Intravenous Total Parenteral Nutrition (TPN) For Adults

LINKS TO RELATED MONOGRAPHS AND OTHER INJECTABLE ROUTES:

MEDICINE NAME: TRADE NAME(S):

Triomel N4-700E Triomel ®
Triomel N5-990E
Triomel N7-1140E
Triomel N9-1070

PRESENTATION OF MEDICINE:
Infusion bags (1500ml, 2000ml or 2500ml) containing an emulsion for infusion

METHOD OF ADMINISTRATION:
TPN must be given via a dedicated intravenous line which must be reserved for TPN only.

Triomel N4-700E– can be given peripherally or centrally. Always check on the prescription

Triomel N5-990E, Triomel N7-1140E, Triomel N9-1070– central only

INSTRUCTIONS FOR RECONSTITUTION:

N/A – not to be manipulated by ward staff

INSTRUCTIONS FOR DILUTION AND SUITABLE DILUENT:

N/A

FLUSHING:

Flush with 0.9% sodium chloride.

ADVERSE EFFECTS WHICH MAY BE CAUSED BY AN INJECTABLE ADMINISTRATION AND

SUGGESTED MONITORING:
Monitor for any signs and symptoms of allergic reaction (such as sweating, fever, chills, headache, skin
rashes, or dyspnea)– Stop infusion immediately

EXTRAVASATION:
No significant reactions known due to extravasation

COMPATIBILITY INFORMATION USEFUL IN CLINICAL PRACTICE:

Infuse via dedicated line.
SPECIAL HANDLING PRECAUTIONS:
Aseptic non-touch technique (ANTT) by fully trained staff when handling the central or peripheral
feeding catheter.

Keep all TPN bags covered to protect from sunlight.

Store in fridge until use.

SODIUM CONTENT (mmol/L):

Triomel N4-700E = 21
Triomel N5-990E = 35
Triomel N7-1140E = 35
Triomel N9-1070 = 35

OSMOLARITY (mOsm/l) :
Triomel N4-700E = 760 mosm/L
Triomel N5-990E = 1120 mosm/L
Triomel N7-1140E = 1360 mosm/L
Triomel N9-1070 = 1310 mosm/L

pH:
Triomel N4-700E = 6.4
Triomel N5-990E = 6.4
Triomel N7-1140E = 6.4
Triomel N9-1070 = 6.4

OTHER COMMENTS:
- Daily inspection of the line site and record daily VIP scores
- Monitor blood glucose
- Maintain fluid balance chart and monitor carefully
- Monitor FBC, U&Es, calcium, magnesium, phopshate and LFTs
- TPN bags contain soybean oil, egg phosphatide and peanut proteins . Check for
allergies

PRODUCT RISK FACTORS: Risk Assessment of a common preparation (as required by NPSA
Patient Safety Alert 20)
USUAL TOTAL RISK FACTORS: 2 OVERALL RISK RATING: Green

OTHER INJECTABLE ROUTES OF ADMINISTRATION: NIL

PHARMACY NOTES:
Refer to TPN Guidelines: 209.5 ADULT PARENTERAL NUTRITION GUIDELINE
CURRENT MANUFACTURERS / DISTRIBUTORS / LICENCE HOLDERS:
Baxter Healthcare Limited
Caxton Way
Thetford
Norfolk
IP24 3SE
United Kingdom

DELETED MANUFACTURERS / DISTRIBUTORS / LICENCE HOLDERS:

REFERENCES:
1. Trust Guideline: 209.5 Adult Parenteral Nutrition Guideline

2. SPC for Triomel N4-700E, emulsion for infusion via www.baxterhealthcare.co.uk

3. SPC for Triomel N5-990E, emulsion for infusion via www.baxterhealthcare.co.uk

4. SPC for Triomel N7-1140E, emulsion for infusion via www.baxterhealthcare.co.uk

5. SPC for Triomel N9-1070, emulsion for infusion via www.baxterhealthcare.co.uk

6. COSHH report compiled by manufacturer

7. Guidelines for writing and updating monographs for the Injectable Medicines Guide website,
January 2010
Version
DATE PUBLISHED: DATE PRINTED: