the other ingredients of this medicine (listed in section 6)
  • if you have a congenital disorder of amino acid metabolism
  • if you have abnormally high blood sugar levels that require more than 6 units of insulin per hour to be kept under control
  • if you have bleeding inside your skull or spinal cord
  • if you have abnormally high levels of acid in your blood ( acidosis )
  • if you have severe hepatic impairment
  • if you have severe renal impairment and are not treated with artificial kidney ( haemofiltration or dialysis )

Like other medicines of this type, Nutriflex peri should not be given if you have:

  • acute phase of a heart attack (heart attack) or stroke
  • any metabolic disorder that is poorly controlled, e.g. unconscious state ( coma ) without known cause, insufficient supply of oxygen to the tissues or diabetes which is poorly controlled
  • life-threatening circulatory disorders that can occur e.g. in case of collapse or shock, accumulation of fluid in the lungs ( pulmonary edema ) or disturbances in the fluid balance.

Nutriflex peri should not be given to newborns, infants, or toddlers under 2 years of age.

Warnings and cautions

Talk to your doctor or nurse before using Nutriflex peri:

  • if you have impaired heart or kidney function
  • if you have fluid, salt or acid base balance disorders one
  • if you have abnormally high blood sugar.
  • if you have impaired liver, adrenal or lung function
  • if your blood-brain barrier is damaged.

This medicine contains glucose (sugar) which may affect your blood sugar level. You may need to have a blood test to check this.

If the infusion is accidentally stopped suddenly, the blood sugar level may drop suddenly. Your doctor will take this into account, especially if your ability to metabolize glucose is impaired (eg if you have diabetes ) or if children under 3 years of age receive this medicine. Therefore, the blood sugar level will be closely monitored, especially after the infusion has been stopped.

In addition, the salinity in the blood, fluid balance, acid-base balance, blood count, blood coagulation, and kidney and liver function need to be checked during treatment.

The doctor also makes sure that your need for fluids and electrolytes (salts) is covered. In addition to Nutriflex peri, you will also receive other nutrients to completely cover your nutritional needs.

Infusion into peripheral veins can cause venous inflammation with blood clot formation. Your doctor will check the infusion site daily.

Other medicines and Nutriflex peri

Tell your doctor if you are taking, have recently taken, or might take any other medicines.

Nutriflex peri and some other medicines may affect each other’s effects. Tell your doctor if you are taking any of the following medicines:

  • certain medicines used to treat inflammation ( corticosteroids )
  • hormone preparations that affect fluid balance (adrenocorticotropic hormone , ACTH)
  • certain drugs that increase urinary excretion ( diuretics ) such as spironolactone , triamterene or amiloride
  • certain medicines for high blood pressure ( ACE inhibitors ) such as captopril and enalapril
  • certain medicines to treat high blood pressure or heart problems ( angiotensin II receptor antagonists) such as losartan and valsartan
  • certain drugs used after organ transplantation such as ciclosporin and tacrolimus.

Pregnancy and breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or are planning to have a baby, ask your doctor for advice before using this medicine.

Pregnancy

If you are pregnant, you will only be given this medicine if your doctor considers it necessary for your recovery.

Breast-feeding

Breast-feeding is not recommended for women who need intravenous nutrition.

Driving and using machines

This drug is usually given to bedridden patients at e.g. hospital or clinic, which excludes the patient from driving or using machines. However, the drug itself does not affect the ability to drive and use machines.

You are responsible for assessing whether you are fit to drive a motor vehicle or perform work that requires sharpened attention. One of the factors that can affect your ability in these respects is the use of drugs due to their effects and/or side effects. Descriptions of these effects and side effects can be found in other sections. Read all the information in this leaflet for guidance. If you are not sure, talk to your doctor or pharmacist.

How to use Nutriflex peri

This medicine is given to you as an infusion (drip) into a vein, ie through a small tube directly into a vein. It can be given in a smaller ( peripheral ) or a larger (central) vein.

The doctor prescribes the appropriate dose and duration of treatment.

If you take more Nutriflex peri than you should

If you have ingested too much medicine or if e.g. a child ingested the medicine by mistake, contact a doctor or hospital for risk assessment and advice.

It is unlikely that you would get an overdose of this medicine if used correctly. If you still get too much of the medicine, this can lead to:

  • abnormally high content of fluid in the body (overhydration)
  • abnormally large amounts of urine ( polyuria )
  • disturbances in the body’s salt balance (electrolyte disturbances)
  • fluid in the lungs ( pulmonary edema )
  • loss of amino acids in the urine and disturbances in the amino acid balance
  • accumulation of acidic substances in the blood (metabolic acidosis )
  • malaise, vomiting, chills, headache
  • high levels of nitrogen in the blood (hyperammonemia)
  • abnormally high blood sugar ( hyperglycaemia )
  • glucose in the urine ( glucosuria )
  • dehydration _ _
  • that the blood becomes much more concentrated than normal (hyperosmolality)
  • unconsciousness caused by extremely high blood sugar levels (hyperglycemic hyperosmolar coma ).

