Intralipid (Soya Oil, Purified)

Intralipid is a parenteral lipid emulsion used in clinical nutrition to address lipid needs in patients receiving intravenous feeding.

• Parenteral nutrition: supplies calories and essential fatty acids for patients unable to tolerate enteral feeding.
• Essential fatty acid deficiency prevention: delivers linoleic and linolenic acids to avert deficiency during prolonged nutrition support.
• Critical illness support: augments energy provision in critically ill patients requiring lipid supplementation.

• Intralipid delivers purified soy oil droplets suspended in a sterile aqueous phase, creating a stable emulsion that is rapidly taken up by the reticuloendothelial system. The triglyceride-rich particles are hydrolyzed by lipoprotein lipase, releasing free fatty acids that serve as an energy source and provide essential fatty acids for membrane synthesis and cellular functions.

Adverse reactions may occur with any intravenous lipid emulsion.

Common Side Effects

• Hypertriglyceridemia: elevated serum triglyceride levels.
• Fever or chills during infusion.
• Nausea or vomiting.
• Infusion site erythema or pain.
• Mild respiratory wheeze.

Serious or Rare Side Effects

• Anaphylactic or severe allergic reaction.
• Fat overload syndrome leading to organ dysfunction.
• Pulmonary embolism from lipid droplets.
• Hepatic dysfunction or cholestasis.
• Thrombocytopenia or coagulopathy.

Intralipid requires careful monitoring and specific handling to minimize risks.

• Assess triglyceride levels: monitor serum triglycerides before and during therapy.
• Check liver function: regularly evaluate hepatic enzymes and bilirubin.
• Avoid in patients with known soy allergy: contraindicated due to soy oil content.
• Use caution in severe hyperlipidemia: risk of fat overload.
• Do not combine with other parenteral lipid emulsions without specialist guidance.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Intralipid may interact with other agents that affect lipid metabolism or increase lipid load.

Major Interactions (Avoid)

• Propofol co‑administration: additive lipid load may cause severe hypertriglyceridemia.
• High‑dose heparin: can increase free fatty acid release and exacerbate lipid abnormalities.
• Concurrent parenteral lipid emulsions: risk of fat overload syndrome.

Moderate Interactions (Monitor Closely)

• Corticosteroids: may raise serum triglyceride concentrations.
• Estrogen therapy: can alter lipid metabolism and increase triglycerides.
• Lopinavir/ritonavir: associated with elevated triglyceride levels during therapy.