Peptamen

Nestlé Peptamen can be used as a full liquid diet or liquid supplement. It can be fed orally or by tubes (eg, nasogastric, nasoduodenal and nasojejunal feeding tubes) for patients with gastrointestinal compromise eg, patients with critical illness eg, trauma, surgery, burns, GI surgery, pancreatitis, protein-energy malnutrition, hypoalbuminaemia, chronic diarrhea, short bowel syndrome, HIV/AIDS, cystic fibrosis, Crohn's disease, elevated gastric residuals, oncology and radiation enteritis.

For oral and tube feeding.

6 scoops or 55 g in 210 mL water provide 250 kcal. Tube Feeding: May be fed at full strength and often at full rate from day 1 to provide maximal nutritional support.

Not for intravenous use. Not suitable for infants under 1 year of age.

Use with caution in children aged 1-6 years (8-20kg body weight). Not

suitable for patients with galactosaemia.

Nestlé Peptamen contains maltodextrin, hydrolysed whey protein (100% of total protein), sucrose, medium-chain triglycerides (70% of total fat), potato starch, soy bean oil, soya lecithin, 30 vitamins and minerals which include vitamins A (retinyl acetate), D3 (cholecalciferol), E (sodium DL-α-tocopheryl acetate), K1 (phylloquinone), C (sodium ascorbate), B1 (thiamine), B2 (riboflavin), niacin, B6 (pyridoxine HCl), Folic Acid (Peptamen), Calcium (Peptamen) D-pantothenate, B12 (cyanocobalamin), nicotinamide, D-biotin, Choline (Peptamen) bitartrate, taurine and L-Carnitine (Peptamen), Calcium (Peptamen) carbonate, sodium phosphate, Magnesium (Peptamen) phosphate, Zinc (Peptamen) sulphate, ferrous sulphate, copper sulphate, Manganese (Peptamen) sulphate, Potassium (Peptamen) iodide, Potassium (Peptamen) citrate, sodium Chloride (Peptamen), Potassium (Peptamen) phosphate, Calcium (Peptamen) Chloride (Peptamen), Chromium (Peptamen) Chloride (Peptamen), sodium molybdate and sodium selenate.

Nestlé Peptamen is a 100% whey hydrolysated formula with 70% medium chain triglycerides (MCT). It is a nutritionally complete, isocaloric (1 kCal/mL), peptide-based elemental diet designed to provide nutritional support in a readily absorbable form for patients with gastrointestinal (GI) impairment both through tube or oral feeding. Nestlé Peptamen can be used as a food replacement or food supplement and meets 100% of US RDAs for all essential vitamins, minerals and protein in only 1500 kCal.

The term peptide-based is used because the presence of peptides as the main source of protein is the most characteristic feature of Nestlé Peptamen. Its source of protein, carbohydrate and ready-to-absorb fat blend was specially developed for the patients at risk for malabsorption or who have documented GI dysfunction. It is powdered and appropriate for both oral and tube feeding. Nestlé Peptamen's protein, carbohydrate and fat are provided in forms that require minimal GI tract functioning for digestion and absorption. Nestlé Peptamen's protein source is 100% whey that has special amino acid profile containing high cysteine to support glutathione antioxidant status as well as having low arginine to support endogenous glutamine synthesis and maintenance of glutamine status. Additionally, whey protein has proven track record to improve gastric emptying and is especially useful for those patients with elevated gastric residuals ie, diabetic gastroparesis and cerebral palsy. Nestlé Peptamen contains complete and balance nutrition to meet patient's need in fighting their illnesses.

Special Characteristics:

Energy Distribution: Nestlé Peptamen's energy distribution is 17% protein, 30% fat and 53% carbohydrate. This distribution well supports sick or injured individuals who may have higher than normal energy and protein requirements due to infection, inflammation, wound healing and tissue repair. If adequate energy is not provided, the individual will utilize body tissues, muscle in particular to produce energy. This loss of lean body mass (LBM) may result in delayed healing and poor immune function, which can increase the risk of infection.

