Consumer medicine information

Vitalipid N Adult & Infant

Retinol palmitate; Ergocalciferol; Dl-alpha-tocopherol; Phytomenadione

BRAND INFORMATION

Brand name

Vitalipid N

Active ingredient

Retinol palmitate; Ergocalciferol; Dl-alpha-tocopherol; Phytomenadione

Schedule

Unscheduled

 

Consumer medicine information (CMI) leaflet

Please read this leaflet carefully before you start using Vitalipid N Adult & Infant.

SUMMARY CMI

Vitalipid® N Infant & Vitalipid® N Adult

Consumer Medicine Information (CMI) summary

The full CMI on the next page has more details. If you are worried about using this medicine, speak to your doctor or pharmacist.

Note: Vitalipid® N Infant & Vitalipid® N Adult will be referred as ‘Vitalipid N’ throughout the CMI.

1. Why am I using Vitalipid N?

Vitalipid N is a sterile emulsion supplement which provides the body with fat-soluble multivitamins by the intravenous route. Vitalipid N contains the active ingredients retinol palmitate (Vitamin A palmitate), ergocalciferol (Vitamin D2), dl-alpha-tocopherol (Vitamin E) and phytomenadione (Vitamin K1).

For more information, see Section 1. Why am I using Vitalipid N? in the full CMI.

2. What should I know before I use Vitalipid N?

Do not use if you or your child have an allergy to soya oil, eggs, peanuts or are allergic to the active ingredients or any of the ingredients listed at the end of this leaflet. Do not use if you or your child have very high levels of vitamins in your system, have a sudden, dangerous drop in your blood pressure or have an inability to break down fats.

Talk to your doctor if you have any other medical conditions, take any other medicines, or are pregnant or plan to become pregnant or are breastfeeding.

For more information, see Section 2. What should I know before I use Vitalipid N? in the full CMI.

3. What if I am taking other medicines?

Tell your doctor or pharmacist if you are taking other medicines, including any medicines, vitamins or supplements that you buy without a prescription from your pharmacy, supermarket or health food shop.

Some medicines may interfere with Vitalipid N and affect how it works.

A list of these medicines is in Section 3. What if I am taking other medicines? in the full CMI.

4. How do I use Vitalipid N?

The dose of Vitalipid N which you will require will be determined by your doctor or pharmacist. The doctor will supervise your treatment or your child's treatment with Vitalipid N.

More instructions can be found in Section 4. How do I use Vitalipid N? in the full CMI.

5. What should I know while using Vitalipid N?

Things you should do
  • Remind any doctor, dentist, pharmacist or nurse treating you that you are using VItalipid N
  • Call you doctor straightaway if you have signs and symptoms of allergic reactions. In case of an allergic reaction, the infusion should be stopped immediately, and appropriate measures need to be taken.
Things you should not do
  • Do not stop using this medicine without consulting your health care professional
  • Do not take any other medicines without first telling your health care professional
  • Do not give this medicine to anyone else, even if they have the same condition as you
Driving or using machines
  • The effects of this medicine on a person's ability to drive and use machines were not assessed as part of its registration.
Drinking alcohol
  • The effects of alcohol with Vitalipid N use were not studied. Your doctor will decide what you need to do.
Looking after your medicine
  • Store below 25°C. Protect from light and do not freeze. Do not use after the expiry date stated on the label.

For more information, see Section 5. What should I know while using Vitalipid N? in the full CMI.

6. Are there any side effects?

No side effects have been reported with Vitalipid N. If you get any adverse effects, talk to your doctor or nurse.

For more information, including what to do if you have any side effects, see Section 6. Are there any side effects? in the full CMI.



FULL CMI

Vitalipid® N Infant & Vitalipid® N Adult

Active ingredients: retinol palmitate (Vitamin A palmitate), ergocalciferol (Vitamin D2), dl-alpha-tocopherol (Vitamin E) and phytomenadione (Vitamin K1).


Consumer Medicine Information (CMI)

This leaflet provides important information about using Vitalipid N. You should also speak to your doctor or pharmacist if you would like further information or if you have any concerns or questions about using Vitalipid N.

