Active substanceAmino acids for parenteral nutritionAmino acids for parenteral nutrition
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  • Hymiks®
    solution d / infusion 
    KRASFARMA, JSC     Russia
  • Dosage form: & nbspsolution for infusions
    Composition:

    Heimiks is a balanced mixture of 13-amino acids (8 of them are essential) and sorbitol.

    The composition of the drug includes: L-alanine, 6.4 g, L-arginine hydrochloride 6.4 g, L-valine-4.9 g, L-histidine hydrochloride 3.2 g, glycine 8.0 g, Lisoleucine - 4.4 g, LL-leucine 9.8 g, Llysine hydrochloride 11.5 g, L-methionine - 5.7 g, L-proline-6.4 g, L-treonine - 4.3 g, L-tryptophan - 1.44 g, Lphenylalanine 7.0 g, D- sorbitol - 50 grams, water for injection up to 1 liter.

    In 1 liter of the drug contains 80 g of amino acids (11.4 g of total nitrogen) and 50 g of sorbitol. Osmolarity - 1000 mOsm / l, energy value - 506.5 kcal.

    Description:Colorless or slightly yellowish transparent liquid with a specific odor.
    Pharmacotherapeutic group:Parenteral nutrition.
    ATX: & nbsp

    B.05.X.B   Amino acids

    Pharmacodynamics:

    Has a balanced, in accordance with the recommendations of the WHO, the composition of amino acids. Contains all eight essential amino acids, and also conditionally replaceable L-arginine and L-histidine. 12 amino acids are in L-form, which ensures the possibility of their direct participation in the biosynthesis of proteins.

    L-arginine promotes the conversion of ammonia into urea, binds toxic ammonium ions, which form in the catabolism of proteins in the liver.

    Sorbitol serves as the main source of energy. It is an insulin-independent source of energy, which excludes the risk of hyperglycemic acidosis.

    Pharmacokinetics:

    A balanced mixture of amino acids with a slow administration is easily absorbed by the body. Included in the composition of Heimix® amino acids are included in the biosynthesis of body proteins and contribute to a positive nitrogen balance, elimination or weakening of protein deficiency.

    Unused amino acids in this process are deaminated to form urea, which is then excreted by urine. With a rapid increase in the concentration of amino acids in the blood, they can be excreted in the urine in an unchanged form, without the time to biotransform.

    Sorbitol is formed in the liver into fructose-6-phosphate.

    Indications:

    Parenteral nutrition (complete or partial) with hypoproteinemia of various origins, with the impossibility or sharp restriction of food intake in the usual way in the pre- and postoperative period, with extensive deep burns, especially with burnout, trauma, suppuration, sepsis, with functional liver failure , inflammatory conditions of the intestine, cachexia, persistent fever, poisoning, malignant tumors of the gastrointestinal tract, in children older than 2 years with protein distro phi, hypotrophy, gastrointestinal tract defects.

    Contraindications:

    Hypersensitivity, severe heart failure, severe renal failure, children under 2 years of age, pregnancy, lactation (safety of use not established).

    Carefully:

    Carefully - Heart failure, renal (with creatinine clearance> 30 ml / min) / liver failure, hemorrhagic stroke, thrombophlebitis.

    Pregnancy and lactation:

    The use of the drug during pregnancy and during lactation has not been specifically investigated, therefore safety of its use in such patients is not established.

    Dosing and Administration:

    Intravenously drip.

    Initial infusion rate (within the first 30 min.) 10-20 cap. in minutes, then the infusion rate is gradually increased to 25 - 35 cap. in a minute. Exceeding the infusion rate of Heimix® is not desirable, because it entails the loss of amino acids in the urine. To introduce every 100 ml of Heimix® it takes at least 1 hour.

    It is necessary to pay attention to simultaneous introduction drugs K +, which promote more complete assimilation of amino acids.

    With partial parenteral nutrition, HYMIX® is administered 400-500 ml per day daily for 5 days or more. If the enteral intake of proteins is completely excluded, then the drug is administered daily at 400-1000 ml per day before the restoration of enteral nutrition.

    Hymiks® is also used for enteral feeding.

    To obtain the optimal effect when parenteral nutrition is performed, the following conditions must be observed: parenteral nutrition after elimination of volemic disorders and shock, simultaneously introduce an adequate amount of amino acids - 1 - 1.5 / kg of weight or 0.1 - 0.17 g of nitrogen / kg of body weight and calories - 150 - 200 kcal per 1 g of nitrogen or 30 kcal / kg body weight (contains the necessary amount of non-protein calories due to sorbitol).

    The introduction of Heimix® can be combined with simultaneous infusion of 10-20% glucose solution with insulin (4 g glucose insulin units), vitamins B1 - 1 ml 2.5% -5% solution, B6 - 1 ml 5% solution, C - 4-6 ml 5% solution and anabolic hormones: nerobol 15 mg / day (but 5 mg 3-4 times a day under the tongue) or retabolyl (nebelil) - 50 mg intramuscularly once a week (for adults); women in the postoperative period should not use anabolic hormones. The rate of administration of glucose solution should be strictly controlled and not exceed 0.5 g (in terms of dry matter) per 1 kg of body weight per hour.

    Side effects:

    Allergic reactions, infections at the injection site, thrombophlebitis.

    Overdose:

    If the recommended speed of administration of Heimix® is exceeded, there may be face hyperemia, sensation of heat, headache, nausea and vomiting. In these cases, the infusion of the drug must be stopped and desensitizing therapy administered. After elimination of side effects, renewal of Heimix® transfusion with reduced speed is permissible.

    Special instructions:

    If parenteral nutrition is necessary for patients with cardiac decompensation, cerebral hemorrhage, thrombophlebitis, Hymiks® is used with the following conditions: when cardiac decompensation is prescribed, the drug is administered in reduced doses, with cerebral hemorrhages, the volume of the injected fluid, including HYMIX®, should not exceed 2 l per day, with thrombophlebitis Heimix® is recommended to enter through the central veins.

    Patients with renal and hepatic insufficiency (which use of preparations for parenteral protein nutrition, as a rule, is contraindicated), hemimix® transfusion in limited doses is permissible, since it does not contain peptides and humic substances.

    Form release / dosage:Solution for infusion.
    Packaging:

    Solution for infusions of 100, 200, 400 and 500 ml into glass bottles.

    Each bottle together with the instruction for use is placed in a pack.

    For hospital: 48 bottles but 100 ml, 24 bottles of 200 ml, 12 bottles of 400 or 500 ml in a box of corrugated cardboard with the application of 5 instructions for use.
    Storage conditions:

    In a place protected from light, inaccessible to children, at a temperature of -10 to + 25 ° C.

    At low temperatures, a precipitate may appear in the preparation as a result of the crystallization of amino acids. In these cases, it is necessary to heat the bottle with the preparation to 50-60 ° C until the sediment dissolves, after reaching the transparency of the solution, stop heating and allow the drug to cool to body temperature, after which the drug can be injected into the vein.

    Shelf life:

    3 years. Do not use after the expiration date printed on the package.

    Terms of leave from pharmacies:On prescription
    Registration number:P N002762 / 01
    Date of registration:02.05.2007
    The owner of the registration certificate:KRASFARMA, JSC KRASFARMA, JSC Russia
    Manufacturer: & nbsp
    Information update date: & nbsp02.05.2007
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