Protein: Nestlé Peptamen, based on 100% hydrolysed whey protein, yields a unique blend of peptides that has a proven track record in improving the nutritional status of patients with severely compromised gut function. Peptide diets also help facilitate nitrogen absorption and utilization and improve patient tolerance. Essential amino acid requirements are fulfilled with this protein source and this blend has a high biological value with a chemical score of >100% of the FAO/WHO standard (1997). Nestlé Peptamen meets 100% of US RDAs for all essential vitamins, minerals and protein in only 1500 kCal which is important for patients with limited mobility and reduced energy requirements eg, the elderly or those with strokes. One thousand five hundred (1500) mL of Nestlé Peptamen contains 66 g protein (17% of total calories) which enhances healing and anabolism of patients. Ninety percent (90%) of protein in Nestlé Peptamen consists of small peptides <40 chain lengths which can enhance absorption and utilization of nitrogen. Nestlé Peptamen contains 17% of calories from hydrolysed whey protein, an ideal formula for metabolically stressed patients. Nestlé Peptamen diet, rich in cysteine, supports normalization of serum glutathione levels. It has been shown to significantly reduce gastric emptying time and frequency of vomiting in children with spastic quadriplegia and gastroesophageal reflux. A more rapid gastric emptying may enhance tolerance to feeding and reduce the risk of aspiration.

Lipid: Nestlé Peptamen contains readily absorbable fat blend (MCT 70% of total fat) to enhance tolerance and ease fat absorption, and reduce unpleasant symptoms of fat intolerance. The lipid profile of Nestlé Peptamen was designed to optimise tolerance for patients with compromised GI function. It is low in long-chain fat (LCT) which is often poorly tolerated by patients with malabsorption, while providing abundant levels of essential fatty acids.

Carbohydrate: Nestlé Peptamen contains complex carbohydrate at the moderate level which helps in reducing risk of hyperglycemia and contributes to the low osmolality of the product. The low level of sugar makes Nestlé Peptamen ideal for oral supplementation; avoiding an excessively sweet taste which may contribute to taste fatigue and poor compliance and to diabetics, with proper monitoring and medical management. As the carbohydrate source is predominantly maltodextrin rather than sucrose, it is able to maintain a low osmolarity, which is an important factor affecting tolerance of a tube feeding.

Vitamins: Nestlé Peptamen provides appropriate level of all essential vitamins and minerals for the nutritionally compromised tube- and oral-fed patients, including additional amounts of vitamins A, D, E, K, Folic Acid (Peptamen), biotin, Choline (Peptamen), taurine and Carnitine (Peptamen).

Minerals: Nestlé Peptamen added ultra trace minerals to assure optimum nutrition, particularly for those individuals on extended feeding. It provides additional levels of Calcium (Peptamen), phosphorus, Magnesium (Peptamen), Iodine (Peptamen), Potassium (Peptamen), Chromium (Peptamen), Molybdenum (Peptamen) and Selenium (Peptamen).

Isotonic osmolality of 375 mOsmol/kg of water (osmolarity is 315 mOsmol/L) allows Nestlé Peptamen to be initiated at full strength and eliminates the risk of osmotic diarrhea and high osmotic intolerance.

Palatability: Nestlé Peptamen's mild vanilla flavor and smooth texture facilitate oral compliance and make it appropriate for patients with altered taste perceptions.

Reconstitution: Nestlé Peptamen is easy to dissolve and mix and thus can be reconstituted at higher caloric densities, 1.5 and 2 kCal/mL. This provides a reliable technique for the clinician to meet the fluid-restricted or volume-sensitive patient's energy requirements in a limited volume. It minimizes preparation time and reduces risk of clogging tubes.

Nestlé Peptamen contains only readily digested nutrients to assure a minimum residue.

Cholesterol-Free: Minimizes hyperlipidemia and arteriosclerosis.

Lactose-Free: Minimizes diarrhea and other side effects of lactose intolerance.

Gluten-free.

See Tables 1 and 2.