Intralipid 20% Dosage/Direction for Use

The ability to eliminate Intralipid 20% should govern the dosage and infusion rate. See Fat elimination as follows:
Intralipid 20%, 1 g triglycerides corresponds to 5 mL.
Adults: Recommended Maximum Dosage: Three (3) g triglycerides/kg body weight/day. Within this upper limit, Intralipid 20% can be given to contribute up to 70% of the energy requirements, also in patients with highly increased energy requirements. The infusion rate for Intralipid 20% should not exceed 500 mL in 5 hrs.
Neonates and Infants: Recommended Dosage Range: 0.5-4 g triglycerides/kg body weight/day. The rate of infusion should not exceed 0.17 g triglycerides/kg body weight/hr (4 g in 24 hrs). In prematures and low birth weight neonates, Intralipid 20% should preferably be infused continuously over 24 hrs. The initial dosage should be 0.5-1 g/kg body weight/day followed by a successive increase by 0.5-1 g/kg body weight/day up to 2 g/kg body weight/day. Only with close monitoring of serum triglyceride concentration, liver tests and oxygen saturation may the dosage be increased to 4 g/kg body weight/day. The rates given are maximum rates and no attempt should be made to exceed these in order to compensate for missed doses.
Essential Fatty Acid Deficiency (EFAD): To prevent or correct EFAD, 4-8% of the nonprotein energy should be supplied as Intralipid 20% to provide sufficient amounts of linoleic and linolenic acid. When EFAD is associated with stress, the amount of Intralipid 20% needed to correct the deficiency may be substantially increased.
Fat Elimination: Adults: The ability to eliminate fat should be closely monitored in patients with conditions mentioned under Precautions and in patients given Intralipid 20% for >1 week. This is done by collecting a blood sample after a fat-free clearance period of 5-6 hrs. Blood cells are then separated from plasma by centrifugation. If the plasma is opalescent, the infusion should be postponed. The sensitivity of this method is such that hypertriglyceridemia can pass undetected. Therefore, it is recommended that serum triglyceride concentrations should be measured in patients who are likely to have impaired fat tolerance.
Neonates and Infants: The ability to eliminate fat should be tested regularly in neonates and infants. Measuring serum triglyceride levels is the only reliable method.