Dipeptiven, 20% vials, 100ml, 10pcs

Composition

Active ingredient:

N(2) – L-alanyl-L-glutamine 200 g;

Auxiliary substance:

water for injection-up to 1 l

Pharmacological action

Dipeptiven is a glutamine deficiency replenisher.

Pharmacodynamics

Dipeptide N (2) – L-alanyl-L-glutamine makes up for glutamine deficiency during stress or critical condition in patients receiving full or partial parenteral nutrition.

use of the drug Dipeptiven regulates the nitrogen balance and protein metabolism, supports the intracellular pool of glutamine, corrects the catabolic reaction, improves immune function, reduces the frequency of infectious complications, and restores intestinal function.

Glutamine in Dipeptiven restores the intestinal barrier, reduces the translocation of bacteria, enhances the immune function of the intestine, reduces the risk of sepsis and organ failure, and prepares the intestine for further nutritional support.

Pharmacokinetics

N(2) – L-alanyl-L-glutamine is rapidly hydrolyzed in blood plasma to form alanine and glutamine after intravenous use. T_1/2 of N(2) – L-alanyl-L-glutamine is 2.4–3.8 min (4.2 min in end-stage renal failure), its plasma clearance is 1.6-2.7 min.

Infusion of the N(2) – L-alanyl-L-glutamine dipeptide leads to a rapid increase in the concentration of glutamine and alanine; during the entire infusion period, only trace amounts of the dipeptide can be detected in plasma. The renal elimination of N (2) – L-alanyl-L-glutamine with constant infusion does not exceed 5% and is the same as the renal elimination of other amino acids.

Indications

Compensation of glutamine in case of its increased consumption in adults and children within the framework of full or mixed parenteral nutrition: hypermetabolic or hypercatabolic state of metabolism (against the background of multiple injuries, burns, severe surgical interventions, sepsis, severe inflammatory processes, immunodeficiency, malignant neoplasms).

Use during pregnancy and lactation

is contraindicated

Contraindications

• intolerance to one of the components of the drug;
• severe renal insufficiency (creatinine clearance
• severe hepatic insufficiency;
• severe metabolic acidosis.

Side effects

Rarely-allergic reactions.

Interaction

When mixing with a carrier solution (0.9% sodium chloride,5 or 10% dextrose solution, amino acid solution), it is necessary to strictly observe the rules of asepsis, first make sure that the solutions are compatible and ensure their complete mixing.

Dipeptiven can be administered intravenously together with solutions of amino acids for parenteral nutrition or in multi-chamber bags for parenteral nutrition.

How to take, course of use and dosage

Intravenous, drip.

Dipeptiven is a concentrated solution that is not intended for direct use. Before infusion, it must be mixed with a compatible carrier solution (0.9% sodium chloride solution,5 or 10% dextrose solution, or 10% amino acid infusion solution). One volume part of Dipeptiven should be mixed with approximately five volume parts of the carrier solution (for example,100 ml of Dipeptiven should be mixed with 500 ml of a 10% amino acid solution). At the same time, the ratio of the dose of amino acids in 100 ml of Dipeptiven (20 g of N(2)-L-alanyl-L-glutamine) and 500 ml of the carrier solution-10% amino acid solution (50 g of amino acids) is 2: 5, which does not exceed the share of Dipeptiven in 30% of the total amount of amino acids administered.

The choice of a central or peripheral vein for use depends on the final osmolarity of the mixture.

Dipeptiven is intended for infusion into central veins after being added to a compatible infusion solution.

Mixtures of solutions with an osmolarity greater than 800 mosmol / l should be injected into the central veins.

Adults and children. The dose depends on the severity of the patient’s hypercatabolic condition and the amino acid requirements.

With parenteral nutrition, the maximum daily dose is 2 g / kg of amino acids.

When calculating the requirement, the addition of alanine and glutamine during the use of Dipeptiven should be taken into account. The proportion of amino acids received during the use of Dipeptiven should not exceed approximately 30% of the total amount of amino acids administered.

The daily dose is 1.5-2.5 ml / kg of Dipeptiven (equivalent to 0.3-0.5 g / kg of N(2) – L-alanyl-L-glutamine). This corresponds to 100-175 ml / day of Dipeptiven for a patient with a body weight of 70 kg. The maximum daily dose is 2.5 ml / kg (equivalent to 0.5 g / kg of N(2) – L-alanyl-L-glutamine).

The maximum daily dose of 0.5 g / kg of N(2) – L-alanyl-L-glutamine should be given in combination with compatible amino acid solutions, providing approximately 1 g / kg / day of amino acids. As a result, the daily dose is approximately 1.5 g/kg of amino acids.

The following indicators are recommended when adding amino acids to the carrier solution: :

• when the amino acid requirements of 1.2 g/kg/day and 0.8 g/kg amino acids with the addition of 0.4 g/kg N(2)-L-I alanyl-L-glutamine;
• when the amino acid requirements of 1.5 g/kg/day to 1 g/kg amino acids with the addition of 0.5 g/kg N(2)-L-I alanyl-L-glutamine;
• when the amino acid requirements of 2 g/kg/day to 1.5 g/kg amino acids with the addition of 0.5 g/kg N(2)-L-I alanyl-L-glutamine.

The infusion rate is determined by the infusion rate of the carrier solution and should not exceed 0.1 g / kg / h of amino acids. _{Cmax of} N(2)-L-alanyl-L-glutamine for therapeutic use is 3.5%.

Duration of application-no more than 3 weeks. However, the experience of using Dipeptiven for more than 9 days is limited.

Overdose

Symptoms:  if the infusion rate is exceeded, chills, nausea, and vomiting may occur.

Treatment:  if adverse reactions occur, the drug should be discontinued immediately.

Special instructions

When Dipeptiven is administered to patients with compensated hepatic insufficiency, monitoring of liver function indicators is necessary. It is necessary to monitor the electrolyte composition and osmolarity of plasma, water balance, acid-base state, as well as dynamically determine liver function indicators (ALP, ALT, AST activity and plasma bilirubin concentration). In addition, it is necessary to monitor the symptoms of hyperammonemia.

The choice of route of use between the central and peripheral veins depends on the osmolarity of the prepared infusion solution. The upper limit of osmolarity of a solution for use into a peripheral vein is usually 800 mosmol / l, but it can be revised depending on the age, general condition of the patient, as well as the condition of the peripheral veins.

Before use, the bottle and the solution in it should be carefully examined. Only clear solutions without suspended particles can be used in undamaged vials.

The drug should be used immediately after opening the bottle.

The bottle is intended for single use only.

Dipeptiven should not be stored after adding other components.

Form of production

Concentrate for preparation of solution for infusions

Storage conditions

In a dark place, at a temperature not exceeding 25 °C

Shelf life

3 years

Active ingredient

Amino acids for parenteral nutrition

Conditions of release from pharmacies

By prescription

Dosage form

solution for infusions

Description

Children as prescribed by a doctor, Adults as prescribed by a doctor

Indications

Restoring water-salt balance