Dipeptive
Dipeptiven: instructions for use and reviews
- 1. Release form and composition
- 2. Pharmacological properties
- 3. Indications for use
- 4. Contraindications
- 5. Method of application and dosage
- 6. Side effects
- 7. Overdose
- 8. Special instructions
- 9. Application during pregnancy and lactation
- 10. In case of impaired renal function
- 11. For violations of liver function
- 12. Drug interactions
- 13. Analogs
- 14. Terms and conditions of storage
- 15. Terms of dispensing from pharmacies
- 16. Reviews
- 17. Price in pharmacies
Latin name: Dipeptiven
ATX code: B05XB02
Active ingredient: amino acids for parenteral nutrition (Aminoacids for parenteral nutrition)
Producer: Fresenius Kabi Austria, GmbH (Austria)
Description and photo update: 2019-11-07
Prices in pharmacies: from 21375 rubles.
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Dipeptiven is a parenteral nutritional supplement that replenishes glutamine deficiency.
Release form and composition
Dosage form - concentrate for the preparation of a solution for infusion 20%: transparent (in a cardboard box there are 10 glass vials containing 50 or 100 ml of concentrate, and instructions for use of Dipeptiven).
Composition of 1 liter of concentrate:
- active substance: N (2) -L-alanyl-L-glutamine - 200 g (approximately corresponds to the content of L-alanine - 82 g, L-glutamine - 134.6 g);
- excipient: water for injection - up to 1 liter.
The theoretical osmolarity of the drug is 921 mOsm per liter; titratable acidity - from 90 to 105 mmol of NaOH per 1 liter; pH - 5.4 to 6.
Pharmacological properties
Pharmacodynamics
Dipeptiven contains the dipeptide N (2) -L-alanyl-L-glutamine, which compensates for the glutamine deficiency in critical conditions or stress in patients receiving partial or complete parenteral nutrition. Its use restores intestinal function, reduces the incidence of infectious complications, improves immune function, corrects the catabolic reaction, maintains the intracellular pool of glutamine, regulates protein metabolism and nitrogen balance.
The glutamine contained in the preparation reduces bacterial translocation, the likelihood of organ failure and sepsis, prepares the intestines for further nutritional support, enhances intestinal immune function and restores the intestinal barrier.
Pharmacokinetics
After intravenous administration, the dipeptide N (2) -L-alanyl-L-glutamine is rapidly hydrolyzed in the blood plasma, with the formation of glutamine and alanine. Its half-life varies from 2.4 to 3.8 minutes (in end-stage renal failure - 4.2 minutes), and plasma clearance - from 1.6 to 2.7 minutes.
When the dipeptide is infused, the concentration of alanine and glutamine rapidly increases. In the blood plasma during the entire period of administration, only trace amounts are found. With constant infusion, the renal elimination of N (2) -L-alanyl-L-glutamine is no more than 5% and is the same as the renal elimination of other amino acids.
Indications for use
Dipeptiven is prescribed for children and adults for mixed or complete parenteral nutrition in order to replace glutamine with its increased consumption against the background of a hypercatabolic or hypermetabolic state of metabolism in cases of such disorders / diseases as:
- malignant tumors;
- immunodeficiency;
- severe inflammatory processes;
- sepsis;
- heavy surgical interventions;
- burns;
- multiple injuries.
Contraindications
Absolute:
- severe liver failure;
- severe renal failure (creatinine clearance less than 25 ml per minute);
- severe metabolic acidosis;
- period of breastfeeding;
- individual intolerance to the components of the drug.
With caution and only after consulting a doctor, it is allowed to use Dipeptiven during pregnancy, only in cases where the potential benefit to the mother is higher than the expected risks to the fetus (due to the lack of data on the use of the drug in women during gestation).
Dipeptive, instructions for use: method and dosage
The solution prepared from the concentrate Dipeptiven is administered intravenously, by drop. Immediately before infusion, it is mixed with a compatible carrier solution - 10% infusion solution containing amino acids, 5 or 10% dextrose solution, or 0.9% sodium chloride solution.
The mixing ratio of the concentrate and the carrier solution is 1: 5. For example, 0.1 L of the drug is mixed with 0.5 L of a 10% amino acid infusion solution. In this case, the ratio of the dose of amino acids in 0.1 L of the drug (L-alanine-L-glutamine content - 20 mg) and 0.5 L of amino acid solution (amino acid content - 50 g) is 2: 5, which does not exceed the proportion of Dipeptiven in 30% of the total amount of injected amino acids.
The final osmolarity of the mixture is the parameter that determines the choice of a peripheral or central vein for infusion.
After adding a compatible infusion solution to the concentrate, the drug is injected into the central veins.
If the osmolarity of the solution mixture exceeds 800 mOsm per 1 liter, it should be injected into the central veins.
The dose of the drug is selected individually, depending on the patient's needs for amino acids and the severity of his hypercatabolic state.
The maximum daily dose for parenteral nutrition is determined based on the calculation of 2 g of amino acids per 1 kg of body weight. When calculating the need, it is important to consider the addition of glutamine and alanine when the drug is administered. The proportion of amino acids received during the infusion of Dipeptiven should not exceed 30% (approximately) of the total number of amino acids administered.
