Pregnancy
Teratogenic Effects

Pregnancy Category C.
Animal reproduction studies have not been conducted with CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections. It is also not known whether CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections should be given to a pregnant woman only if clearly needed.

Nursing Mothers:Caution should be exercised when CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections are administered to a nursing woman.

Pediatric UseDextrose is safe and effective for the stated indications in pediatric patients (see INDICATIONS AND USAGE ). As reported in the literature, the dosage selection and constant infusion rate of intravenous dextrose must be selected with caution in pediatric patients, particularly neonates and low birth weight infants, because of the increased risk of hyperglycemia/hypoglycemia. Frequent monitoring of serum glucose concentrations is required when dextrose is prescribed to pediatric patients, particularly neonates and low birth weight infants.

Safety and effectiveness of CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections in pediatric patients have not been established by adequate and well-controlled studies. However, the use of amino acid injections in pediatric patients as an adjunct in the offsetting of nitrogen loss or in the treatment of negative nitrogen balance is referenced in the medical literature. See DOSAGE AND ADMINISTRATION.

Geriatric UseClinical studies of CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from other younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients.

In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or drug therapy.

ADVERSE REACTIONS

See WARNINGS and PRECAUTIONS

Too rapid infusion of these CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections may result in diuresis, hyperglycemia, glycosuria, and hyperosmolar coma. Continual clinical monitoring of the patient is necessary in order to identify and initiate measures for these clinical conditions.

Reactions that may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia. Policies and procedures should be established for the recognition and management of such reactions.

If an adverse reaction does occur, discontinue the infusion, eva luate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary.

DOSAGE AND ADMINISTRATION

If a patient is unable to take oral nourishment for a prolonged period of time, institution of total parenteral nutrition should be considered.

The total daily dose of CLINIMIX sulfite-free (Amino Acid in Dextrose) Injections depends on the patient’s metabolic requirement and cl