Clinimix (amino acids in dextrose) Injections
Now Available Clinimix [amino acids in dextrose] and Clinimix E [amino acids with electrolytes in dextrose with calcium] Injections with higher protein* -- the first and only premix formulations with up to 80 grams of amino acids per liter.1,2,3 Clinimix formulations with higher protein are available in 8/14 and 8/10, with and without electrolytes, and in 6/5, which is formulated for peripheral or central administration. *Protein is provided as amino acids.
Indications
Clinimix sulfite-free (amino acid in dextrose) Injections and Clinimix E sulfite-free (amino acid with electrolytes in dextrose with calcium) Injections are indicated as a source of calories and protein (and electrolytes for Clinimix E) for patients requiring parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated. Clinimix and Clinimix E may be used to treat negative nitrogen balance in patients. Please read the accompanying full Indication(s) and Important Risk Information, as well as the Package Insert for full Prescribing Information for Clinimix and Clinimix E.
Most Critically Ill Patients Receive Half the Recommended Protein During Their First Week in the ICU4
Critically ill adult patients often lose significant lean body mass in the first 7-10 days of ICU stay.5
Protein, not calories, is the crucial macronutrient in catabolic critical illness.4
Clinimix is an amino acids in dextrose parenteral nutrition (PN) solution NOW AVAILABLE with higher protein (amino acid) and with and without electrolytes.
Clinimix is appropriate for adult and pediatric use and is available in a variety of formulations in one-liter and two-liter bags, offering clinicians flexibility to help meet the nutritional goals of each patient.
Please read the accompanying full Indication(s) and Important Risk Information, as well as the Package Insert for full Prescribing Information for Clinimix and Clinimix E.
Clinimix With HIGHER PROTEIN [amino acids] Helps Deliver Nutrition Care as Unique as Each Patient
REACH PROTEIN TARGETS WITH LESS FLUID
With up to 80 g/L of protein, Clinimix with higher protein enables you to reach recommended doses for protein in less fluid.1-3
REDUCE CALORIES FROM DEXTROSE
Protein, not calories, is the crucial macronutrient in catabolic critical illness.4 Clinimix with higher protein offers the most protein per liter.1-3**
**When compared to other multi-chamber bags available in the U.S.
CHOOSE FROM FORMULATIONS AS DISTINCT AS YOUR PATIENTS
With Clinimix and Clinimix E with higher protein formulations, the Clinimix portfolio of multi-chamber PN offers 14 distinct formulations, available in different volumes, with and without electrolytes.1,2
Clinimix and Clinimix E Now Available with Higher Protein
- Source of calories and protein/amino acid
[and electrolytes with Clinimix E] - Only premix products formulated with up to 80 grams of amino acids per liter to meet SCCM/ASPEN guidelines for protein intake in critically ill patients6
- Suitability for the majority of PN patients
- 24-month shelf life
- Vertical Peel Seal CLARITY Dual Chamber container in 1L and 2L sizes
- Flexibility with seven formulations of Clinimix E and seven formulations of Clinimix
Please read the accompanying full Indication(s) and Important Risk Information, as well as the Package Insert for full Prescribing Information for Clinimix and Clinimix E.
Choose From Formulations As Distinct As Your Patients
Clinimix 8/14 formula
8% Amino Acid
14% Dextrose
Composition (based on the maximum available in other Clinimix variants):
Protein/Amino Acid: 80 g/L
Dextrose: 140 g/L
Total kcal: 797 kcal/L
Available with and without electrolytes
Clinimix 8/10 formula
8% Amino Acid
10% Dextrose
Composition (based on the maximum available in other Clinimix variants):
Protein/Amino Acid: 80 g/L
Dextrose: 100 g/L
Total kcal: 663 kcal/L
Available with and without electrolytes
Clinimix 6/5 formula
6% Amino Acid
5% Dextrose
Composition (based on the maximum available in other Clinimix variants):
Protein/Amino Acid: 60 g/L
Dextrose: 50 g/L
Total kcal: 410 kcal/L
Formulated for peripheral and central administration
Selected Important Risk Information
● As with all injectable products, there are risks associated with Clinimix and Clinimix E, including being contraindicated in patients with known hypersensitivity to one or more amino acids or dextrose; in patients with inborn errors of amino acid metabolism due to risk of severe metabolic and neurologic complications; and in patients with pulmonary edema or acidosis due to low cardiac output.
