When This Medicine Should Not Be Used:
Make sure the doctor knows about any severe health problems you have, including liver or kidney disease, or trouble urinating. Tell the doctor about any allergy you have, especially if you are allergic to amino acids or sulfites.

How to Use This Medicine:
Injectable

• TPN and PPN solutions are usually made by the pharmacist for your specific medical needs. Your doctor will prescribe your dose and schedule. This medicine is given through a needle placed in a vein.
• A nurse or other health provider will give you this medicine.
• You may be taught how to give your medicine at home. Make sure you understand all instructions before giving yourself an injection. Do not use more medicine or use it more often than your doctor tells you to.
• Check the liquid in the IV bag before you use this medicine. Do not use it if the bag has a leak or the liquid is cloudy or has solid pieces in it. Get a new bag and tell your caregiver.
• Use a new needle and syringe each time you inject your medicine.

Drugs and Foods to Avoid:
Ask your doctor or pharmacist before using any other medicine, including over-the-counter medicines, vitamins, and herbal products.

• Make sure your doctor knows if you are also using tetracycline. Tell your doctor if you use anything else that makes you sleepy. Some examples are allergy medicine, narcotic pain medicine, and alcohol.
• Do not add anything to the solution unless your doctor or other health caregiver has told you to.

Warnings While Using This Medicine:

• Make sure your doctor knows if you are pregnant or breastfeeding, or if you have kidney disease, liver disease, diabetes, asthma, or other breathing problems. Tell your doctor if you have mineral level problems in your blood (such as abnormal electrolyte levels, which may include high potassium levels or low calcium). Make sure your doctor knows if you have heart disease, stomach bleeding, or circulation problems, such as heart failure or blood-clotting problems.
• Your IV could cause an infection. Carefully follow all instructions about how to keep the IV area clean and how to handle the TPN or PPN solution. Tell your caregiver if you have a fever; redness, swelling, or pain around the IV needle; or any other symptoms that resemble an infection.
• Your doctor will do lab tests at regular visits to check on the effects of this medicine. Keep all appointments.

Possible Side Effects While Using This Medicine:
Call your doctor right away if you notice any of these side effects:

• Allergic reaction: Itching or hives, swelling in your face or hands, swelling or tingling in your mouth or throat, chest tightness, trouble breathing
• Change in how much or how often you urinate
• Confusion, fainting
• Redness, warmth, swelling, or a lump where the needle is placed
• Trouble breathing
• Unexplained fever or chills

If you notice these less serious side effects, talk with your doctor:

• Nausea or vomiting
• Warmth or redness in your face, neck, arms, or upper chest

If you notice other side effects that you think are caused by this medicine, tell your doctor.
Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088