Huruutmanju

Adult administration

To be used as directed by a physician with monitoring of plasma trace element levels for dose adjustment guidance. For patients receiving parenteral nutrition solutions, zinc 2.5–4 mg daily, copper 0.5–1.5 mg daily, manganese 0.15–0.8 mg daily, chromium 10–15㎍ daily. Patients with fluid loss in the small intestine should receive an additional 12.2 mg/L or 17.1 mg/kg based on the amount of stool output, and 20㎍ daily additionally in acute cases.

Child administration

For children under 5 years old, 100㎍ of zinc per kg of body weight, for premature infants weighing less than 3 kg, 300㎍ of zinc per kg of body weight. Copper 20㎍ per kg of body weight daily, manganese 2–10㎍ per kg of body weight daily, chromium 10–15㎍ per kg of body weight daily

This drug should not be administered undiluted directly into the vein as it may cause phlebitis; it must be diluted before use. This drug is intended for use only in admixture solutions due to its low osmotic pressure. If any component of this drug shows toxicity, administration must be immediately stopped, and it should strictly be used according to a physician's instructions. The amounts of zinc, copper, manganese, and chromium in this drug are very low, so toxic symptoms are not usually observed at generally prescribed doses. Before injection, the physician should carefully assess the patient's medical condition and necessary metabolic requirements. Zinc is primarily excreted through the kidneys, so patients with impaired kidney function may accumulate zinc in the body, requiring caution. Copper and manganese are primarily excreted via bile, so patients with biliary obstruction are at risk of accumulation of these metals in the body. Manganese is also excreted through pancreatic juice and is reabsorbed in various parts of the small intestine, requiring caution in cases where there is an issue in that area. Chromium can affect blood sugar control, so diabetic patients must verify whether they are taking any diabetes medications when using this drug. The safety of this drug during pregnancy is uncertain, so it should only be used when the benefits of treatment outweigh the risks for women who are pregnant or may become pregnant. Excessive intake of zinc can lead to serious side effects such as nausea, vomiting, dehydration, electrolyte imbalance, dizziness, abdominal pain, drowsiness, coordination difficulties, asthenia, behavioral abnormalities, diarrhea, progressive wasting syndrome, decreased muscle tone, photophobia, peripheral edema, ulcers, renal impairment, liver dysfunction, convulsions, and coma, so caution is needed. Excessive copper intake may result in symptoms such as asthenia, behavioral abnormalities, diarrhea, muscle hypotonia, photophobia, and peripheral edema, and D-penicillamine is used as an antidote. Manganese toxicity has not been reported in patients receiving parenteral nutrition solutions, and toxicity from normal dietary intake is rare. Excessive intake of chromium can lead to central nervous system anomalies such as nausea, vomiting, ulcers, renal and hepatic dysfunction, seizures, and coma, so caution is required. When adding this drug to parenteral nutrition solutions, it is recommended to work in a sterile environment to prevent infections.

Serious side effects

Peripheral edema

Mild side effects

• Nausea
• vomiting
• dehydration
• electrolyte imbalance
• dizziness
• abdominal pain
• drowsiness
• ataxia
• asthenia
• behavioral abnormalities

This drug should be stored in a sealed container to prevent exposure to air or moisture. This will help maintain the efficacy of the drug and prevent degradation.

Appearance

An injectable solution containing a clear, pale blue liquid in a colorless vial

Package unit

2mL×10 vials