Trace Metal Combination (2-1)

What it is and how it works

A sterile concentrate of essential trace elements (typically zinc, copper, manganese, selenium, chromium and, in some products, iodine, fluoride, iron or molybdenum) used to meet basal or moderately increased requirements during parenteral nutrition. These elements act as cofactors for numerous enzymes involved in metabolism, antioxidant defence, haematopoiesis and immune function.

Indications

Supply of trace elements as part of parenteral nutrition, to prevent or correct trace element deficiency in patients receiving intravenous feeding.

Dosage and administration (summary)

Added to the parenteral nutrition admixture and never given undiluted; the dose is individualised by the nutrition team according to the product composition, age, weight and clinical and laboratory status.

Contraindications

Hypersensitivity to components; pronounced cholestasis (copper and manganese accumulate); Wilson’s disease; elevated blood levels of any contained element.

Warnings and precautions

Use with caution in hepatic or biliary impairment and in renal impairment, where elimination of some elements is reduced. Monitor trace element status (e.g. manganese, copper, zinc, selenium) during long-term parenteral nutrition, as both deficiency and accumulation can occur. Must be diluted before administration; the hypertonic concentrate can cause venous irritation.

Pregnancy

May be used in pregnancy as part of clinically indicated parenteral nutrition.

Storage and supply

Store below 25 °C; do not freeze; use immediately after addition to the nutrition admixture.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.