Intralipid 20% Dosage/Direction for Use

The patient's ability to eliminate administered fat should govern the dosage (see IMPORTANT).
Adults: The quantity of intravenously administered fat should not normally exceed 3 g per kg bodyweight per day. When starting the infusion, the following points be observed. During the first 10 minutes the rate of infusion should be about 20 drops/minute. The infusion rate is then continually increased and after 30 minutes it can be stabilized at the desired rate: 40-60 drops/minute for Intralipid 10% and 25-40 drops/minute for Intralipid 20%, at which rates 500 ml can be infused in 3-5 and 5-7 hours respectively. The infusion times must not be shorter than 3 and 5 hours respectively.
Newborns and infants: The infant's ability to eliminate fat should govern the dosage. Recommended dosage per 24 hours is 0.5-4 g fat per kg bodyweight equivalent to 2.5-20 ml Intralipid 20% and 5-40 ml Intralipid 10% per kg bodyweight respectively. Recommended initial dose in very low-birth-weight infants and small for gestational age infants is 0.5 g fat per kg bodyweight per 24 hours. The dose should be increased in relation to the infant's ability to eliminate fat which should be checked daily- See Fat elimination test. The daily dose should preferably be administered at a constant rate over 24 hours by infusion pump.
Intralipid and Vamin solutions can be infused simultaneously, the two solutions being given, for instance, through a twin infusion set or separate sets connected to a single tap so that the mixture reaches the vein through the same cannula.
IMPORTANT: In cases where daily infusions of intravenous fat are indicated for more than one week the ability of the patient to eliminate administered fat should be tested. Before starting the infusion a fasting blood sample is taken as for ESR (citrate). The sample is centrifuges at 1,200-1,500 rpm. If the plasma is milky or markedly opalescent, the planned infusion should be postponed. In the conditions mentioned under PRECAUTIONS the patient's fat elimination ability should be checked daily.
Intralipid must not be mixed with other drugs, nutrient or electrolyte solutions, but can be infused simultaneously with Vamin by the method described above. The unused content of an opened bottle should be discarded and must not be kept for later use.