See WARNINGS and SPECIAL PRECAUTIONS FOR CENTRAL VENOUS NUTRITION.
Reactions secondary to the administration technique or the solution include febrile response, infection at the injection site, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia.
Local reactions at the infusion site, consisting of a warm sensation, erythema, phlebitis and thrombosis have been reported with peripherally administered amino acid solutions, especially if other substances are also administered through the same site.
Generalized flushing, fever and nausea have been reported during peripheral administration of amino acids.
Symptoms may result from an excess or deficit of one or more of the ions present in the solution; therefore, frequent monitoring of electrolyte levels is essential.
If electrolyte supplements are required during peripheral infusions, it is recommended that additives be administered throughout the day in order to avoid possible vein irritation. Irritating additive medications may require injection at another site and should not be added directly to the amino acid infusate.
Phosphorus deficiency may lead to impaired tissue oxygenation and acute hemolytic anemia. Relative to calcium, excessive phosphorus intake can precipitate hypocalcemia with cramps, tetany and muscular hyperexcitability.
If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary.