Junimin

Indications

This is a sterile concentrate containing a mixture of five essential trace elements, typically Zinc, Copper, Manganese, Selenium and Chromium (the exact contents vary by product). It is added to intravenous (parenteral) nutrition to meet the daily trace element needs of patients, including infants and children, who cannot eat or absorb enough food through the gut and are fed through a vein.

How It Works

Trace elements are minerals the body needs in very small amounts. Zinc supports growth, wound healing and immunity; Copper is needed for blood formation and nerves; Manganese and Selenium are parts of enzymes, including antioxidant systems; Chromium helps the body use glucose. Supplying them in the drip prevents deficiency during long term intravenous feeding.

Dosage and Administration

It is a hospital product given by doctors, nurses or pharmacists. It must never be injected undiluted; it is added to the parenteral nutrition bag or a suitable infusion fluid and given slowly into a vein. The amount is as prescribed and depends on age, body weight, the patient's condition and blood levels of trace elements.

Interactions

It is mixed only with compatible infusion solutions under controlled conditions. Other sources of the same trace elements, such as separate zinc or selenium supplements, must be counted to avoid excess. Some elements may interact with other components of the nutrition mixture, so mixing follows pharmacy guidance.

Contraindications

• Allergy to any component.
• Severe cholestasis (blocked bile flow), because Copper and Manganese are removed in bile and can build up.
• High blood levels of any of the contained elements, such as Wilson's disease (copper overload).

Side Effects

When used correctly, side effects are uncommon. Pain or irritation can occur at the infusion site. Long term excess can cause toxicity: Manganese build up may affect the brain, especially in liver disease, and Copper excess may harm the liver. Allergic reactions are rare.

Get urgent medical help, or tell the nurse at once, if there is swelling, pain or redness along the vein, a rash, breathing difficulty, unusual drowsiness, tremor, or yellowing of the skin or eyes.

Pregnancy and Lactation

Trace elements are needed during pregnancy and breastfeeding, and this product may be used if intravenous nutrition is required, with doses adjusted by the doctor.

Precautions and Warnings

Blood levels of trace elements, liver function and kidney function are checked during long term use. Doses are reduced in liver disease or bile flow problems (Copper and Manganese) and in kidney failure (Selenium, Chromium and Zinc). Preterm infants and patients with large losses, such as from burns or fistulas, need careful dosing.

Overdose

Overdose is unlikely because it is prepared and given in hospital. Excess over time may cause trace element toxicity, which is treated by stopping or reducing the supplement and monitoring blood levels.

Therapeutic Class

Parenteral nutrition additive, trace element preparation

Storage

Hospital product: store below 25°C or as directed on the pack. Do not freeze. Use immediately after adding to the infusion, as directed.