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HSA Approval

NUTRIFLEX® OMEGA SPECIAL EMULSION FOR INFUSION

SIN15469P

NUTRIFLEX® OMEGA SPECIAL EMULSION FOR INFUSION

NUTRIFLEX® OMEGA SPECIAL EMULSION FOR INFUSION

April 23, 2018

B. BRAUN SINGAPORE PTE LTD

B. BRAUN SINGAPORE PTE LTD

Regulatory Information

B. BRAUN SINGAPORE PTE LTD

B. BRAUN SINGAPORE PTE LTD

Therapeutic

Prescription Only

Formulation Information

INJECTION, EMULSION

**4.2 Posology and method of administration** Posology The dosage should be adapted to the patients’ individual requirements. It is recommended that Nutriflex Omega special be administered continuously. A stepwise increase of the infusion rate over the first 30 minutes up to the desired infusion rate avoids possible complications. _Adults_ The maximum daily dose amounts to 35 ml / kg body weight, corresponding to 2.0 g amino acids/ kg body weight per day5.04 g glucose/ kg body weight per day1.4 g lipid/ kg body weight per day. The maximum rate of infusion is 1.7 ml / kg body weight per hour, corresponding to 0.1 g amino acids/ kg body weight per hour0.24 g glucose/ kg body weight per hour0.07 g lipid/ kg body weight per hour. For a patient weighing 70 kg, this corresponds to a maximum infusion rate of 119 ml per hour. The amount of substrate administered is then 6.8 g of amino acids per hour, 17.1 g of glucose per hour and 4.8 g of lipids per hour. _Paediatric population_ Nutriflex Omega special is contraindicated in newborn infants, infants and toddlers < 2 years of age (see section 4.3). Safety and efficacy in children > 2 years and adolescents have not been established. _Patients with renal/hepatic impairment_ The doses should be adjusted individually in patients with hepatic or renal insufficiency (see also section 4.4 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_). _Duration of treatment_ The duration of treatment for the indications stated is not limited. During the administration of Nutriflex Omega special it is necessary to provide an appropriate amount of trace elements and vitamins. _Duration of infusion of one single bag_ The recommended duration of infusion for a parenteral nutrition bag is maximum 24 h. Method of administration Intravenous use. For central venous infusion only.

INTRAVENOUS

Medical Information

**4.1 Therapeutic indications** Supply of energy, essential fatty acids including omega-3 and omega-6 fatty acids, amino acids, electrolytes and fluids for parenteral nutrition of patients in states of moderate to severe catabolism when oral or enteral nutrition is impossible, insufficient or contraindicated. Nutriflex Omega special is indicated in adults.

**4.3 Contraindications** - Hypersensitivity to the active substances, to egg, fish, peanut or soya protein or to any of the excipients listed in section 6.1 – _please refer to the Product Insert/Patient Information Leaflet published on HSA for the full drug information_ - Inborn errors of amino acid metabolism - Severe hypertriglyceridaemia (≥ 1000 mg/dl or 11.4 mmol/l) - Severe coagulopathy - Hyperglycaemia not responding to insulin doses of up to 6 units insulin/hour - Acidosis - Intrahepatic cholestasis - Severe hepatic insufficiency - Severe renal insufficiency in absence of renal replacement therapy - Aggravating haemorrhagic diatheses - Acute thrombo-embolic events, lipid embolism On account of its composition, Nutriflex Omega special must not be used in newborn infants, infants and toddlers under 2 years of age. General contraindications to parenteral nutrition include: - Unstable circulatory status with vital threat (states of collapse and shock) - Acute phases of cardiac infarction and stroke - Unstable metabolic condition (e.g. severe postaggression syndrome, coma of unknown origin) - Inadequate cellular oxygen supply - Disturbances of the electrolyte and fluid balance - Acute pulmonary oedema - Decompensated cardiac insufficiency

B05BA10

combinations

Manufacturer Information

B. Braun Singapore Pte Ltd.

B. Braun Melsungen AG

Active Ingredients

Glycine

2.312g/1000ml

Glycine

Tryptophan

0.800g/1000ml

Tryptophan

Methionine

2.736g/1000ml

Methionine

Zinc acetate dihydrate

7.024mg/1000ml

Zinc acetate

Serine

4.200g/1000ml

Serine

Valine

3.604g/1000ml

Valine

Potassium acetate

3.689g/1000ml

Potassium acetate

Arginine

3.780g/1000ml

Arginine

Triglycerides, medium chain

20.00g/1000ml

Sodium chloride

0.378g/1000ml

Sodium chloride

Glutamic acid

4.908g/1000ml

Glutamic acid

Lysine hydrochloride eqv to lysine 3.184g/1000ml

3.980g/1000ml

Lysine

Phenylalanine

4.916g/1000ml

Phenylalanine

Calcium chloride dihydrate

0.623g/1000ml

Calcium chloride

Glucose monohydrate eqv to anhydrous glucose 144.0g/1000ml

158.4g/1000ml

Glucose

Soya-bean oil, refined

16.00g/1000ml

Soybean oil

Isoleucine

3.284g/1000ml

Isoleucine

Omega-3-acid triglycerides

4.00g/1000ml

Omega-3 fatty acids

Histidine hydrochloride monohydrate eqv to histidine 1.75g/1000ml

2.368g/1000ml

Histidine

Sodium acetate trihydrate

0.250g/1000ml

Sodium acetate

Leucine

4.384g/1000ml

Leucine

Proline

4.760g/1000ml

Proline

Magnesium acetate tetrahydrate

0.910g/1000ml

Alanine

6.792g/1000ml

Alanine

Sodium hydroxide

1.171g/1000ml

Sodium hydroxide

Aspartic acid

2.100g/1000ml

Aspartic acid

Sodium dihydrogen phosphate dihydrate

2.496g/1000ml

Flunisolide

Threonine

2.540g/1000ml

Threonine

Documents

Package Inserts

Nutriflex Special PI.pdf

Approved: April 13, 2020

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