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Intravenous (IV) Therapy

IV Amino Acids

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Amino Acids

Amino acids are the building blocks of protein molecules. Protein builds the body. 

  • Synthesis of muscle: actin, myosin
  • Synthesis of skin & connective tissue; collagen
  • Synthesis of digestive enzymes 
  • Synthesis of hormones: insulin, growth hormone, thyroid hormone
  • Synthesis of neurotransmitters: serotonin, dopamine, norepinephrine, adrenaline, GABA (influence our behavior, mood, sleep, and cravings)

Suggested Use

  • Malabsorption
  • Leaky Gut
  • Pancreatitis
  • Depression
  • Anxiety
  • Insomnia
  • Impaired Immune Function
  • Fatigue
  • Stress
  • Muscle Wasting
  • Intensive Exercise
  • Sub-Optimal Health
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  • Stomach surgery
  • Liver damage
  • Alcohol
  • Infections
  • Antibiotics
  • Small Bacterial Overgrowth (SIBO)
  • Auto-immune Diseases:
    Celiac, Crohn’s Disease
  • Diabetes
  • Autoimmune Disease & Condition
How Often & Why do I need IV Amino Acid?

IV amino acid is the fastest and most effective way to directly deliver amino acids into your circulation, boost your reserves, and send them to your cells in high concentration.

Testing is not necessary to begin therapy. But we recommend advanced testing when repeated infusions of higher amounts of amino acids and customized amino acid therapy to relieve chronic deficiency.
FreAmine® III

10% FreAmine® III (Amino Acid Injection) is a sterile, nonpyrogenic, hypertonic solution containing crystalline amino acids. Each 1000 mL provides 15.3 g of nitrogen in 97 g of amino acids, equal to 95.6 grams of protein equivalent. All amino acids designated USP is the “L”-isomer, except Glycine USP, which does not have an isomer.

Generic Name: isoleucine, leucine, lysine acetate, methionine, phenylalanine, threonine, tryptophan, valine, alanine, arginine, histidine, proline, serine, glycine, cysteine hydrochloride, and phosphoric acid

Each 100mL contains:

  • Essential Amino Acids
  • Isoleucine USP 0.69 g
  • Leucine USP 0.91 g
  • Lysine USP 0.73 g added as Lysine Acetate USP 1.02 g
  • Methionine USP 0.53 g
  • Phenylalanine USP 0.56 g
  • Threonine USP 0.40 g
  • Tryptophan USP 0.15 g
  • Valine USP 0.66 g
  • Phosphoric Acid NF 0.12 g
  • Water for Injection USP qs
  • Calculated Osmolarity: 950 mOsmol/liter
  • Specific Gravity: 1.032
  • Non-Essential Amino Acids
  • Alanine USP 0.71 g
  • Histidine USP 0.28 g
  • Cysteine USP <0.016 g
    as Cysteine HCl•H2O USP <0.024 g
  • Serine USP 0.59 g
  • Arginine USP 0.95 g
  • Glycine USP 1.40 g
  • Proline USP 1.12 g
  • Sodium Bisulfite (as an antioxidant) <0.10 g
  • pH adjusted with Glacial Acetic Acid USP
    pH: 6.5 (6.0 – 7.0)
  • Concentration of Electrolytes (mEq/liter): Sodium 10
    Phosphate (HPO) 20 (10 mmole P/liter); Acetate Approx. 89
    (provided as acetic acid and lysine acetate); Chloride <3.
FreAmine III – Clinical Pharmacology

10% FreAmine® III provides a physiological ratio of biologically utilizable amino acids in concentrated protein synthesis. It is used with focused calorie sources such as hypertonic dextrose or fat emulsion, and with electrolytes, vitamins, and minerals, it provides total parenteral nutrition. Administered peripherally as an isotonic solution (3%) without nonprotein calories or minimal caloric supplementation such as 5% dextrose, it provides nutritional support and spares body protein.

Phosphate is a major intracellular anion that participates in providing energy for the metabolism of substrates and contributes to significant metabolic and enzymatic reactions in all organs and tissues. It exerts a modifying influence on calcium levels, a buffering effect on acid-base equilibrium, and has a primary role in the renal excretion of hydrogen ions.

It is thought that the acetate from lysine acetate and acetic acid, under the condition of parenteral nutrition, does not impact net acid-base balance when renal and respiratory functions are normal. Clinical evidence seems to support this thinking; however, confirmatory experimental evidence is not available.

The amounts of sodium and chloride present are not of clinical significance.

Indications and Usage

Parenteral nutrition with 10% FreAmine® III (Amino Acid Injection) is indicated to prevent nitrogen loss or treat negative nitrogen balance in adults. 

Contraindications
10% FreAmine® III is contraindicated in patients with anuria, hepatic coma, inborn errors of amino acid metabolism, or hypersensitivity to one or more amino acids present in the solution.
Warnings
This product contains sodium bisulfite, a sulfite that may cause allergic-type reactions, including anaphylactic symptoms and life-threatening or less severe asthmatic episodes in certain susceptible people. The overall prevalence of sulfite sensitivity in the general population is unknown and probably low. Sulfite sensitivity is seen more frequently in asthmatic than in nonasthmatic people. WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.

Laboratory Tests

Frequent clinical evaluation and laboratory determinations are necessary for proper monitoring of central venous nutrition.

Laboratory tests should include measurement of blood sugar, electrolyte, serum protein concentrations; kidney and liver function tests; and acid-base balance and fluid balance evaluation. The patient’s condition may suggest other laboratory tests.

Possible Adverse Reactions

Injection site redness, swollen, warmth, Generalized flushing, fever, and nausea Symptoms may result from an excess or deficit of one or more of the ions present in the solution; therefore, frequent monitoring of electrolyte levels is essential. If electrolyte supplementation requires peripheral infusion, it recommends that additives administer throughout the day to avoid possible venous irritation. Irritating additive medications may require Injection at another site and should not be added directly to the amino acid infusate. Phosphorus deficiency may lead to impaired tissue oxygenation and acute hemolytic anemia. Relative to calcium, excessive phosphorus intake can precipitate hypocalcemia with cramps, tetany, and muscular hyperexcitability. If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary.

FreAmine III Dosage and Administration

Daily amino acid doses of approximately 1.5 g/kg of body weight for adults with adequate calories are generally sufficient to satisfy protein needs and promote positive nitrogen balance. 

For protein sparing in well-nourished patients not receiving significant additional calories, amino acid dosages of 1.0 to 1.7 g/kg/day significantly reduce nitrogen losses and spare body protein. If rises in BUN exceed 20 mg% in 48 hours, the amino acid infusion should discontinue or the rate of administration reduced.

The provision of sufficient intracellular electrolytes, principally potassium, magnesium, and phosphate, is also required for optimum utilization of amino acids. Approximately 60–180 mEq of potassium, 10–30 mEq of magnesium, and 20–80 mEq of phosphate per day appear necessary to achieve an optimum metabolic response. Also, sufficient quantities of the major extracellular electrolytes (sodium, calcium, and chloride) must be given. Patients with hyperchloremic or other metabolic acidoses may add sodium and potassium as the acetate or lactate salts to provide bicarbonate precursors. The electrolyte content of 10% FreAmine® III (Amino Acid Injection) must consider when calculating daily electrolyte intake. Serum electrolytes, including magnesium and phosphorus, should be monitored frequently.