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Adult dose

As a standard adult dosage, 1200–2000mL (1200–2000kcal) should be administered over 12–24 hours via a nasogastric tube, gastrostomy, or jejunostomy into the stomach, duodenum, or jejunum. The rate of administration is to be set at 75–125mL/hour. If oral intake is possible, it can be administered intermittently once or multiple times a day. At the start of administration, 400mL (400kcal) should be diluted with water.

Child dose

For children aged 1 month to under 10 years, start administration at a concentration of approximately 0.4kcal/mL, while closely observing clinical symptoms and gradually increasing the concentration and dosage. The standard administration amount is 70–100kcal/kg/day.

This medication should not be administered to certain patients. Patients who are allergic to this medication or its components, or those with hypersensitivity to milk proteins may experience serious allergic reactions and should not use it. Additionally, this medication should not be administered to patients with bowel obstruction or severe gastrointestinal dysfunction, as it may cause complications due to inability to pass through the digestive tract. Patients with severe liver or kidney dysfunction should also be cautious, as serious side effects like hepatic coma or increased blood nitrogen levels may occur. Patients with severe diabetes with glucose metabolism abnormalities or congenital amino acid metabolism disorders may also experience worsening symptoms, so they should not be administered this medication. Caution should be exercised when using this drug in patients with short bowel syndrome or acute pancreatitis, as there is a risk of aggravated diarrhea or worsening pancreatitis. Special attention is also needed for patients in a comatose state, unconsciousness, exhibiting severe dehydration symptoms, or with poor kidney function regarding maintenance of fluid balance. Women who are pregnant or may become pregnant should also be administered this medication cautiously due to the risk of fetal malformations from the Vitamin A content. Common gastrointestinal side effects from this medication include diarrhea, abdominal bloating, abdominal pain, nausea, and vomiting. Symptoms such as abnormal liver function tests, skin rash, urticaria, fever, and headache have also been reported. Patients should immediately inform healthcare providers of any unusual symptoms. Severe allergic reactions such as shock or anaphylaxis can occur, so if symptoms like hypotension, dyspnea, facial flushing, or pruritus appear, administration should be stopped immediately, and treatment should be sought. After surgery, gastrointestinal motility should recover and when sufficient oral nutritional intake becomes possible, it is advisable to quickly switch to oral administration. Since there may be deficiencies of vitamins, electrolytes, and trace elements, supplementation may be needed if required. Long-term use may potentially lead to selenium deficiency, so caution should be exercised. The long-term effects of this drug have not been confirmed beyond 35 days, so caution is necessary for prolonged administration. This medication may reduce the efficacy of warfarin if used together, so caution is warranted when used concurrently. Older adults may have diminished physiological functions; thus, dosage and rate of administration should be adjusted carefully. In women in the first trimester of pregnancy, there is a risk of fetal malformations due to excessive Vitamin A intake, so the dosage should be limited and administered with caution. It is also advisable not to use this drug for neonates under 1 month of age or low birth weight infants, as its safety has not been established. This drug is not for intravenous use; therefore, the specified route of administration must be followed, and any adverse event should be carefully monitored initially after administration. When administering, residual content in the stomach should be checked, and thorough cleaning of the tubing should be performed; the container should be shaken well before use, and any damaged preparations should not be used. When warming, high temperatures above 70 degrees should be avoided, and heating must be done by double boiling while unopened. During storage, freezing or high temperatures should be avoided, and it should be used as soon as possible after opening. Additionally, since the plasticizer DEHP included in this medication may leach out, it is recommended to use feeding sets or feeding tubes that do not contain DEHP.

Serious side effects

Urticaria, severe allergic reactions (shock, anaphylaxis-like reaction, hypotension, altered consciousness, dyspnea, cyanosis), respiratory distress, chest pain

Mild side effects

Diarrhea, abdominal bloating, abdominal pain, nausea, vomiting, constipation, skin rash, headache, fever, abnormalities in liver function tests, and unusual blood test results (e.g., AST, ALT, Al-P, LDH, γ-GTP, LAP, blood urea nitrogen, triglycerides, potassium, creatinine, calcium, chloride, sodium, blood sugar levels, etc.)

This medication is sensitive to light; therefore, it should be stored in a container that blocks light, and the ideal storage temperature should be at room temperature, avoiding extremes of heat and cold. Thus, it should be stored safely by avoiding direct sunlight and by staying clear of excessively high temperatures or humid locations.

Appearance

A light brown liquid with a milk, coffee, banana, or corn flavor, contained in a square aluminum foil pouch.

Package unit

200 mL, 400 mL