Where to find information in this leaflet:

1. Why am I using Vitalipid N?
2. What should I know before I use Vitalipid N?
3. What if I am taking other medicines?
4. How do I use Vitalipid N?
5. What should I know while using Vitalipid N?
6. Are there any side effects?
7. Product details

1. Why am I using Vitalipid N?

Vitalipid N contains the active ingredients retinol palmitate (Vitamin A palmitate), ergocalciferol (Vitamin D2), dl-alpha-tocopherol (Vitamin E) and phytomenadione (Vitamin K1).

Vitalipid N is a sterile supplement emulsion which provides the body with fat-soluble multivitamins via intravenous route. Intravenous nutrients and supplement can be given when the intake of nutrients or food into the mouth or directly into the gut is not possible or not enough to supply the body's needs. Vitamins supplementation is especially important during physical stress from illness or recent surgery.

Vitalipid N Adult is intended as a supplement in complete intravenous nutrition to meet the daily requirements of the fat-soluble vitamins A, D2, E and K1.

Vitalipid N Infant is intended as a supplement in complete intravenous nutrition to meet the daily requirements of the fat-soluble vitamins A, D2, E and K1 in paediatric patients up to 11 years of age.

2. What should I know before I use Vitalipid N?

Warnings

Do not use Vitalipid N if you or your child:

  • are allergic to the active ingredients or any of the ingredients listed at the end of this leaflet.

Always check the ingredients to make sure you can use this medicine.

  • have very high levels of vitamins in your system.
  • have a sudden, dangerous drop in your blood pressure.
  • have an inability to break down fats.

Check with your doctor if you or your child:

  • have liver or kidney disease
  • are taking anticoagulants (medicines for preventing blood clotting)
  • are allergic to soya-, egg- or peanut protein or any other medicines or any other substances, such as foods, preservatives or dyes
  • are taking any other medicines including any that you buy without a prescription from your pharmacy, supermarket or health food shop. These medicines may affect the action of Vitalipid N or may affect how well Vitalipid N works.

During treatment, you may be at risk of developing certain side effects. It is important you understand these risks and how to monitor for them. See additional information under Section 6. Are there any side effects?

Pregnancy and breastfeeding

The recommended Vitalipid N doses may be insufficient in pregnancy and during lactation due to the patient's altered vitamin requirements for example, increased requirements for Vitamin D and E.

Vitalipid N has been administered to pregnant women with no adverse reactions reported.

Check with your doctor if you are pregnant or intend to become pregnant.

Talk to your doctor if you are breastfeeding or intend to breastfeed.

Use in elderly

No data is available for use of Vitalipid N in elderly patients. Your doctor will decide what to do.

Use in Paediatrics

Vitalipid N Infant is indicated in paediatric patients up to 11 years of age.

3. What if I am taking other medicines?

Some medicines may interfere with Vitalipid N and affect how it works.

Vitalipid N contains vitamin K1 which may interact with anticoagulants of the coumarin type.

Check with your doctor or pharmacist if you are not sure about what medicines, vitamins or supplements you are taking and if these affect Vitalipid N.

4. How do I use Vitalipid N?

How much is given

The dose of Vitalipid N which you will require will be determined by your doctor or pharmacist.

How to take Vitalipid N

  • Vitalipid N will be given to you under supervision by a health care professional.
  • Vitalipid N is usually mixed in a bottle or a bag of lipid, amino acids, glucose and other standard intravenous solutions, alone or together with water-soluble vitamins and given as a continuous infusion into a vein. An electronic pump may be used to control the speed of the infusion of drip.
  • For single use and for one person only. Any unused portion must be discarded.

If you forget to use Vitalipid N

This rarely happens as Vitalipid N is usually administered under the care of a trained health care professional in a hospital or clinic setting.

If you use too much Vitalipid N

This rarely happens as Vitalipid N is usually administered under the care of a trained professional in a hospital or clinic setting. However, if you or your child is given too much of Vitalipid N, you or your child may experience a condition of high levels of vitamins in your system.

Your doctor has information on how to recognise and treat an overdose. Ask your doctor if you have any concerns.

If you think that you have used too much Vitalipid N, you may need urgent medical attention.

You should immediately:

  • phone the Poisons Information Centre
    (by calling 13 11 26), or
  • contact your doctor, or
  • go to the Emergency Department at your nearest hospital.

