Intralipid (Soya Oil, Purified)

Intralipid is employed in parenteral nutrition to provide essential fatty acids and caloric support for patients unable to receive enteral feeding.

• Parenteral nutrition for patients unable to receive enteral feeding: supplies needed calories and essential fatty acids.
• Essential fatty acid deficiency prevention and treatment: restores normal fatty acid levels in at‑risk individuals.
• Caloric supplementation in critically ill or postoperative patients: supports energy requirements during recovery and intensive care.

• After intravenous infusion, the triglyceride droplets in Intralipid are hydrolyzed by circulating lipoprotein lipase into free fatty acids and glycerol. These free fatty acids are taken up by cells and oxidized to generate ATP, while glycerol contributes to gluconeogenesis. The emulsion also delivers phospholipids and vitamin E, providing essential fatty acids required for cell membrane synthesis and antioxidant protection.

Intralipid may be associated with a range of adverse reactions, varying from mild infusion‑related events to serious metabolic complications.

Common Side Effects

• Hypertriglyceridemia: elevated serum triglyceride levels during therapy.
• Fever and chills: transient temperature rise and shaking during infusion.
• Nausea or vomiting: gastrointestinal discomfort following administration.
• Infusion site reactions: erythema, pain or swelling at the catheter site.

Serious or Rare Side Effects

• Fat overload syndrome: excessive lipid accumulation leading to organ dysfunction.
• Pancreatitis: inflammation of the pancreas associated with high triglyceride levels.
• Anaphylactic or severe allergic reaction: rapid onset of respiratory or cardiovascular collapse.
• Pulmonary embolism: lipid emboli causing respiratory compromise.

When using Intralipid, clinicians should observe specific safety measures to minimize risks and ensure therapeutic efficacy.

• Assess triglyceride levels: monitor serum triglycerides before and during therapy.
• Screen for soy or egg phospholipid allergy: avoid use in patients with known hypersensitivity.
• Use aseptic technique: ensure sterile preparation and administration of the emulsion.
• Avoid concurrent lipid‑containing medications: reduce risk of cumulative fat load.
• Monitor for signs of infection: observe infusion site and systemic symptoms.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Intralipid can interact with other agents that affect lipid metabolism or increase the risk of fat overload.

Major Interactions (Avoid)

• Propofol infusion: additive lipid load may cause severe hypertriglyceridemia.
• High‑dose heparin therapy: enhances lipolysis and may raise triglyceride concentrations.
• Co‑administration of other parenteral lipid emulsions: risk of fat overload syndrome.

Moderate Interactions (Monitor Closely)

• Corticosteroids: may increase serum triglyceride levels.
• Estrogen therapy: can elevate lipid concentrations.
• Lipid‑lowering agents (e.g., fibrates): may alter triglyceride metabolism and require monitoring.