Intralipid (Soya Oil, Purified)

Intralipid is an intravenous lipid emulsion used in parenteral nutrition and related clinical situations.

• Parenteral nutrition for patients unable to receive enteral feeding: provides essential calories and fatty acids to maintain energy balance.
• Essential fatty acid deficiency prevention and treatment: restores linoleic and alpha‑linolenic acid levels in at‑risk individuals.
• Solvent for certain intravenous drug formulations: serves as a compatible lipid carrier for lipophilic medications.

• Intralipid consists of soybean oil droplets stabilized by phospholipids, glycerol and water, forming a stable emulsion. After intravenous infusion, plasma lipoprotein lipase hydrolyzes the triglycerides in the droplets to free fatty acids, which are taken up by peripheral tissues for energy production and incorporation into cell membranes. The emulsion also supplies essential fatty acids that the body cannot synthesize, supporting membrane integrity and metabolic functions.

Intralipid may be associated with a range of adverse reactions, varying from mild to severe.

Common Side Effects

• Hypertriglyceridemia: transient rise in serum triglycerides that may require monitoring.
• Fever and chills: mild temperature increase and shivering often occurring at infusion start.
• Nausea or vomiting: occasional gastrointestinal upset during or shortly after administration.
• Infusion site reactions: erythema, pain, swelling or phlebitis at the catheter entry point.

Serious or Rare Side Effects

• Fat overload syndrome: excessive lipid load causing respiratory distress, hepatic enlargement and coagulopathy.
• Pancreatitis: acute inflammation of the pancreas linked to markedly elevated triglyceride concentrations.
• Anaphylaxis or severe allergic reaction: rapid onset of urticaria, bronchospasm, hypotension and possible shock.
• Hepatic dysfunction: significant rise in liver enzymes or fatty liver changes with prolonged therapy.

When using Intralipid, specific precautions help minimize risks and ensure safe administration.

• Monitor triglyceride levels: check serum triglycerides regularly to avoid fat overload.
• Assess lipid tolerance: evaluate for signs of hypersensitivity before each infusion.
• Use aseptic technique: prepare and administer under sterile conditions to prevent contamination.
• Avoid in severe hyperlipidemia: contraindicated for patients with markedly elevated baseline lipids.
• Adjust in hepatic impairment: reduce dosage or frequency in patients with liver disease.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Intralipid can interact with other medications, influencing lipid metabolism or infusion compatibility.

Major Interactions (Avoid)

• Concurrent lipid emulsions: co‑administration with other IV lipid products may cause fat overload.
• Propofol infusion: both are lipid‑based, increasing risk of hypertriglyceridemia.
• Heparin therapy: enhances lipolysis and may exacerbate triglyceride elevation.
• Certain antibiotics (e.g., ceftriaxone): can precipitate when mixed with lipid emulsions.

Moderate Interactions (Monitor Closely)

• Warfarin: lipid load may alter INR, requiring closer coagulation monitoring.
• Corticosteroids: both increase serum triglycerides, necessitating periodic lipid checks.
• Diuretics: electrolyte shifts may affect lipid metabolism during therapy.
• Other parenteral nutrition components: ensure compatible osmolarity and pH to prevent precipitation.