Dipeptiven

General characteristics. Structure:

Active ingredient: 200 g of N(2)-L - alanyl - L - a glutamine that corresponds to 82 g of L-alanine and 134,6 g of a L-glutamine.

Theoretical osmolarity 921 ¼Äß¼/l, titrable acidity of 90-105 mmol of NaOH/l, рН 5.4-6.0.

Excipients: water for injections. 

Pharmacological properties:

Pharmacodynamics. Glutamine drug for parenteral use. Dipeptiven contains N(N)-L dipeptide - alanine - L - a glutamine and is used for addition in infusion solutions, being at the same time first of all a glutamine source. The glutamine is necessary not only for protein synthesis as one of amino acids, but also is an important component of various metabolic processes, promoting, in particular, considerable decrease in degree of a hyper catabolism, normalization of indicators of protein metabolism, recovery of integrity of a mucous membrane of a GIT and the immune status.

Pharmacokinetics. N(N)-L - alanine - L - a glutamine is quickly hydrolyzed in plasma later in/in introductions with formation of alanine and a glutamine. N(N)-L semi-life period - alanine - L - a glutamine makes 2.4-3.8 min. N(N)-L dipeptide infusion - alanine - L - a glutamine leads to bystry increase in concentration of a glutamine and alanine, during the entire period of infusion only trace amounts of dipeptide can be found in plasma. With urine less than 5% of the entered dipeptide dose are removed, it is equal to losses at administration of drugs of amino acids. Drug does not kumulirut.

Indications to use:

At adults and children at deficit of a glutamine, at its increased consumption within the full or mixed parenteral food, including at the hyper metabolic or hyper catabolic types of a metabolism (arising at multiple injuries, burns, heavy surgical interventions, sepsis, heavy inflammatory processes, an immunodeficiency, malignant new growths).

Route of administration and doses:

The drug is administered in/in, kapelno. Dipeptiven is strong solution and is not intended for the isolated introduction. Before injection it needs to be mixed with compatible solution of amino acids (solution carrier) or the infusional drug containing amino acids or to enter in parallel with these solutions or drugs. One volume part of Dipeptiven has to be mixed or entered at the same time approximately with 5 volume parts of solution carrier (for example, 100 ml of solution of Dipeptiven enter from 500 ml of solution of amino acids).

The choice of the central or peripheral vein for administration of drug depends on final osmolarity at joint introduction with other solutions.

Dipeptiven is intended for infusion in the central veins after addition to compatible infusion solution. Mixes of solutions with final osmolarity more than 800 ¼Äß¼«½ý/l have to be entered into the central veins.
 
The dose of drug depends on weight of a catabolic state and the need for amino acids.
 
The maximum daily dose of amino acids makes 2 g/kg of body weight. When calculating amount of the entered amino acids it is necessary to consider addition of alanine and a glutamine at Dipeptiven's introduction. The share of alanine and the glutamine entered with drug Dipeptiven should not exceed 20% of total quantity of the amino acids entered in/in and is enteral.
 
The daily dose makes 1.5-2 ml/kg of body weight that is equivalent to introduction of 0.3-0.4 g/kg. This dose corresponds to 100-140 ml of drugs/days for patients with the body weight of 70 kg. The maximum daily dose makes 2 ml/kg.
 
The recommended Dipeptiven's doses:
 
— at the need for amino acids of 1.5 g/kg of mass of bodies/days it is recommended to enter 1.2 g of amino acids and 0.3 g of N(N)-L - alanine - L - glyutamina/kg the mass of bodies/days;
 
— at the need for amino acids of 2 g/kg of mass of bodies/days it is recommended to enter 1.6 g of amino acids and 0.4 g of N(N)-L - alanine - L - glyutamina/kg the mass of bodies/days.
 
Speed of injection should not exceed 0.1 g of amino acids/kg of mass of body/h. Use duration - no more than 3 weeks.

Features of use:

Use at pregnancy and feeding by a breast. Data on use of drug at pregnancy and in the period of a lactation (breastfeeding) are absent. It is necessary to appoint drug pregnant only in case the advantage for mother exceeds potential harm for a fruit. At use of drug for mothers feeding of the child a breast should be stopped.

Use at abnormal liver functions.  It is contraindicated at the expressed abnormal liver functions.

Use at renal failures. Protiovpokazan at the expressed renal failures (KK less than 25 ml/min.).

Use for children. Use is possible according to the dosing mode.

Special instructions. At Dipeptiven's introduction it is regularly recommended to control functions of a liver at patients with the compensated liver failure.
 
It is necessary to control blood serum electrolytes, a water balance, an alkaline state, hepatic tests (ShchF, bilirubin) and possible symptoms of a giperammoniyemiya.

Side effects:

Perhaps: a fever, nausea, vomiting (when speeding injection).
 
Seldom: allergic reactions.
 
At emergence of side effects administration of drug should be stopped immediately.

Interaction with other medicines:

Dipeptiven it is possible to mix with solutions of amino acids, strictly following rules of an asepsis. When mixing with solution carrier it is necessary to be convinced of compatibility of solutions and to provide full mixing.

It is not necessary to add other medicines to mix.

Contraindications:

— renal failure of heavy degree (KK less than 25 ml/min.);
 
— heavy liver failure;
 
— the expressed metabolic acidosis;
 
— hypersensitivity to drug components.

Overdose:

The drug overdoses given about cases Dipeptiven are absent now.

Storage conditions:

Drug should be stored in protected from light, the place, unavailable to children, at a temperature not above 25 °C. A period of validity - 3 years. To use only transparent solutions in the unimpaired bottles. After addition of other components drug is not subject to storage.

Issue conditions:

According to the recipe

Packaging:

50 ml - bottles glass (10) - boxes cardboard.
50 ml - bottles glass with holders (10) - boxes cardboard.
100 ml - bottles glass (10) - boxes cardboard.
100 ml - bottles glass with holders (10) - boxes cardboard.