Medicinal Products

DIPEPTIVEN 20 g / 100 mL

Generic drug of the therapeutic class: Anesthesia, resuscitation, analgesics
active ingredients: N (2) -L-alanyl-L-glutamine
laboratory: Fresenius Kabi France

Solution for solution for IV infusion
Bottle of 100 ml
All forms

Indication

This product is indicated during parenteral nutrition in addition to a standard solution of amino acids or other mixtures used in parenteral nutrition in intensive care patients requiring glutamine.

Dosage DIPEPTIVEN 20 g / 100 mL Concentrate for solution for infusion IV 100 ml bottle

CENTRAL VENOUS PATHWAY after dilution in a solution for parenteral nutrition.

The dosage depends on the severity of the catabolic state and the need for amino acids. It is advisable not to exceed a maximum daily dosage of 2 g of amino acids per kg of body weight when administering parenteral nutrition. The intake of alanine and glutamine by Dipeptiven should not exceed about 30% of the total intake of amino acids.

Daily dose:

1.5 - 2.5 ml of Dipeptiven per kg of body weight (corresponding to 0.3 - 0.5 g of N (2) - L-alanyl-L-glutamine per kg of body weight), ie 100 ml to 175 ml of Dipeptiven for a patient weighing 70 kg body weight.

Maximum daily dose: 2.5 ml of Dipeptiven per kg of body weight (corresponding to 0.5 g of N (2) -L-alanyl-L-glutamine per kg of body weight).

The maximum daily intake of 0.5 g of N (2) -L-alanyl-L-glutamine per kg of body weight should be administered in combination with a compatible amino acid solution providing at least 1.0 g of amino acids per kg of body weight per day. The resulting daily dose is at least 1.5 g of amino acids per kg of body weight per day.

The following adjustments are examples of assays for Dipeptiven and other amino acids provided by the associated amino acid solution:

Amino acid requirements

Dipeptiven

Associated amino acid solution

1.2 g / kg / day

0.3 g / kg / day

0.9 g / kg / day

1.2 g / kg / day

0.4 g / kg / day

0.8 g / kg / day

1.5 g / kg / day

0.3 g / kg / day

1.2 g / kg / day

1.5 g / kg / day

0.5 g / kg / day

1.0 g / kg / day

2.0 g / kg / d

0.3 g / kg / day

1.7 g / kg / day

2.0 g / kg / d

0.5 g / kg / day

1.5 g / kg / day

The rate of infusion is a function of that of the associated solution and should not exceed 0.1 g of amino acids per kg of body weight per hour.

Before administration, Dipeptiven should be diluted in a standard solution of amino acids or other mixtures used in parenteral nutrition.

One volume of Dipeptiven must be mixed with at least 5 volumes of the associated solution (for example 100 ml of Dipeptiven + 500 ml of at least one amino acid solution).

During treatment, the maximum concentration of the active ingredient must not exceed 3.5%.

The duration of use should not exceed 3 weeks.

Against indications

These are those of parenteral nutrition in general and the standard solution of amino acids in which Dipeptiven was diluted either:
- known hypersensitivity to one of the constituents,
- renal failure in the absence of hemodialysis, haemofiltration or haemodiafiltration,
- severe hepatocellular insufficiency,
- in the child because of the absence of data.
In addition, general contraindications for infusion therapy should be considered:
- pulmonary edema,
- water inflation,
- decompensated heart failure.
Pregnancy and breast-feeding: Due to the lack of data, it is best not to administer Dipeptiven, either during pregnancy or during breastfeeding.

Adverse effects Dipeptiven

Potential adverse effects may result from improper use: for example, overdose, too fast infusion rate ....
The effects that may be encountered and that require discontinuation of treatment are: chills, nausea, sweating, hyperthermia, headache.
During prolonged parenteral nutrition with amino acids, a transient increase in liver enzymes and bilirubin has been reported. Dose reduction usually leads to normalization.

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