Quick Facts

• Key Therapeutic Use: Provides supplemental calories for the body.
• Nutrient Support: Supplies necessary essential fatty acids.
• Primary Application: Used as a component of parenteral nutrition (intravenous feeding).
• Deficiency Correction: Assists in preventing or addressing essential fatty acid deficiency (EFAD).

Интралипид is a component of comprehensive intravenous nutritional support for adult and pediatric patients who require nourishment directly into a vein. This may occur when a patient is unable to receive adequate nutrients through the digestive system for an extended period.

Its primary purpose is to provide the body with a source of calories for energy requirements. Furthermore, it supplies essential fatty acids, which are necessary for various biological functions. This helps to prevent the development of Essential Fatty Acid Deficiency (EFAD) or address the clinical manifestations of this condition when it is present.

Интралипид is administered as part of a balanced intravenous regimen that also incorporates other vital nutrients. Its role involves providing essential nutrients for patients needing parenteral nutrition and supporting the prevention of essential fatty acid deficiency.

Official Eligibility Rules for Intralipid

Intralipid (Intravenous Fat Emulsion) is indicated for adult and pediatric patients (including neonates) requiring nutritional support through the vein. Eligibility is strictly defined by regulatory documents, focusing on patient status and underlying metabolic capacity.

Absolute Contraindications

Intralipid is contraindicated and must not be used in patients with a known hypersensitivity (allergy) to egg, soybean, or peanut protein. It is also prohibited for patients with severe disorders of lipid metabolism, such as severe hypertriglyceridemia (high triglyceride levels, typically defined as above 1,000 mg/dL) and severe conditions like acute shock or pathologic hyperlipemia.

Populations Requiring Conditional Use

Use requires special caution and monitoring in patients with impaired renal or hepatic function due to increased risks like Aluminum Toxicity and Parenteral Nutrition-Associated Liver Disease (PNALD). For neonates and infants, use is allowed but requires intense monitoring due to their limited capacity to clear intravenous fat. During pregnancy and lactation, use is conditional and should occur only if clearly needed, as safety data in these populations are not fully established.

Interactions with other Medicines and Products

Official regulatory information for this product focuses on two key areas of interaction: its effect on certain laboratory tests and a potential interaction with specific anticoagulant medications.

Documented Pharmacological Interactions

This product contains Vitamin K1, which is documented to be important for patients receiving coumarin derivatives, such as warfarin. Regulatory documents advise that the presence of Vitamin K1 may affect the activity of these anticoagulants. For patients stabilized on these blood-thinning medicines, professional monitoring may be required to assess any changes in clotting parameters.

Interference with Laboratory Tests

Due to its high fat content, the infusion can cause the blood serum to become lipemic (cloudy or milky). This lipemia is officially documented to interfere with certain common laboratory measurements that rely on colorimetric methods, including tests for bilirubin, lactate dehydrogenase, hemoglobin, and oxygen saturation.

To avoid inaccurate results from this procedural interaction, regulatory labeling includes a specific timing requirement. Blood samples intended for laboratory testing should be drawn only after a fat-free interval of 5 to 6 hours has passed since the infusion ended. This interval allows the fat particles to clear sufficiently from the bloodstream, thereby preventing interference with the test results.

How Intralipid Works

Intralipid is an intravenous lipid emulsion composed primarily of long-chain triglycerides (LCTs), which are rapidly cleared from the bloodstream through metabolic pathways analogous to those for endogenous chylomicrons. Upon infusion, the triglycerides are hydrolyzed by lipoprotein lipase (LPL), an enzyme anchored to the endothelial surface of capillaries, particularly in muscle and adipose tissue. This hydrolysis generates free fatty acids (FFAs) and glycerol.

The released FFAs are taken up by peripheral cells via passive diffusion and membrane transporters, where they are primarily directed toward beta-oxidation in the mitochondria, serving as substrates for ATP generation. The residual components, including phospholipids and cholesterol, are incorporated into cell membranes and used for synthesis of lipoproteins. This process modulates systemic energy availability and supports the maintenance of cellular membrane integrity by providing essential structural lipids. The emulsion further acts as a lipid sink, sequestering lipophilic compounds from the circulation, which influences their systemic distribution.

Интралипид is administered exclusively via intravenous infusion under the supervision of a healthcare professional. The product is a sterile fat emulsion available in various strengths, including 10% and 20% concentrations for direct use, or a 30% emulsion which is designated for preparing compound admixtures, such as Total Parenteral Nutrition (TPN).

The general principle of use involves calculating the required dose based on the patient’s body weight in grams of fat per kilogram (g/kg). For most adult patients, the total dosage of fat administered per day must not exceed 2.5 g/kg over a 24-hour period. Therapy is typically initiated with a controlled, slower starting dose.

The medication is generally delivered as a continuous infusion, meaning the total daily dose is provided steadily throughout the 24-hour cycle. Maximum limits for the hourly delivery rate for stable adults must not surpass 0.1 g/kg of fat.

