Intralipid (Soya Oil, Purified)

Intralipid is employed in clinical situations that require intravenous lipid delivery for nutrition or as a vehicle for drug solubilisation.

• Parenteral nutrition: supplies calories and essential fatty acids when oral or enteral feeding is not possible.
• Lipid supplementation in patients unable to receive enteral feeding: maintains membrane integrity and prevents essential fatty‑acid deficiency.
• Solvent/vehicle for intravenous drug formulations: acts as a carrier for lipophilic medications administered intravenously.

• Intralipid delivers purified soy oil droplets suspended in a sterile aqueous phase, creating a stable emulsion that mimics natural plasma lipids. Upon infusion, the triglyceride particles are hydrolysed by lipoprotein lipase, releasing free fatty acids that serve as an immediate energy source and as precursors for phospholipid synthesis, thereby supporting cell membrane formation and metabolic needs.

Adverse reactions may occur with any intravenous lipid emulsion.

Common Side Effects

• Hypertriglyceridaemia: elevated serum triglyceride levels.
• Fever or chills: transient infusion‑related reactions.
• Mild respiratory distress: transient dyspnoea or wheezing.
• Injection site irritation: erythema or discomfort at the catheter site.
• Electrolyte shifts: changes in calcium or phosphate levels.

Serious or Rare Side Effects

• Fat overload syndrome: hepatic dysfunction and coagulopathy.
• Anaphylactoid reaction: severe hypersensitivity requiring immediate intervention.
• Pulmonary embolism: lipid emboli causing respiratory compromise.
• Sepsis: contamination leading to bloodstream infection.
• Severe hyperlipidaemia: risk of pancreatitis.
• Metabolic acidosis: due to excessive acid load.

Intralipid should be administered with careful monitoring of metabolic and infusion parameters.

• Patient assessment: evaluate baseline triglyceride levels and liver function before initiation.
• Infusion rate: adhere to recommended rates to minimise risk of fat overload.
• Compatibility: verify compatibility with co‑administered drugs to avoid precipitation.
• Monitoring: regularly check serum electrolytes, glucose, and acid‑base status during therapy.
• Contraindications: avoid in patients with known soy oil allergy or severe hyperlipidaemia.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Intralipid may alter the pharmacokinetics of concurrently administered agents.

Major Interactions (Avoid)

• Propofol: additive lipid load can precipitate fat overload syndrome.
• Lipophilic antibiotics (e.g., ceftriaxone): risk of precipitation in the emulsion.

Moderate Interactions (Monitor Closely)

• Warfarin: lipid infusion may affect INR stability.
• Heparin: may enhance triglyceride clearance, altering lipid levels.
• Immunosuppressants (e.g., cyclosporine): potential for altered plasma concentrations.
• Vitamin A and D supplements: risk of hypervitaminosis due to fat‑soluble vitamin accumulation.