The daily dose ranges from 1.5 to 2.5 ml of the drug per 1 kg of body weight (which corresponds to 0.3–0.5 g per 1 kg of N (2) -L-alanyl-L-glutamine). For patients with a body weight of 70 kg, this is equivalent to 100-175 ml of the drug per day.
The maximum daily dose is 2.5 ml per 1 kg of body weight (which corresponds to 0.5 g per 1 kg of body weight of N (2) -L-alanyl-L-glutamine). It must be combined with compatible amino acid solutions to provide approximately 1 g of amino acids per kg of body weight per day. As a result, the content of amino acids in a daily dose is 1.5 g per 1 kg of body weight.
Depending on the patient's need for amino acids, it is recommended that when adding Dipeptiven concentrate to the carrier solution, focus on the following indicators:
- daily requirement for amino acids 1.2 g / kg: 0.8 g / kg amino acids with the addition of 0.4 g / kg N (2) -L-alanyl-L-glutamine;
- daily requirement for amino acids 1.5 g / kg: 1 g / kg amino acids with the addition of 0.5 g / kg N (2) -L-alanyl-L-glutamine;
- daily requirement for amino acids 2 g / kg: 1.5 g / kg of amino acids with the addition of 0.5 g / kg N (2) -L-alanyl-L-glutamine.
The rate of infusion of the carrier solution determines the rate of infusion of Dipeptiven, it should not exceed 0.1 g of amino acids per 1 kg of body weight in 1 hour.
In therapeutic use, the maximum concentration of N (2) -L-alanyl-L-glutamine is 3.5%.
The duration of treatment should not exceed 3 weeks, but it should be borne in mind that the experience of using the drug used for more than 9 days is limited.
Side effects
With the correct use of Dipeptiven, the development of side effects is not observed. In rare cases, allergic reactions are noted.
Overdose
The main symptoms: nausea, chills, vomiting (if the infusion rate is exceeded).
Therapy: cancellation of drug administration.
special instructions
In case of compensated liver failure, the administration of Dipeptiven should be carried out under monitoring of liver function indicators.
It is required to monitor the symptoms of hyperammonemia, monitor the acid-base state, water balance, osmolarity and electrolyte composition of plasma, as well as dynamically determine liver function indicators (plasma bilirubin concentration, aspartate aminotransferase, alanine aminotransferase and alkaline phosphatase activity).
The route of Dipeptiven administration (peripheral or central vein) is selected depending on the osmolarity index of the ready-to-use solution. The upper limit of the osmolarity of the solution when injected into a peripheral vein is considered to be 800 mOsm per 1 liter, however, depending on the state of the peripheral veins, the general condition and age of the patient, it can be revised.
Before preparing the solution, the bottle and concentrate should be carefully inspected. Only a clear solution in undamaged vials, in which there are no suspended particles, is subject to use. The drug should be used immediately after opening the bottle. The concentrate in the vial is intended for single infusion only and should not be stored after adding other components. In accordance with the standard procedure for the disposal of medicines adopted in this hospital, the unused part of the concentrate is destroyed.
Application during pregnancy and lactation
During pregnancy, the introduction of the drug is possible in cases where the potential benefit to the mother is higher than the expected risks to the fetus.
Dipeptive is not prescribed during lactation.
With impaired renal function
In severe renal failure, Dipeptiven is not prescribed.
For violations of liver function
The use of Dipeptiven is contraindicated in severe hepatic insufficiency.
Drug interactions
It is important to strictly follow the rules of asepsis when mixing Dipeptiven with 5 or 10% dextrose solution, 0.9% sodium chloride solution or amino acid solution (carrier solutions). You should also make sure that the products are compatible and mix them completely.
The drug can be administered intravenously in combination with amino acid solutions intended for parenteral nutrition, or in multi-chamber bags for parenteral nutrition.
Analogs
Analogues of Dipeptiven are: Aminoplasmal Hepa, Nephrotect, Aminosol-Neo, Heimix, Aminoven Infant, Aminoven.
Terms and conditions of storage
Store in a place protected from light and moisture at temperatures up to 25 ° C. Keep out of the reach of children.
Shelf life is 2 years.
Terms of dispensing from pharmacies
Released for hospitals.
Reviews about Dipeptiven
Reviews of Dipeptiven are few, since the drug is used only in a hospital setting.
Price for Dipeptiven in pharmacies
The approximate price for Dipeptiven (10 bottles of 100 ml in a cardboard box) is 20,605–20,761 rubles.
Dipeptiven: prices in online pharmacies
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Drug name Price Pharmacy |
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Dipeptiven 200 mg / ml concentrate for preparation of solution for infusion 100 ml 10 pcs. RUB 21375 Buy |
Maria Kulkes Medical journalist About the author
Education: First Moscow State Medical University named after I. M. Sechenov, specialty "General Medicine".
Information about the drug is generalized, provided for informational purposes only and does not replace the official instructions. Self-medication is hazardous to health!
