Drug Info: E: Enteral Nutrition Formulas (Systemic)

Some commonly used brand names are:

In the U.S.—

In Canada—

• Nutritional replacement --EnteralNutrition Formulas

Enteral nutrition formulas are used as nutritionalreplacements for patients who are unable to get enoughnutrients in their diet. These formulas are taken by mouth orthrough a feeding tube and are used by the body for energyand to form substances needed for normal body functions.

Patients with the following conditions may be more likelyto need enteral feedings:

• Acquired immunodeficiency syndrome (AIDS)
• Burns
• Cancer
• Infections, prolonged
• Kidney problems
• Liver problems
• Lung problems
• Pancreas problems
• Stomach problems
• Surgery
• Trauma
• Vomiting, prolonged

Enteral nutrition formulas are available without aprescription. However, they should only be used under medicalsupervision.

The benefits of enteral formulas in healthy people havenot been proven.

Enteral nutrition formulas are available in the followingdosage forms:

• Oral
• Blenderized Enteral Nutrition
  • Oral solution (U.S. and Canada)
• Disease-specific Enteral Nutrition
  • Oral solution (U.S. and Canada)
  • Powder for solution (U.S. and Canada)
• Fiber-containing Enteral Nutrition
  • Oral solution (U.S. and Canada)
• Milk-based Enteral Nutrition
  • Oral solution (U.S. and Canada)
  • Powder for solution (U.S. and Canada)
• Modular Enteral Nutrition
  • Oral solution (U.S. and Canada)
  • Oral powder (U.S. and Canada)
• Monomeric Enteral Nutrition
  • Oral solution (U.S. and Canada)
  • Powder for solution (U.S.)
• Polymeric Enteral Nutrition
  • Oral solution (U.S. and Canada)
  • Powder for solution (U.S.)

If you are taking any of these enteral nutrition formulaswithout a prescription, carefully read and follow anyprecautions on the label. For enteral nutrition formulas, thefollowing should be considered:

Allergies—Tell your doctor if you haveever had any unusual or allergic reaction to any of theingredients listed for your enteral nutrition formula. Alsotell your health care professional if you are allergic to anyother substances, such as foods, preservatives, or dyes.

Pregnancy—Studies on effects inpregnancy have not been done in either humans or animals.

Breast-feeding—This enteral nutritionformula has not been reported to cause problems in nursingbabies.

Children—Caution should be used whengiving enteral feedings to children less than one year ofage. Very young children may not be able to eliminate thefeeding from the body. Although there is no specificinformation about the use of enteral feedings in olderchildren, it is not expected to cause different side effectsor problems in these children than it does in adults.

Older adults—Older adults may be atrisk of developing problems related to the use of anasogastric tube (tube going through the nose into thestomach), such as aspiration (sucking fluid into the lungs)or removing the nasogastric tube. The enteral feeding itselfhas not been shown to cause different side effects orproblems in older people than it does in younger adults.

Other medicines—Medicines

Although certain medications and enteral nutritionformulas should not be used together at all, in other casesthey may be used together even if an interaction might occur.In these cases, your doctor may want to change the dose, orother precautions may be necessary. Tell your health careprofessional if you are taking any prescription ornonprescription (over-the-counter [OTC]) medicine.

• Breathing problems or
• Dehydration or
• Diabetes mellitus (sugar diabetes) or
• Diarrhea or
• Heart problems or
• Hyperglycemia (high levels of sugar in the blood) or
• Hyperlipidemia or
• Lactose intolerance or
• Liver problems or
• Pancreas problems—Enteral feedings may make theseconditions worse; your doctor may recommend a special formulafor your condition

• Intestine problems or
• Stomach problems—These problems may prevent enteralformulas from being absorbed properly

• Kidney problems—Higher blood levels of certainingredients of the enteral feeding may result, and a smalleramount of enteral feeding may be needed.

• Malnutrition, severe—Heart and nerve problems havebeen reported when feeding a patient who is severelymalnourished; enteral formula may need to be used in smalleramounts

Your enteral feeding may be given by mouth or by a feedingtube. Use the amount recommended by your doctor.

For patients taking the oral liquid form of enteral nutrition:

• This preparation is in ready-to-use form. No dilutionis needed unless directed by your physician.
• Shake the preparation well before opening. Refrigerateafter opening, out of the reach of children. Most formulascan be kept in the refrigerator for 1 to 2 days. Check thelabel of your product.

For patients using the powder form of this preparation:

• For mixing or other use, follow carefully theinstructions on the package.
• Any unused solution should be kept in the refrigerator,out of the reach of children. Most formulas can be kept inthe refrigerator for 1 to 2 days. Check the label of yourproduct.

Storage—

To store the unopened container:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store in the bathroom, near the kitchen sink, orin other damp places. Heat or moisture may cause theenteral nutrition formula to break down.
• Keep the enteral nutrition formula from freezing. Donot refrigerate, unless the product has been opened ormixed.
• Do not keep outdated enteral nutrition formulas orthose no longer needed. Be sure that any discarded enteralnutrition formula is out of the reach of children.

Enteral feedings must be handled properly to protect themfrom bacteria. Enteral feedings should be used for no morethan 12 hours at room temperature and then should bediscarded.

If you are taking your enteral feeding through a tube,enteral formulas that are too thick may clog the feedingtube. If this happens, check with your doctor, nurse,dietitian, or pharmacist.

Some problems may result from improper use of an enteralformula or use of the incorrect formula in your condition.Check with your doctor if any of the following problemsoccur:

• More common
  • Confusion; convulsions (seizures); decrease inurine volume; dryness of mouth; frequent urination;increased thirst; irregular heartbeat; mood or mentalchanges; muscle cramps or pain; numbness or tingling inhands, feet, or lips; respiratory distress, shortnessof breath or difficulty breathing; unexplainednervousness; unusual tiredness or weakness; weakness orheaviness of legs; weak pulse
  
  

Other problems may occur that usually do not need medicalattention. They may go away during treatment as your bodyadjusts to the enteral nutrition formula. However, check withyour doctor if any of the following side effects continue orare bothersome:

• More common
  • Constipation; diarrhea; nausea or vomiting
  
  

Other side effects not listed above may also occur in somepatients. If you notice any other effects, check with yourdoctor.