Intralipid (Soya Oil, Purified)

Intralipid is used in clinical nutrition and as a carrier for intravenous therapies, addressing patients who cannot obtain sufficient nutrients by mouth or tube.

• Inadequate oral or enteral intake: Provides calories and essential fatty acids to support energy requirements and cell membrane formation in patients unable to receive enteral nutrition.
• Essential fatty acid deficiency: Supplies linoleic and alpha‑linolenic acids to prevent or correct deficiency in long‑term parenteral nutrition.
• Intravenous drug delivery: Serves as a lipid vehicle for lipophilic medications administered intravenously, enhancing solubility and distribution.

• Intralipid consists of purified soy oil droplets stabilized by phospholipids. After intravenous infusion, lipoprotein lipase hydrolyzes the triglyceride particles, releasing free fatty acids and glycerol that are taken up by tissues for oxidative metabolism and membrane biosynthesis. The emulsion also delivers essential fatty acids that cannot be synthesized endogenously, fulfilling both caloric and structural lipid requirements.

Adverse reactions to Intralipid may occur despite its generally favorable safety profile.

Common Side Effects

• Hypertriglyceridemia: Elevated serum triglyceride levels, especially with prolonged high‑dose infusion.
• Fever or chills: Transient temperature rise or shivering during or shortly after infusion.
• Lipemia: Milky appearance of plasma due to circulating lipid particles.
• Respiratory distress: Mild dyspnea or cough related to infusion.

Serious or Rare Side Effects

• Fat overload syndrome: Severe metabolic disturbance with hepatic dysfunction, coagulopathy, and organ failure.
• Anaphylactoid reaction: Acute hypersensitivity with hypotension, bronchospasm, or urticaria.
• Infection risk: Contamination of the emulsion can lead to sepsis.

Clinicians should observe specific precautions when prescribing or handling Intralipid to ensure patient safety and product integrity.

• Patient assessment: Evaluate baseline triglyceride levels and liver function before initiating therapy.
• Infusion rate: Administer at recommended rates to avoid fat overload and pulmonary complications.
• Compatibility: Verify compatibility with other intravenous solutions; avoid mixing with drugs that may precipitate.
• Monitoring: Regularly monitor serum lipids, glucose, and electrolytes during prolonged use.
• Contraindications: Do not use in patients with known hypersensitivity to soy oil or egg phospholipids.
• Storage: Store at 2‑8 °C: keep refrigerated, protect from light, do not freeze or shake.

Intralipid can interact with certain medications and clinical conditions, influencing efficacy or safety.

Major Interactions (Avoid)

• Propofol: Co‑administration may increase lipid load and risk of hypertriglyceridemia.
• Lipid‑soluble drugs: High concentrations can alter distribution of drugs such as cyclosporine or tacrolimus.

Moderate Interactions (Monitor Closely)

• Heparin: May potentiate triglyceride elevation by stimulating lipoprotein lipase.
• Warfarin: Lipid infusion can affect INR; monitor coagulation parameters.
• Antibiotics (e.g., ceftriaxone): Potential for precipitation when mixed with calcium‑containing solutions.