Lipidem (Omega-3-Acid Triglycerides, Soya-Bean Oil Refined, Triglycerides, Medium Chain)

Lipidem, an intravenous omega‑3 fatty acid lipid emulsion, is used to support patients requiring parenteral nutrition.

• Parenteral nutrition for patients unable to receive enteral feeding: Provides calories and essential fatty acids to maintain nutritional status.
• Postoperative nutrition support: Supplies needed lipids to aid recovery when oral intake is delayed.
• Critical care essential fatty acid supplementation: Delivers omega‑3 fatty acids to patients with high metabolic demand.
• Long‑term parenteral nutrition maintenance: Prevents essential fatty acid deficiency during prolonged intravenous feeding.

• Lipidem delivers triglyceride molecules that are hydrolyzed by lipases into free fatty acids and glycerol, which are then taken up by cells for energy production and membrane synthesis. The omega‑3 fatty acids (EPA and DHA) serve as precursors for anti‑inflammatory eicosanoids and support cellular functions, while the emulsion supplies a dense caloric source essential for patients unable to ingest nutrients enterally.

Lipidem may cause a range of adverse reactions, which are categorized by frequency.

Common Side Effects

• Hypertriglyceridemia: Elevated serum triglyceride levels.
• Fever or chills: Transient temperature rise during infusion.
• Infusion site reactions: Redness, swelling, or pain at the catheter site.
• Elevated liver enzymes: Increases in ALT or AST.
• Electrolyte disturbances: Shifts in phosphate or calcium levels.

Serious or Rare Side Effects

• Fat overload syndrome: Excessive lipid accumulation leading to organ dysfunction.
• Pancreatitis: Inflammation of the pancreas.
• Severe allergic reaction or anaphylaxis: Rapid onset of systemic hypersensitivity.
• Pulmonary embolism: Lipid emboli causing respiratory compromise.
• Thrombocytopenia: Significant drop in platelet count.
• Infection risk: Potential for microbial contamination of the emulsion.

When using Lipidem, clinicians should observe several safety measures.

• Assess triglyceride levels: Monitor serum triglycerides before and during therapy.
• Check liver function: Perform regular hepatic enzyme tests.
• Avoid in known soy or egg phospholipid allergy: Contraindicated in patients with hypersensitivity.
• Use caution in severe hyperlipidemia or pancreatitis risk: Evaluate risk-benefit ratio.
• Limit duration: Reassess need for continued infusion regularly.
• Store at 2-8°C: Keep refrigerated, protect from light, do not freeze or shake.

Lipidem can interact with other medications, requiring attention to potential effects.

Major Interactions (Avoid)

• Concurrent lipid emulsions: Increases risk of fat overload.
• High‑dose propofol: Both provide lipid load, raising triglyceride levels.
• Anticoagulants (e.g., warfarin): May alter anticoagulant effect.
• Estrogen‑containing therapies: Can exacerbate hypertriglyceridemia.
• Retinoids: May increase lipid levels.

Moderate Interactions (Monitor Closely)

• Fibrates: May potentiate triglyceride changes.
• Statins: Monitor for hepatic effects.
• Immunosuppressants (e.g., cyclosporine): Observe for altered drug levels.
• Beta‑blockers: Watch for changes in lipid metabolism.
• Diuretics: May affect electrolyte balance during infusion.