Perikabiven Generic Name & Formulations
Lipid 20% (Intralipid 20%) emulsion (soybean oil 3.5g), dextrose anhydrous 6.8g, amino acids 2.36g, total nitrogen 375mg, electrolytes (sodium acetate 170mg, potassium chloride 124mg, sodium glycerophosphate 105mg, magnesium sulfate 68mg, calcium chloride 20mg); per 100mL; for IV infusion after mixed; contains aluminum.
Macronutrients + electrolytes.
Emulsion (1440mL, 1920mL, 2400mL)—1
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.
Perikabiven Dosage and Administration
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 peripheral or central vein. Usual dose: 27–40mL/kg/day; max: 40mL/kg/day. Max infusion rate: 3.7mL/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.
<2yrs: not recommended.
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.
Perikabiven Boxed Warnings
Death in preterm infants.
Risk of deaths in preterm and low birth weight infants: see full labeling. Correct severe fluid, electrolyte and acid-base disorders prior to initiation. 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.
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).
Perikabiven Adverse Reactions
Hyperglycemia, hypokalemia, pyrexia, hypertriglyceridemia; refeeding syndrome, thrombophlebitis, hepatobiliary disorders, PNALD, aluminum toxicity (esp. preterm infants, renal impairment); rare: fat overload syndrome.
Perikabiven Clinical Trials
Perikabiven Patient Counseling