Nutryelt

Indications

This is a concentrated solution of 9 trace elements (usually zinc, copper, manganese, selenium, iodine, fluoride, chromium, molybdenum and iron). It is added to intravenous (IV) nutrition, called parenteral nutrition, for adults who cannot eat or absorb enough food through the gut. It supplies the small daily amounts of these minerals the body needs and prevents deficiency during IV feeding.

How It Works

Trace elements are minerals the body needs in tiny amounts. They are parts of many enzymes and proteins involved in wound healing, immunity, thyroid hormone production, blood formation, sugar control and protection against cell damage. People who depend on IV nutrition cannot get them from food, so they are given directly into the blood with the nutrition mixture.

Dosage and Administration

It is a hospital product prepared by a pharmacist and given by a doctor or nurse. It must never be injected undiluted. It is added to the parenteral nutrition bag or a suitable infusion fluid and given slowly through a vein. The dose is set by the doctor according to the patient's needs, blood levels and liver and kidney function.

Interactions

• It should only be mixed with fluids and nutrition products shown to be compatible; the pharmacist checks this.
• Other supplements containing the same minerals, including oral zinc, iron or selenium, may lead to excess.

Contraindications

• Serious blockage of bile flow (cholestasis), because copper and manganese can build up.
• Wilson's disease or iron overload conditions.
• Known allergy to any ingredient.
• Not for use in newborns and young children unless a paediatric product is specifically chosen by the doctor.

Side Effects

When given correctly, side effects are uncommon. Pain or irritation can occur at the infusion site. Long-term use can lead to build-up of some elements (such as manganese or copper) in people with liver or kidney problems.

Tell the nurse or doctor at once if you notice difficulty breathing, rash or swelling of the face (signs of allergy), yellow skin or eyes, new tremor, stiffness or confusion, or pain, redness or swelling along the vein.

Pregnancy and Lactation

Trace elements are essential during pregnancy and breastfeeding. When IV nutrition is needed, the doctor adjusts the amount to meet the mother's needs.

Precautions and Warnings

Blood levels of trace elements, liver tests and kidney function are checked regularly during long-term IV nutrition. Doses may need reducing in liver or kidney disease. Patients with high losses (such as from burns, fistulas or diarrhoea) may need extra amounts.

Overdose

Overdose is unlikely as it is given in hospital. If excess is suspected, the infusion is stopped and blood levels are checked; treatment depends on which element is in excess.

Therapeutic Class

Trace element additive for parenteral nutrition; electrolyte and mineral replenisher.

Storage

Hospital product: store as directed on the pack, usually below 25°C. Do not freeze. Use promptly once added to the nutrition bag. Keep out of the reach of children.