Clinimix E 2.75/10 (Intravenous)

Amino acids and electrolytes with calcium injection is used as a dietary supplement for patients who cannot get enough calories, proteins, and electrolytes in their diet, usually due to certain illnesses or recent surgery. It may also be used to treat negative nitrogen balance in the blood.

This medicine should only be given by or under the supervision of your doctor.

It is very important that your doctor checks you or your child closely to ensure that this medicine is working correctly. Blood and urine tests are necessary to monitor for any unwanted effects.

Do not give this medicine together with ceftriaxone in children younger than 28 days of age (neonates).

This medicine may increase your risk of blood clots in the lungs or veins. This can be life-threatening and requires immediate medical attention. Contact your doctor right away if you experience a cough, chest pain, fast heartbeat, trouble breathing, dizziness, lightheadedness, fainting, or tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins in the affected area.

Serious allergic reactions may occur while you are using this medicine. Inform your doctor immediately if you have any of the following symptoms: rapid, shallow breathing, trouble breathing, fast heartbeat, lightheadedness, dizziness, fainting, nausea or vomiting, rash or itchy skin, or fever or chills.

This medicine may increase your risk of developing infections. Call your doctor right away if you start to have a persistent cough, weight loss, night sweats, fever, chills, flu-like symptoms (such as a runny or stuffy nose, headache, blurred vision, or feeling generally unwell), painful or difficult urination, or sores, ulcers, or white spots in the mouth or on the lips.

This medicine may affect your blood sugar levels. Contact your doctor immediately if you have increased thirst or increased urination. If you notice a change in your urine or blood sugar test results, or if you have any questions, speak with your doctor.

Call your doctor if you have redness, swelling, pain, or signs of infection at the injection site.

This medicine may cause liver problems, including parenteral nutrition associated liver disease (PNALD). This usually occurs in patients who have been receiving parenteral nutrition for a long time, especially preterm infants. Contact your doctor right away if you have pain or tenderness in the upper stomach, pale stools, dark urine, loss of appetite, nausea, vomiting, or yellowing of the eyes or skin.

This medicine may also cause electrolyte imbalance, fluid overload, and aluminum toxicity (too much aluminum in the blood). Discuss any concerns with your doctor.

In deciding to use a medicine, it’s important to consider the risks of taking it against the benefits it may provide. This is a choice you will make with your doctor. For this medicine, please consider the following:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, let your health care professional know if you have other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies so far have not shown any specific problems in children that would limit the use of amino acids with electrolytes in dextrose with calcium injection in kids. However, infants and children receiving this medicine are more likely to experience serious side effects (such as low or high blood sugar, aluminum toxicity, liver issues, or excess ammonia in the blood). Safety and effectiveness have not been confirmed.

Geriatric

Studies so far have not shown any specific problems in older adults that would limit the use of amino acids in dextrose injection in this age group. However, older patients are more likely to have age-related issues with their liver, kidneys, or heart, which may require careful monitoring and possible dose adjustments for those receiving this medicine.

Breast Feeding

There are not enough studies in women to determine the risk to infants when using this medication while breastfeeding. Consider the potential benefits against the potential risks before taking this medication while breastfeeding.

Interactions with Medicines

While some medicines should not be taken together at all, others may be used together even if there is a chance of interaction. In these cases, your doctor may adjust the dose or take other precautions. It is very important for your healthcare professional to know if you are taking any of the medicines listed below while receiving this medicine. The following interactions have been highlighted based on their potential importance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is usually not recommended, but may be necessary in some cases. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both of the medicines.

• Amiloride
• Azilsartan
• Azilsartan Medoxomil
• Baloxavir Marboxil
• Bictegravir
• Candesartan
• Canrenoate
• Canrenone
• Cilazapril
• Cyclosporine
• Digoxin
• Eltrombopag
• Enalapril
• Enalaprilat
• Eplerenone
• Eprosartan
• Erdafitinib
• Fosinopril
• Irbesartan
• Lisinopril
• Losartan
• Moexipril
• Olmesartan
• Perindopril
• Quinapril
• Raltegravir
• Ramipril
• Spirapril
• Spironolactone
• Tacrolimus
• Telmisartan
• Trandolapril
• Triamterene
• Valsartan
• Zofenopril

Using this medicine with any of the following medicines may increase the risk of certain side effects, but taking both might be the best treatment for you. If both medicines are prescribed together, your doctor may adjust the dose or how often you take one or both medicines.

• Chlorothiazide
• Delafloxacin
• Felodipine
• Isradipine
• Nicardipine
• Strontium Ranelate

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used at or around mealtime or with certain foods due to potential interactions. Using alcohol or tobacco with specific medicines may also cause interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may affect the use of this medicine. Be sure to inform your doctor if you have any other medical conditions, especially:

• Acidosis (too much acid in the blood) or
• Errors in amino acid metabolism, inborn or
• Pulmonary edema (fluid in the lungs)—Should not be used in patients with these conditions.

• Diabetes or
• Heart disease or
• Kidney disease—Use with caution. May worsen these conditions.

• Electrolyte imbalance or
• Severe metabolic disorders—Should be corrected before using this medicine.

• Hyperglycemia (high blood sugar) worsened by dextrose or
• Weak immune system due to poor nutrition or other medications—May raise the risk of infections.

• Severely undernourished patients—May lead to refeeding syndrome. Monitor and gradually increase nutrient intake for these patients.

Along with its necessary effects, a medicine can cause some unwanted effects. Not all of these side effects may happen, but if they do, they might require medical attention.

Check with your doctor or nurse right away if any of the following side effects happen:

Incidence not known

• Anxiety
• bloating
• blurred vision
• chest pain
• chills
• confusion
• cough or hoarseness
• dark urine
• decrease in the amount of urine
• dizziness or lightheadedness
• dry mouth
• extreme thirst
• fainting
• fast heartbeat
• fatigue
• fever
• flushed, dry skin
• fruit-like breath odor
• increased hunger
• increased thirst
• increased urination
• light-colored stools
• lower back or side pain
• nausea
• noisy, rattling breathing
• pain or redness at the injection site
• painful or difficult urination
• pale skin at the injection site
• seizure
• stomach pain
• sugar in the urine
• sweating
• swelling of the fingers, hands, feet, or lower legs
• tenderness, pain, swelling, warmth, skin discoloration, and prominent superficial veins over the affected area
• troubled breathing
• troubled breathing at rest
• unexplained weight loss
• urinating large amounts or very little
• vomiting
• weakness
• weight gain
• yellow eyes or skin

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You can report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Clinimix 5/20
• Clinimix E 2.75/10
• Clinimix E 2.75/5
• Clinimix E 4.25/10
• Clinimix E 4.25/25
• Clinimix E 4.25/5
• Clinimix E 5/15
• Clinimix E 5/25

Available Dosage Forms:

• Solution

Therapeutic Class: Parenteral Amino Acids

Chemical Class: Amino Acid

A nurse or other trained health professional will give you this medicine in a hospital or clinic. It is given through a needle placed into one of your veins.