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Kabiven Generic Name & Formulations
Legal Class
Rx
General Description
Lipid 20% (Intralipid 20%) emulsion (soybean oil 3.9g), dextrose anhydrous 9.8g, amino acids 3.31g, total nitrogen 526mg, electrolytes (sodium acetate 239mg, potassium chloride 174mg, sodium glycerophosphate 147mg, magnesium sulfate 96mg, calcium chloride 29mg); per 100mL; for IV infusion after mixed; contains aluminum.
Pharmacological Class
Macronutrients + electrolytes.
How Supplied
Emulsion (2566mL, 2053mL, 1540mL, 1026mL)—1
Manufacturer
Generic Availability
NO
Kabiven Indications
Indications
To provide a source of calories, protein, electrolytes, and essential fatty acids in adults requiring parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated. May be used to prevent essential fatty acid deficiency or treat negative nitrogen balance.
Kabiven Dosage and Administration
Adult
Individualize. Dose based on patient’s clinical condition, body wt, nutritional/fluid requirements, and additional energy given orally/enterally. Administer by IV infusion via a central vein only. Usual dose: 19–38mL/kg/day; max: 40mL/kg/day. Max infusion rate: 2.6mL/kg/hr. Usual infusion duration: 12–24 hours; may continue treatment based on patient’s clinical condition. If serum triglycerides (>400mg/dL): interrupt infusion and monitor serum triglycerides; restart at a lower rate once triglycerides are <400mg/dL; increase in smaller increments and check levels before each adjustment. Renal impairment: may adjust dose based on protein requirements; see full labeling.
Children
<2yrs: not recommended.
Kabiven Contraindications
Contraindications
Concomitant treatment with ceftriaxone in neonates ≤28 days of age. Egg, soybean or peanut protein allergy. Severe hyperlipidemia or severe disorders of lipid metabolism characterized by hypertriglyceridemia (serum triglyceride >1000mg/dL). Inborn errors of amino acid metabolism. Cardiopulmonary instability (including pulmonary edema, cardiac insufficiency, MI, acidosis, hemodynamic instability requiring significant vasopressor support). Hemophagocytic syndrome.
Kabiven Boxed Warnings
Boxed Warning
Death in preterm infants.
Kabiven Warnings/Precautions
Warnings/Precautions
Risk of deaths in preterm and low birth weight infants: see full labeling. Correct severe fluid, electrolyte and acid-base disorders prior to initiating. Measure serum triglycerides at baseline, with each dose increase, and regularly during therapy. Discontinue and treat if hypersensitivity reactions occur. Monitor for signs/symptoms of infection. Severely undernourished: monitor closely and slowly increase nutrient intake. Diabetes or hyperglycemia. Risk of parenteral nutrition-associated liver disease (PNALD); consider discontinuation or dose reduction if abnormal LFTs occur. Risk of pulmonary embolism and respiratory distress due to pulmonary vascular precipitates; discontinue and evaluate if occurs. Monitor essential fatty acids, fluids, electrolytes, serum osmolarity, blood glucose, liver and kidney function, CBCs, coagulation parameters, and overall energy intake periodically during treatment. Renal or hepatic impairment. Elderly. Pregnancy. Nursing mothers.
Kabiven Pharmacokinetics
See Literature
Kabiven Interactions
Interactions
See Contraindications. Do not administer simultaneously with ceftriaxone via a Y-site: precipitation can occur; may administer sequentially if infusion lines are thoroughly flushed. Vitamin K content may antagonize anticoagulants (eg, coumarin, warfarin); monitor. High lipid levels in plasma may interfere with blood tests (eg, hemoglobin, triglycerides, bilirubin, LDH, oxygen saturation).
Kabiven Adverse Reactions
Adverse Reactions
Nausea, pyrexia, hypertension, vomiting, decreased hemoglobin and total protein, hypokalemia, increased gamma glutamyltransferase; hyperglycemia, hyperosmolar syndrome, refeeding syndrome, thrombophlebitis, hepatobiliary disorders, hypertriglyceridemia, aluminum toxicity (esp. preterm infants, renal impairment); rare: fat overload syndrome.
Kabiven Clinical Trials
See Literature
Kabiven Note
Not Applicable
Kabiven Patient Counseling
See Literature