Dosing Limits by Population

Population	Maximum Daily Dosage (Fat)	Maximum Hourly Infusion Rate
Adults	2.5 g/kg/day	0.1 g/kg/hour
Neonates & Infants	3.0 g/kg/day	0.125 g/kg/hour

When administered, specific technical requirements must be met: the solution must be passed through a 1.2 micron in-line filter, and a dedicated intravenous line should be used. The 30% concentration is designated as a Pharmacy Bulk Package and must never be administered directly into the bloodstream.

Recent Clinical Evidence Summary

Интралипид (Intralipid) is an intravenous fat emulsion primarily approved for use in parenteral nutrition, providing essential fatty acids and calories for patients unable to receive oral or enteral feeding. Recent clinical research, however, has explored its use in several off-label therapeutic contexts.

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Research in Toxicology (Lipid Rescue)

Intralipid has been studied extensively as a component of Lipid Emulsion Therapy (LET), often termed "lipid rescue," for treating local anesthetic systemic toxicity (LAST). Professional societies recommend its use as an adjunct to advanced cardiac life support (ACLS) measures for local anesthetic-induced cardiac arrest. Studies suggest its mechanism may involve creating a "lipid sink" to sequester lipophilic drugs, or restoring metabolic function in cardiac cells. Research is also ongoing to evaluate its effectiveness in overdoses involving other lipophilic drugs.

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Reproductive Immunology Research

There is a body of controversial research exploring the use of Intralipid infusions in women experiencing recurrent implantation failure (RIF) or recurrent pregnancy loss (RPL), often linked to elevated natural killer (NK) cell activity. While some systematic reviews and meta-analyses suggest an association with improved clinical pregnancy rates and live birth rates in specific patient groups, the quality of evidence is often considered moderate due to potential bias in studies. Other research has found no significant benefit, and in some advanced-age groups, potential detriment was noted. Consensus remains lacking, and its routine use for these indications is not universally recommended.

Key Studies & References

1. Intravenous Intralipid for treating recurrent miscarriage: A systematic review and meta-analysis of randomized controlled trials

Common questions about Интралипид (FAQ)

Q: Can Intralipid be co-infused with other solutions, like glucose or amino acids, through the same IV line?

A: According to official administration instructions, Intralipid can be infused into the same vein as solutions containing dextrose and amino acids. Official guidance permits the co-infusion of solutions, which typically involves the use of a Y-connector near the infusion site, where the flow rates are managed by infusion pumps. Administration must adhere to specific technical protocols.

Q: Is Intralipid safe for long-term use, and if so, what is considered 'long-term'?

A: Intralipid is indicated for patients who require parenteral nutrition (feeding through the vein) for extended periods, usually defined as more than five days. However, official warnings note that long-term use carries a risk of Parenteral Nutrition-Associated Liver Disease (PNALD). Official guidance emphasizes that monitoring should take place when the product is used for prolonged nutritional support.

Q: What is the difference between Intralipid 10% and 20%?

A: The primary difference between the two concentrations is their composition and caloric density. Official product information states that the 20% emulsion contains a higher concentration of soybean oil and thus delivers greater energy per milliliter (e.g., 2.0, kcal/mL for the 20% versus 1.1, kcal/mL for the 10%). This difference is factored into the maximum allowable infusion rates defined in the product labeling.

Q: Does Intralipid affect blood glucose levels?

A: Official warnings recommend that Intralipid be administered with caution in patients who have pre-existing conditions that affect lipid metabolism, such as uncompensated diabetes mellitus. Official documentation indicates the need for close monitoring of plasma triglyceride concentrations in these specific patient groups.

Q: How quickly is Intralipid cleared or eliminated from the body after infusion?

A: The process by which the infused fat particles are cleared from the bloodstream is comparable to the body's natural clearing of fats. Official safety information specifies a fat-free interval of four to six hours following the end of the infusion before blood samples should be drawn for laboratory testing.

Q: What is the purpose of the 1.2 micron in-line filter used with Intralipid?

A: A specific technical requirement for the administration of Intralipid is the use of a 1.2 micron in-line filter. The filter is a required component of the administration protocol, used to help ensure that the emulsion is delivered appropriately by filtering large particles.

Q: Can Intralipid 30% be used in premature babies?

A: Regulatory documents indicate that the 30% concentration of Intralipid is not recommended for use in infants and children. The restriction for the 30% concentration is noted in official documents due to a reported lack of adequate clinical experience in the pediatric population.

How to Store and Dispose of Intralipid?

The storage of Intralipid is governed by strict regulatory conditions to ensure the product's stability. The medicine must be stored at a controlled room temperature, specifically below 25 C (77 F). It is mandatory that the product not be frozen; if freezing occurs accidentally, the emulsion must be discarded immediately.

Packaging and Stability

Intralipid should remain in its original container and be protected from light until it is ready for use. Once a Pharmacy Bulk Package is penetrated, the contents must be transferred to an admixture container within 4 hours. Any unused portion remaining in a single-dose container must also be discarded.

Disposal and Safety

To prevent access, Intralipid must be kept out of the sight and reach of children. The disposal of any unused or expired product and waste material is required to be carried out in accordance with local regulatory requirements.