Intralipid (Soya Oil, Purified)

Intralipid is used in clinical situations that require parenteral delivery of calories, essential fatty acids, or a lipid vehicle for lipophilic medications.

• Parenteral nutrition: supports patients who cannot receive enteral feeding by providing a source of calories and essential fatty acids.
• Essential fatty acid deficiency: prevents or treats deficiency in patients on long‑term fat‑restricted diets or receiving total parenteral nutrition.
• Lipophilic drug carrier: serves as a solvent/vehicle for intravenous administration of lipophilic drugs such as certain chemotherapy agents.

• Intralipid delivers a mixture of triglycerides, phospholipids, and glycerol that are rapidly hydrolyzed by lipoprotein lipase after infusion. The resulting free fatty acids are taken up by tissues for energy production and membrane synthesis, while the phospholipid shell stabilizes the emulsion and enables solubilisation of lipophilic compounds for intravenous delivery. These fatty acids enter the β‑oxidation pathway, providing ATP, and also serve as precursors for phospholipid and eicosanoid biosynthesis, supporting cellular functions.

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

Common Side Effects

• Hypertriglyceridemia: elevated blood triglyceride levels during or after infusion.
• Fever and chills: transient temperature rise and shivering.
• Nausea: mild gastrointestinal discomfort.
• Vomiting: occasional emesis following infusion.
• Infusion site reactions: erythema, pain, or swelling at the catheter site.
• Lipemia: milky appearance of blood samples.

Serious or Rare Side Effects

• Fat overload syndrome: severe metabolic disturbance with high triglycerides and organ dysfunction.
• Pancreatitis: inflammation of the pancreas linked to excessive lipid load.
• Anaphylaxis: severe allergic reaction with respiratory and circulatory compromise.
• Pulmonary embolism: rare occurrence of lipid emboli in the lungs.
• Hepatic dysfunction: abnormal liver enzymes or steatosis.

When using Intralipid, clinicians should observe specific safety measures to minimise risks and ensure optimal therapy.

• Assess triglyceride levels: measure baseline and monitor during therapy to avoid hypertriglyceridemia.
• Monitor for infection: observe catheter site and patient for signs of sepsis.
• Use aseptic technique: prepare and administer under sterile conditions to prevent contamination.
• Adjust in liver disease: reduce dose or avoid in patients with severe hepatic impairment.
• Avoid in soy allergy: contraindicated in individuals with known hypersensitivity to soy components.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Intralipid can interact with other medications, affecting lipid metabolism or drug distribution.

Major Interactions (Avoid)

• Concurrent lipid emulsions: co‑administration with other intravenous lipid products can cause excessive triglyceride accumulation.
• Propofol infusion: combined use increases risk of hypertriglyceridemia and pancreatitis.
• High‑dose heparin: may potentiate lipid metabolism disturbances.

Moderate Interactions (Monitor Closely)

• Corticosteroids: may augment serum triglyceride levels, requiring closer monitoring.
• Certain antibiotics (e.g., ceftriaxone): can bind to lipid particles, potentially altering drug efficacy.