Nouress (Intravenous)

Cysteine injection is used to provide the necessary nutrition for newborns (including preterm babies) who need total parenteral nutrition (TPN).

Cysteine injection is also given to adults and children with severe liver disease who may have problems with their enzymes and need TPN. This medicine can also help ensure a fuller range of amino acids for making proteins.

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

Your doctor will closely monitor you or your child's progress while receiving this medicine. This will help your doctor determine if the medicine is effective. Blood and urine tests will be required to look for any unwanted effects.

Inform your doctor immediately if you or your child experience chest pain, cough, fainting, rapid heartbeat, difficulty breathing, or dizziness or lightheadedness after receiving this medicine. These could indicate pulmonary embolism caused by the precipitates found in the TPN solution, infusion set, and catheter.

Notify your doctor if you or your child develop pain, tenderness, changes in skin color, or swelling in the foot or leg after receiving this medicine. These may be signs of vein damage or thrombophlebitis.

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 yellow eyes or skin. These could be symptoms of a serious liver issue.

In deciding to use a medicine, you and your doctor need to consider the risks of taking the medicine against the benefits it will provide. Here are some important points to think about for this medicine:

Allergies

Let your doctor know if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also inform your healthcare professional about any other allergies you might have, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pediatric

Studies have not shown any specific problems that would limit the use of cysteine injection in children. However, children may have immature kidney and liver functions, which means extra caution may be needed when they receive this medicine.

Geriatric

Studies on how age affects the use of cysteine injection in older adults have not been done. The safety and effectiveness for this age group have not been established.

Breast Feeding

There are no adequate studies to determine the risk to infants when this medication is used during breastfeeding. Consider the potential benefits and risks before using this medication while breastfeeding.

Interactions with Medicines

Some medicines should never be used together, while in other cases, two different medicines may be used together despite potential interactions. In such situations, your doctor may adjust the dose or take other precautions. Inform your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Some medicines should not be taken at the same time as food or specific types of food due to possible interactions. Drinking alcohol or using tobacco with certain medicines may also lead to interactions. Talk to your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may impact how this medicine works for you. Be sure to tell your doctor if you have any other medical conditions, especially:

• Acid-base imbalance or
• Electrolyte imbalance—These should be corrected before receiving this medicine.

• Acidosis (caused by low cardiac output) or
• Amino acid metabolism problems, inborn errors or
• Pulmonary edema (fluid in the lungs)—This medicine should not be used in patients with these conditions.

• Gallstones or
• Hyperammonemia (high ammonia levels in the blood) or
• Liver disease—Use this medicine with caution, as it may worsen these conditions.

• Kidney disease—Using this medicine for a long time in preterm babies may increase the risk of aluminum toxicity.

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur, they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

• Anxiety
• chest pain
• confusion
• cough
• dizziness or lightheadedness
• drowsiness
• fainting
• fast heartbeat
• feeling of warmth
• fever
• muscle tremors
• nausea
• pain, tenderness, or swelling of the foot or leg
• rapid, deep breathing
• redness of the face, neck, arms, and occasionally, upper chest
• restlessness
• stomach cramps
• sudden shortness of breath or troubled breathing
• unusual tiredness or weakness
• warmth, redness, pain, or changes in skin color at the infusion site

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 may report side effects to the FDA at 1-800-FDA-1088.

In the U.S.

• Nouress

Available Dosage Forms:

• Solution

Therapeutic Class: Amino Acid Supplement

A nurse or other trained health professional will give you or your child this medicine. Cysteine is added to your or your baby's TPN bag. After mixing, it is given through a needle placed in one of your or your baby's veins.

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