Addaven Multiple Trace Elements Injection (III)

1. Indications and Usage
Indications: Multiple Trace Elements Injection (III) is indicated as an additive for parenteral nutrition in adult patients and children weighing ≥15 kg to provide essential trace elements.
Dosage: The standard dosage provides the daily basic and moderate requirements for chromium, copper, iron, manganese, molybdenum, selenium, zinc, fluorine, and iodine.
2. Dosage and Administration
Adults: The recommended dosage is 10 mL once daily.
Pediatrics: For children weighing ≥15 kg, the recommended dosage is 0.1 mL/kg once daily.
Dilution: The undiluted concentrate must not be administered intravenously. It must be diluted in a total nutrient admixture (TNA), with or without lipid emulsion.
Administration: After preparation, use immediately or store at 2-8°C and use within 24 hours. The infusion rate should not exceed 1 mL per minute.
3. Mechanism of Action
Physiological Role: Trace elements (Cr, Cu, Fe, Mn, Mo, Se, Zn, F, I) are essential cofactors for various enzymes and proteins involved in metabolic pathways, antioxidant defense, and cellular function.
Metabolism: Once intravenously administered and diluted, these trace elements are transported by specific plasma proteins, incorporated into metalloenzymes, and are primarily excreted via the bile and kidneys.
4. Safety and Warnings
Contraindications: Contraindicated in patients with severe cholestasis (serum bilirubin >140 μmol/L), known hypersensitivity to any component, Wilson’s disease, methemoglobinemia, or existing trace element toxicity.
Premature Infusion: High osmolarity and low pH (2.2) require strict dilution to prevent vascular irritation and thrombophlebitis.
Accumulation Risk: Caution is advised in patients with renal or hepatic impairment, as altered excretion pathways can lead to trace element accumulation.
Monitoring: Long-term use requires regular monitoring of serum trace element levels and liver/renal function.
5. Adverse Reactions and Clinical Research
Common Adverse Reactions: Reported reactions include hypersensitivity (fever, chills, flushing), local infusion site reactions (pain, phlebitis), and gastrointestinal symptoms (nausea, vomiting).
Clinical Research: Clinical studies confirm that Multiple Trace Elements Injection is indispensable in parenteral nutrition to prevent deficiency syndromes, support immune function, and maintain metabolic homeostasis.
6. Drug Interactions
Incompatibility: Do not add directly into lipid emulsions or L-alanyl-L-glutamine injections to avoid precipitation and discoloration.
Interactions: Do not add other drugs to the infusion mixture to prevent physical or chemical incompatibility.
7. Pharmaceutical Information
Composition: Contains chromium, copper, iron, manganese, molybdenum, selenium, zinc, fluorine, and iodine in a clear, pale yellow solution.
Storage: Store below 30°C in a tight container, protected from light.