● In addition, Clinimix E is contraindicated in neonates (less than 28 days of age) receiving concomitant treatment with ceftriaxone, even if separate infusion lines are used, due to the risk of fatal ceftriaxone calcium salt precipitation in the neonate's bloodstream.
2-Port Clinimix / Clinimix E Bag Activation Video
3-Port Clinimix / Clinimix E Bag Activation Video
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Indications and Important Risk Information for CLINIMIX
Indications
CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections and CLINIMIX E sulfite-free (Amino Acid with Electrolytes in Dextrose with Calcium) Injections are indicated as a source of calories and protein (and electrolytes for CLINIMIX E) for patients requiring parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated. CLINIMIX and CLINIMIX E may be used to treat negative nitrogen balance in patients.
Important Risk Information
- CLINIMIX and CLINIMIX E Injections are contraindicated in patients with known hypersensitivity to one or more amino acids or dextrose; in patients with inborn errors of amino acid metabolism due to risk of severe metabolic and neurologic complications; and in patients with pulmonary edema or acidosis due to low cardiac output.
- In addition, CLINIMIX E is contraindicated in neonates (less than 28 days of age) receiving concomitant treatment with ceftriaxone, even if separate infusion lines are used, due to the risk of fatal ceftriaxone calcium salt precipitation in the neonate’s bloodstream.
- Pulmonary vascular precipitates causing pulmonary vascular emboli and pulmonary distress have been reported in patients receiving parenteral nutrition.
- Excess addition of calcium and phosphate increases the risk of the formation of calcium phosphate precipitates.
- The solution should be inspected for precipitates before admixing, after admixing, and again before administration.
- Protect the admixed parenteral nutrition solution from light.
- If signs of pulmonary distress occur, stop the infusion and initiate a medical evaluation.
- Precipitation of ceftriaxone-calcium can occur when ceftriaxone is mixed with CLINIMIX E, in the same intravenous administration line.
- Do not administer ceftriaxone simultaneously with CLINIMIX E via a Y-site.
- Stop infusion immediately and treat patient accordingly if signs or symptoms of a hypersensitivity reaction develop.
- Monitor for signs and symptoms of early infections. Refeeding severely undernourished patients may result in refeeding syndrome. Thiamine deficiency and fluid retention may also develop.
- Monitor severely undernourished patients and slowly increase nutrient intakes.
- CLINIMIX and CLINIMIX E solutions containing more than 5% dextrose have an osmolarity of ≥ 900 mOsm/L and must be infused through a central catheter.
- CLINIMIX and CLINIMIX E contain no more than 25 mcg/L of aluminum which may reach toxic levels with prolonged administration in patients with renal impairment.
- Preterm infants are at greater risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions which contain aluminum.
- Patients with renal impairment, including preterm infants, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day, accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.
- Parenteral Nutrition Associated Liver Disease (PNALD) has been reported in patients who receive parenteral nutrition for extended periods of time, especially preterm infants.
- If CLINIMIX and CLINIMIX E treated patients develop liver test abnormalities consider discontinuation or dosage reduction.
- Use CLINIMIX and CLINIMIX E with caution in patients with cardiac insufficiency or renal impairment due to increased risk of electrolyte and fluid volume imbalance.
- Monitor renal and liver function parameters, ammonia levels, fluid and electrolyte status, serum osmolarity, blood glucose, blood count and coagulation parameters throughout treatment.
- In situations of severely elevated electrolyte levels, stop CLINIMIX and CLINIMIX E until levels have been corrected.
- Adverse reactions include diuresis, extravasation, glycosuria, hyperglycemia, and hyperosmolar coma.
Please click here for full Prescribing Information for Clinimix.
Please click here for full Prescribing Information for Clinimix E.