Causes & Side Effects
Intralipid Infusions
1. Intralipid is a brand name for the first safe fat emulsion for human use, approved in 1962 in Europe and invented by Professor Arvid Wretlind, Sweden. The FDA initially would not approve the product due to prior experience with another fat emulsion. It was approved in the United States in 1972. It is used as a component of parenteral nutrition for patients who are unable to get nutrition via an oral diet. It is an emulsion of soy bean oil, egg phospholipids and glycerin. It is available in a 10%, 20% and 30% concentration. The 30% concentration is not approved for direct intravenous infusion, but should be mixed with amino acids and dextrose as part of a total nutrient admixture.
Intralipid provides essential fatty acids, linoleic acid (LA), an omega-6 fatty acid, alpha-linolenic acid (ALA), an omega-3 fatty acid.
2. Intralipid and fertility
Intralipids are far less expensive than Intravenous Immunoglobulin (IVIG), and initial studies show comparable efficacy for deactivation of natural killer cells and pregnancy rates. Intralipids are well tolerated by patients with few side effects and are created synthetically, unlike IVIG which is a blood product. It takes about an hour and a half to two hours for the intralipids to be administered through the IV.
Throughout the infusion the medical staff will monitor you for adverse effect by observations.
Evidence from both animal and human studies suggests that intralipid administered intravenously may enhance implantation. Intralipid stimulated the immune system to remove “danger signals” that can lead to pregnancy loss.
3. What is the frequency of the Intralipids infusion?
In a Natural cycle/IUI the Intralipids infusion is administered at positive pregnancy test, then at 8 weeks and 12 weeks gestation.
In IVF/ICSI the Intralipids infusion is administered 7-10 days prior to embryo transfer and then at 7-8 weeks gestation and 12 weeks gestation.
This may be continued later in the pregnancy in some patients.
4. Contra-Indications:
Only in conditions characterized by severely disordered fat metabolism such as in severe liver damage, acute myocardial infarction and shock.
5. Manufacturers’ Warnings in Clinical States:
Rare cases of hypersensitivity have been observed in patients allergic to soybean protein, egg yolk and egg whites.
6. Precautions:
Patients with Special Diseases and Conditions: Fat metabolism may be disturbed in conditions such as renal insufficiency, uncompensated diabetes, certain forms of liver insufficiency, metabolic disorders and sepsis. In cases of verified or suspected liver insufficiency, liver function must be closely followed.
If increased levels of transaminases, alkaline phosphatases or bilirubin appear, further infusion of Intralipid should be postponed, or the dosage decreased, until normalization is achieved.
7. Adverse Reactions:
Adverse reactions reported to occur during and/or following infusion of Intralipid include: fever, chills, nausea, vomiting, headache, back or chest pain with dyspnea and cyanosis.
8. Symptoms and Treatment of Overdose:
When fat emulsion is given in amounts exceeding the capacity of fat elimination the following symptoms may occur: hyperlipemia, hepatosplenomegaly, jaundice, hemolytic anemia, prolonged clotting time and thrombocytopenia. All symptoms clear in days to weeks after cessation of fat infusion.
9. Administration:
Intralipid must not be mixed with electrolyte or nutrient solutions, nor must drugs or vitamins be added to the emulsion in the infusion bottle other than drugs or vitamins especially formulated for addition to fat emulsions.
10. Storage:
Store at controlled room temperature below 25°C. Do not freeze.