Intralipid (Soya Oil, Purified)

Intralipid is used in parenteral nutrition to supply calories and essential fatty acids, addressing metabolic needs in specific clinical situations.

• Parenteral nutrition in patients requiring intravenous caloric supplementation: supplies calories and essential fatty acids to support energy requirements.
• Prevention of essential fatty acid deficiency: delivers linoleic and alpha‑linolenic acids to avoid deficiency during prolonged lipid‑free nutrition.
• Support in severe burns or trauma patients: provides additional energy and membrane components to meet increased metabolic demand.

• Intralipid delivers a sterile emulsion of purified soybean oil droplets that are metabolized by lipoprotein lipase into free fatty acids and glycerol. These components serve as substrates for beta‑oxidation, providing ATP, and as building blocks for phospholipid synthesis in cell membranes. The emulsion also supplies essential fatty acids, such as linoleic and alpha‑linolenic acids, which cannot be synthesized endogenously, thereby supporting cellular function and growth.

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

Common Side Effects

• Hypertriglyceridemia: transient rise in serum triglyceride levels.
• Fever or chills: mild temperature elevation during infusion.
• Infusion site reactions: erythema, pain, or swelling at the catheter site.
• Respiratory discomfort: mild dyspnea or cough.
• Elevated liver enzymes: mild increase in ALT/AST.
• Electrolyte shifts: mild changes in calcium or phosphate.

Serious or Rare Side Effects

• Fat overload syndrome: severe hyperlipidemia with organ dysfunction.
• Pancreatitis: inflammation of the pancreas due to high triglycerides.
• Anaphylaxis: acute allergic reaction with hypotension and bronchospasm.
• Pulmonary embolism: lipid emboli causing respiratory compromise.
• Severe hypertriglyceridemia: risk of pancreatitis and cardiovascular events.
• Infection risk: contamination leading to sepsis.

When using Intralipid, clinicians should observe specific precautions to minimize risks and ensure safe administration.

• Assess triglyceride levels: monitor serum triglycerides before and during therapy.
• Check for soy or egg protein allergy: avoid in patients with known hypersensitivity.
• Use aseptic technique: maintain sterility of the emulsion and infusion set.
• Monitor liver function: watch for hepatic steatosis with prolonged use.
• Avoid in severe hyperlipidaemia: contraindicated in patients with markedly elevated triglycerides.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Intralipid can interact with several medications, affecting lipid metabolism or infusion safety.

Major Interactions (Avoid)

• Propofol: combined lipid load may cause severe hypertriglyceridemia.
• Heparin: may potentiate hyperlipidaemia by releasing lipoprotein lipase.
• Concurrent lipid emulsions: simultaneous use can lead to fat overload syndrome.

Moderate Interactions (Monitor Closely)

• Insulin: lipid infusion may alter glucose control, requiring dose adjustment.
• Ceftriaxone: may precipitate when mixed with lipid emulsion, risking emboli.