The approximate daily dose of amino acids to be used with dextrose or with dextrose and intravenous fat emulsion will typically depend upon the metabolic status and clinical response of the patient as therapy proceeds. Doses which get the nitrogen equilibrium or positive balance are the most desirable. The dosage of amino acid injection on the first day needs to be approximately half the anticipated optimal dosage and needs to be increased moderately for minimizing glycosuria; similarly, withdrawal needs to be accomplished moderately in order to avoid rebound hypoglycemia.
Recommended Dosage in Adults: The recommended daily dosage of Amino Acid for stable patients and for Critically Ill Patients is 8 to 10 mL/kg/day and 15 to 20 mL/kg/day respectively.
Recommended Dosage in Pediatric Patients: The recommended dosage of Amino Acid for preterm and term infants aged less than 1 month, pediatric patients 1 month to less than 1 year of age, pediatric patients 1 to 10 years of age, and pediatric patients aged greater than 10 to less than 17 years are 30 to 40 mL/kg/day, 20 to 30 mL/kg/day, 10 to 20 mL/kg/day, and 8 to 15 mL/kg/day respectively.
The most commonly reported side effects due to amino acid injection may include: hypersensitivity reactions infection, pulmonary vascular emboli, refeeding syndrome, hyperglycemia and hyperosmolar hyperglycemic state, vein thrombosis, hyperammonemia, elevated liver function tests, electrolyte imbalances, and hypervolemia.