You should do this even if there are no signs of discomfort or poisoning.

5. What should I know while using Vitalipid N?

Things you should do

  • Remind any doctor, dentist, pharmacist or nurse treating you that you are using VItalipid N.

Call your doctor straight away if you:

  • have signs and symptoms of allergic reactions. In case of an allergic reaction, the infusion should be stopped immediately, and appropriate measures need to be taken.

Driving or using machines

Be careful before you drive or use any machines or tools until you know how Vitalipid N affects you.

The effects of this medicine on a person's ability to drive and use machines were not assessed as part of its registration.

Drinking alcohol

Tell your doctor if you drink alcohol.

The effects of alcohol with Vitalipid N use were not studied. Your doctor will decide what you need to do.

Looking after your medicine

Your doctor and hospital pharmacist are responsible for the correct storage, use and disposal of Vitalipid N.

Vitalipid N should be stored below 25°C in a cool dry place, protected from light and away from moisture and heat. Do not freeze. Do not use this medicine after the expiry date which is stated on the carton label and the ampoule. The expiry date refers to the last day of that month.

6. Are there any side effects?

All medicines can have side effects. Most of side effects are minor and temporary, however some side effects may need medical attention.

No side effects have been reported with Vitalipid N, however since Vitalipid N must be diluted with other nutrient solutions or likely given together with water soluble vitamins, these may cause unwanted effects in some people. Tell your doctor or nurse if you notice anything that may be making you feel unwell.

Reporting side effects

After you have received medical advice for any side effects you experience, you can report side effects to the Therapeutic Goods Administration online at www.tga.gov.au/reporting-problems. By reporting side effects, you can help provide more information on the safety of this medicine.

Always make sure you speak to your doctor or pharmacist before you decide to stop taking any of your medicines.

7. Product details

This medicine is only available with a doctor's prescription.

What Vitalipid N Adult contains

Active ingredient
(main ingredient)
(10 mL ampoule)
retinol palmitate (Vitamin A palmitate) 1.941 mg (corresponding to retinol 990 µg) ergocalciferol (Vitamin D2) 5 µg dl-alpha-tocopherol (Vitamin E) 9.1 mg phytomenadione (Vitamin K1) 150 µg
Other ingredients
(inactive ingredients)
soya oil
egg lecithin
glycerol
sodium hydroxide (pH adjustment)
water for injections
Potential allergenssoya oil
egg lecithin

What Vitalipid N Infant contains

Active ingredient
(main ingredient)
(10 mL ampoule)
retinol palmitate (Vitamin A palmitate) 1.353 mg (corresponding to retinol 690 µg) ergocalciferol (Vitamin D2) 10 µg dl-alpha-tocopherol (Vitamin E) 6.4 mg phytomenadione (Vitamin K1) 200 µg
Other ingredients
(inactive ingredients)
soya oil
egg lecithin
glycerol
sodium hydroxide (pH adjustment)
water for injections
Potential allergenssoya oil
egg lecithin

Do not take this medicine if you are allergic to any of these ingredients.

Vitalipid N does not contain gluten, lactose, sucrose, tartrazine or any other azo dyes.

Vitalipid N does not contain any preservative.

Vitalipid N comes in a carton of 10 ampoules:

Vitalipid N Adult: Aust R 40252

Vitalipid N Infant: Aust R 40253

What Vitalipid N looks like

Vitalipid N is a milky white 10 mL emulsion in an ampoule.

Who distributes Vitalipid N

Fresenius Kabi Australia Pty Limited
Level 2, 2 Woodland Way
Mount Kuring-gai NSW 2080
Australia
Telephone: 1300 361 004

This leaflet was prepared in March 2023.

Published by MIMS April 2024

BRAND INFORMATION

Brand name

Vitalipid N

Active ingredient

Retinol palmitate; Ergocalciferol; Dl-alpha-tocopherol; Phytomenadione

Schedule

Unscheduled

 

1 Name of Medicine

Retinol palmitate (vitamin A palmitate), ergocalciferol (vitamin D2), dl-alpha-tocopherol (vitamin E), phytomenadione (vitamin K1).

2 Qualitative and Quantitative Composition

10 mL ampoule contains (see Table 1):

Excipients with known effect.

