Omacor

To open: • Remove the protective overpouch. • Discard the oxygen absorber sachet. • Use only if the bag is not damaged, the non-permanent seals are intact (i.e., no content mixture of any of the three chambers), the solution in the amino acids chamber and the solution in the glucose chamber are clear, colorless, or slightly yellow, free of visible particles, and the lipid emulsion is a homogeneous liquid with a milky appearance. To mix the chambers: • Ensure that the product is at room temperature when breaking the nonpermanent seals. • Manually roll the bag onto itself, starting at the top of the bag (hanger end). The nonpermanent seals will disappear from the side near the inlets. Continue to roll the bag until the seals are open along approximately half of their length. • Mix by inverting the bag at least 3 times. • After reconstitution, the mixture is a homogeneous emulsion with a milky appearance. After removing the protective cap from the medication port, one can add compatible additives via the medication port. No additions to the bag should be made without first checking the compatibility, as the formation of precipitates or destabilization of the lipid emulsion could result in vascular occlusion. Addition should be made aseptically Finomel can be mixed with the following additives: • Multi-vitamin preparations • Multi-trace element preparations • Selenium • Zinc • Sodium salt • Potassium salt • Magnesium salt • Calcium salt • Phosphate salt The compatibility indicative table below shows possible additions of multi-trace element product such as Nutryelt and multi-vitamin product such as Cernevit and generics of electrolytes and trace elements in defined quantities. The addition of clinically needed electrolytes and trace elements should take into account the amounts already included in the initial bag formulation. Additive Total content after addition for all bag sizes of Finomel Nutryelt (Composition per vial: Zinc 153 µmol; Copper 4.7 µmol; Manganese 1.0 µmol; Fluorine 50 µmol; Iodine 1.0 µmol; Selenium 0.9 µmol; Molybdenum 0.21 µmol; Chromium 0.19 µmol; Iron 18 µmol) 2 vials a /bag Cernevit (Composition per vial: Vit. A (as Retinol palmitate) 3500 IU, Vit. D3 (Cholecalciferol) 220 IU, Vit. E (Alpha-tocopherol) 11.2 IU, Vit. C (Ascorbic acid) 125 mg, Vit. B1 (Thiamine) 3.51 mg, Vit. B2 (Riboflavin) 4.14 mg, Vit. B6 (Pyridoxine) 4.53 mg, Vit. B12 (Cyanocobalamin) 6 µg, Vit. B9 (Folic acid) 414 µg, Vit. B5 (Pantothenic acid) 17.25 mg, Vit. B8 (Biotin) 69 µg, Vit. PP (Nicotinamide) 46mg) 2 vials b /bag Sodium 138 mmol/L Potassium 138 mmol/L Magnesium 5 mmol/L Calcium 4.6 mmol/L Phosphate (organic such as sodium glycerophosphate) Or Phosphate (mineral such as potassium phosphate) 18.5 mmol/L 5.5 mmol/L Selenium 7.6 µmol/L Zinc 0.31 mmol/L a Volume of vial: 10mL concentrate solution b Volume of vial: 5 mL lyophilisate Compatibility may vary between products from different sources and health care professionals are advised to carry out appropriate checks when mixing Finomel with other parenteral solutions. Mix the contents of the bag thoroughly and visually inspect the mixture. There should be no signs of emulsion phase separation. The mixture is a milky white homogenous emulsion. When making additions, the final osmolarity of the admixture must be assessed. Remove the protector cap from the infusion port and attach the infusion set. Hang the bag on an infusion stand and carry out infusion using the standard technique. After opening the bag, content should be used immediately, and should not be stored for a subsequent infusion. Do not reconnect any partially used bag. Do not connect in series in order to avoid the possibility of air embolism. Any unused medicinal product or waste material should be disposed of in accordance with local requirements.