ClinOleic Special Precautions

To avoid air embolism due to possible residual gas contained in the primary bag, do not connect flexible bags in series.
Air embolism can result if residual gas in the bag is not fully evacuated prior to administration if the flexible bag is pressurized to increase flow rates.
Use of a vented intravenous administration set with the vent in the open position could result in air embolism.
Before starting the infusion, correct severe water and electrolyte equilibration disorders, severe fluid overload states, and severe metabolic disorders.
Fluid status should be closely monitored in patients with pulmonary edema or heart failure.
Monitor serum triglycerides, fluid and electrolyte status, serum osmolarity, blood glucose, liver and kidney function, and blood count, including platelets and coagulation parameters, throughout treatment.
Parenteral nutrition should be used with caution in patients with preexisting liver disease or liver insufficiency. Liver function parameters should be closely monitored in these patients.
Parenteral Nutrition Associated Liver Diseases (PNALD) including cholestasis, hepatic steatosis, fibrosis and cirrhosis, possibly leading to hepatic failure, as well as cholecystitis and cholelithiasis are known to develop in some patients on parenteral nutrition. The etiology of these disorders is thought to be multifactorial and may differ between patients. Patients developing abnormal laboratory parameters or other signs of hepatobiliary disorders should be assessed early by a clinician knowledgeable in liver diseases in order to identify possible causative and contributory factors, and possible therapeutic and prophylactic interventions.
Light exposure of solutions for intravenous parenteral nutrition, after admixture with trace elements and/or vitamins, may have adverse effects on clinical outcome in neonates, due to generation of peroxides and other degradation products. When used in neonates and children below 2 years, CLINOLEIC 20% should be protected from ambient light after admixture until administration is complete (Dosage & Administration and Instructions for Use/Handling and Disposal under Cautions for Usage).
EFFECTS ON ABILITY TO DRIVE AND USE MACHINES: Not applicable.