Soya oil, egg lecithin.
For the full list of excipients, see Section 6.1 List of Excipients.

3 Pharmaceutical Form

Concentrated emulsion for injection.
A milky white emulsion. Sterile oil/water emulsion with pH: approx. 8 and osmolality: approx. 300 mOsm/kg water.

4 Clinical Particulars

4.1 Therapeutic Indications

Vitalipid N Adult is indicated as a supplement in complete intravenous nutrition to meet the daily requirements of the fat-soluble vitamins A, D2, E and K1.
Vitalipid N Infant is indicated as a supplement in complete intravenous nutrition to meet the daily requirements of the fat-soluble vitamins A, D2, E and K1 in paediatric patients up to 11 years of age.

4.2 Dose and Method of Administration

Must be diluted before use.

Adults and children aged 11 years and above.

Vitalipid N Adult should be added aseptically within one hour of the commencement of the infusion and should be used within 24 hours.

Must be diluted before use.

Infants and children under 11 years.

Vitalipid N Infant in a dosage of 1 mL per kg bodyweight per day is added to Intralipid 10% or 20%. The daily dose must not exceed 10 mL. After mixing by gentle agitation the emulsion is infused as described for Intralipid.
Vitalipid N Infant should be added aseptically within one hour of the commencement of the infusion and should be used within 24 hours.

Compatibility.

Compatibility of Vitalipid N Adult and Vitalipid N Infant has been demonstrated for use with the named branded products SMOFlipid, Intralipid, Glamin, Dipeptiven, Addaven, Soluvit N (lyophilized) and Glycophos in defined amounts and standard IV solutions of glucose and electrolytes in defined concentrations.
Up to 10 mL (1 ampoule) of Vitalipid N Adult can be added to 500 mL of SMOFlipid. To ensure a homogeneous admixture, the bottle should be inverted several times immediately before the infusion. Vitalipid N Adult up to 10 mL (1 ampoule) can also be added to Intralipid.
Vitalipid N Adult can be used to dissolve Soluvit N. The contents of one vial of Soluvit N is dissolved by the addition of 10 mL of Vitalipid N Adult and added to SMOFlipid or Intralipid.
Vitalipid N Adult is used as an additive to TPN admixtures in compounded bags where data are available and can also be added to the SmofKabiven and Kabiven range of products.

4.3 Contraindications

Vitalipid N is contraindicated in patients with known hypersensitivity to any of the components and a pre-existing hypervitaminosis.
Hypersensitivity to egg-, soya- or peanut protein or to any of the active substances or excipients.
As Vitalipid N is added to Intralipid 10% or 20% before use, it should be noted that Intralipid is contraindicated in patients with acute shock and those with severe disturbances in lipid metabolism such as pathologic hyperlipaemia. See Section 4.3 Contraindications of Intralipid product information.

4.4 Special Warnings and Precautions for Use

The Vitalipid N doses recommended are insufficient to correct severe deficiency states and may be insufficient in patients with markedly increased requirement.
In patients for whom total parenteral nutrition is continued for prolonged periods, periodic monitoring of blood levels of vitamins, particularly A and D, should be considered.
In patients receiving total parenteral nutrition, routine supplementation with both fat-soluble and water-soluble vitamins is recommended to prevent deficiency states and to obviate the need to speculate on individual vitamin status. However, daily vitamin requirements must be calculated to avoid overdosage and toxic effects, especially with regards to vitamins A and D, and particularly in paediatric patients. Hypervitaminosis A is characterised by fatigue, irritability, anorexia and loss of weight, vomiting and other gastrointestinal disturbances, polyuria and cracking and bleeding lips. Hypervitaminosis D is a metabolic bone disease characterised by hypercalciuria, intermittent hypercalcaemia, osteomalacia and bone pain.
Fractures have been reported in patients receiving prolonged parenteral nutrition. This syndrome regressed in some patients after withdrawal of vitamin D supplements.
Fat embolism has been reported as a complication in the rapid infusion of Intralipid (see Section 4.4 Special Warnings and Precautions for Use of Intralipid product information).
This product contains soya oil and egg lecithin which may rarely cause allergic reactions. Cross allergic reaction has been observed between soya-bean and peanut.