If any of these symptoms occur, the infusion will be stopped immediately. Your doctor will decide if you need further treatment. Infusion one should not be restarted until you have recovered.

If you have any further questions on the use of this product, ask your doctor or nurse.

Possible side effects

Like all medicines, this medicine can cause side effects, although not everybody gets them.

The side effects usually disappear when the infusion is stopped.

Common (may affect up to 1 in 10 people)

  • irritation of the blood vessel, inflammation of the blood vessels at the infusion site ( phlebitis , thrombophlebitis )

Rare (may affect up to 1 in 1,000 people)

  • nausea, vomiting and decreased appetite

Very rare (may affect up to 1 in 10,000 people)

  • electrolyte disturbances such as low levels of potassium , phosphate or magnesium in the blood

If nausea, vomiting, or decreased appetite occur, treatment should either be stopped or continued at a lower dose according to the doctor’s instructions.

If signs of irritation of a blood vessel or inflammation of a blood vessel occur, your doctor may switch to another infusion site.

How to store Nutriflex peri

Keep this medicine out of the sight and reach of children.

Do not store above 25 ° C.

Store the bag in the outer carton. Sensitive to light.

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.

Contents of the pack and other information

Content declaration

  • Active substances:

After mixing, a bag contains:

1,000 ml2,000 ml
Isoleucine2.34 g4.68 g
Leucine3.13 g6.26 g
Lysine hydrochloride corresponding to lysine2.84 g2.27 g5.68 g4.54 g
Methionine1.96 g3.92 g
Phenylalanine3.51 g7.02 g
Troponin1.82 g3.64 g
Tryptophan0.57 g1.14 g
Valin2.60 g5.20 g
Arginine monoglutamate
corresponding to arginine
4.98 g2.70 g9.96 g5.40 g
Histidine hydrochloride monohydrate
corresponding to histidine
1.69 g1.25 g3.38 g2.50 g
Alanine4.85 g9.70 g
Aspartic acid1.50 g3.00 g
The total amount of glutamic acid3.50 g7.00 g
(as glutamic acid)(1.22 g)(2.44 g)
(from arginine monoglutamate)(2.28 g)(4.56 g)
Glycine1.65 g3.30 g
Proline3.40 g6.80 g
Serine3.00 g6.00 g
Magnesium acetate tetrahydrate0.86 g1.72 g
Sodium acetate trihydrate1.56 g3.12 g
Potassium dihydrogen phosphate0.78 g1.56 g
Potassium hydroxide0.52 g1.04 g
Sodium hydroxide0.50 g1.00 g
Glucose monohydrate
corresponding to glucose
88.0 g80.0 g176.0 g160.0 g
Sodium chloride0.17 g0.34 g
Calcium chloride dihydrate0.37 g0.74 g
Electrolytes:1,000 ml2,000 ml
Sodium27.0 mmol54.0 mmol
Potassium15.0 mmol30.0 mmol
Calcium2.5 mmol5.0 mmol
Magnesium4.0 mmol8.0 mmol
Chloride31.6 mmol63.2 mmol
Phosphate5.7 mmol11.4 mmol
Acetate19.5 mmol39.0 mmol
1,000 ml2,000 ml
Amino acids40 g80 g
Nitrogen5.7 g11.4 g
Carbohydrates80 g160 g
1,000 ml2,000 ml
Energy in the form of amino acids [kJ (kcal)]669 (160)1339 (320)
Energy in the form of carbohydrates [kJ (kcal)]1339 (320)2678 (640)
The total amount of energy [kJ (kcal)]2008 (480)4017 (960)
Theoretical osmolarity [mOsm / l]900900
pH4.8–6.04.8–6.0
  • The other ingredients are citric acid and water for injections.

What the medicine looks like and contents of the pack

This drug is an infusion solution, ie it is given through a small tube in a vein.

Nutriflex peri comes in an infusion bag with two chambers. The lower chamber contains glucose and the upper chamber contains an amino acid solution. The solutions with glucose and amino acids are clear and colorless or slightly yellowish.

The product comes in a plastic bag with two chambers that contains:

  • 1,000 ml (400 ml amino acid solution + 600 ml glucose solution)
  • 2,000 ml (800 ml amino acid solution + 1,200 ml glucose solution)

Pack sizes: 1,000 ml, 5 × 1,000 ml, 2,000 ml, 5 × 2,000 ml

Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

B. Braun Melsungen AG

Carl-Braun-Strasse 1

34212 Melsungen, Germany

Postal address

34209 Melsungen, Germany

For any information about this medicine, please contact the local representative of the Marketing Authorization Holder:

B. Braun Medical AB

Box 110

SE-182 12 Danderyd

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