Use in the elderly.

No data available.

Paediatric use.

Vitalipid N Infant is indicated in paediatric patients up to 11 years of age.

Effects on laboratory tests.

No data available.

4.5 Interactions with Other Medicines and Other Forms of Interactions

Vitalipid N contains vitamin K1 which may interact with anticoagulants of the coumarin type.
Interaction with Intralipid, see Section 4.4 Special Warnings and Precautions for Use of Intralipid product information.
Other drugs and solutions should not be added to Vitalipid N when mixed with Intralipid unless specified in Dose and Method of Administration.

4.6 Fertility, Pregnancy and Lactation

Effects on fertility.

No data available.
The recommended Vitalipid N doses may be insufficient in pregnancy and during lactation due to the patient's altered vitamin requirements for example, increased requirements for vitamin D and E.
Vitalipid N has been administered to pregnant women with no adverse reactions reported.
No data available.

4.7 Effects on Ability to Drive and Use Machines

The effects of this medicine on a person's ability to drive and use machines were not assessed as part of its registration.

4.8 Adverse Effects (Undesirable Effects)

No adverse effects have been reported with Vitalipid N Adult or Vitalipid N Infant.

Reporting suspected adverse effects.

Reporting suspected adverse reactions after registration of the medicinal product is important. It allows continued monitoring of the benefit-risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions at https://www.tga.gov.au/reporting-problems.

4.9 Overdose

The possibility of hypervitaminosis A and D should be considered.
For information on the management of overdose, contact the Poison Information Centre on 131126 (Australia) or 0800 764 766 (New Zealand).

5 Pharmacological Properties

5.1 Pharmacodynamic Properties

Mechanism of action.

No data available.

Clinical trials.

No data available.

5.2 Pharmacokinetic Properties

No data available.

5.3 Preclinical Safety Data

Genotoxicity.

No data available.

Carcinogenicity.

No data available.

6 Pharmaceutical Particulars

6.1 List of Excipients

10 mL contains (see Table 2):

6.2 Incompatibilities

Vitalipid N may only be added to or mixed with other medicinal products for which compatibility has been documented. For compatibility information, please see Section 4.2 Dose and Method of Administration.

6.3 Shelf Life

Approved shelf life as packaged for sale.

2 years.

Shelf life after addition or mixing according to directions.

Chemical and physical in-use stability of the mixed three chamber bag has been demonstrated for 24 hours at 25°C.
From a microbiological point of view the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are the responsibility of the user and would normally not be longer than 24 hours at 2-8°C. The resulting solution should be infused within 24 hours and any residue discarded.

6.4 Special Precautions for Storage

Unopened ampoule.

Store below 25°C. Protect from light. Do not freeze.
For storage conditions after mixing of the medicinal product, see Section 6.3 Shelf Life.

6.5 Nature and Contents of Container

Infusion concentrate (white emulsion).
10 mL Type I clear glass break-off ampoules.
Ampoules are for single use in one patient only. Discard any residue.

Pack sizes.

Vitalipid N Adult: 10 x 10 mL ampoules (AUST R 40252).
Vitalipid N Infant: 10 x 10 mL ampoules (AUST R 40253).

6.6 Special Precautions for Disposal

In Australia, any unused medicine or waste material should be disposed of in accordance with local requirements.

6.7 Physicochemical Properties

Chemical structure.

Retinol palmitate (vitamin A).


Empirical formula: C36H60O2.
Molecular weight: 524.86 g/mol.

Ergocalciferol (vitamin D2).


Empirical formula: C28H44O.
Molecular weight: 396.65 g/mol.

dl-alpha-tocopherol (vitamin E).


Empirical formula: C29H50O2.
Molecular weight: 430.72 g/mol.

Phytomenadione (vitamin K1).


Empirical formula: C31H46O2.
Molecular weight: 450.70 g/mol.

CAS number.

Retinol palmitate (vitamin A palmitate): 79-81-2.
Ergocalciferol (vitamin D2): 50-14-6.
dl-alpha-tocopherol (vitamin E): 10191-41.
Phytomenadione (vitamin K1): 84-80-0.

7 Medicine Schedule (Poisons Standard)

Australia: Not Scheduled.

Summary Table of Changes