The U.S. Food and Drug Administration (FDA),an agency within the U.S. Department of Health and Human Services has approved Clinolipid (lipid injectable emulsion, USP) for intravenous feeding (parenteral nutrition) in adult patients, providing a source of calories and essential fatty acids for adult patients who are unable to eat or drink. Clinolipid, marketed by Deerfield, Ill.-based Baxter Healthcare Corporation, was granted a priority review to help alleviate a drug shortage.
“Preventing and mitigating drug shortages is a top priority for the FDA,” said Dr Janet Woodcock, director of the FDA’s Center for Drug Evaluation and Research. “Approving submissions from manufacturers who can start new production or increase existing production of a product in short supply is one of the many effective mitigation tools that the FDA employs to address a shortage problem.”
Clinolipid is a lipid emulsion that contains a mixture of refined olive oil and refined soybean oil. The fatty acids contained in Clinolipid serve as an important source of energy in patients receiving parenteral nutrition. The omega-3: omega-6 fatty acid ratio in Clinolipid has not been shown to improve clinical outcomes compared to other lipid emulsion products.
“The FDA has been very concerned about the short supply of injectable lipid emulsion products,” said Dr Donna Griebel, director of the Division of Gastroenterology and Inborn Errors Products in the FDA’s Center for Drug Evaluation and Research. “The approval of Clinolipid will help in the effort to resolve this shortage so that patients have access to these parenteral nutrition products.”
Clinolipid is intended for adults, and like other intravenous lipid emulsions, should be used with caution in patients with preexisting liver disease or liver insufficiency. Clinolipid should not be used in patients with a known hypersensitivity to egg or soybean proteins, or in those with severe disorders of lipid metabolism (hyperlipidemia).
The safety and effectiveness of Clinolipid were evaluated in clinical efficacy and safety studies comparing Clinolipid with a soybean oil-based lipid emulsion. Clinolipid is an effective source of energy in adults. The most common side effects in patients treated with Clinolipid during clinical trials included infectious complications, nausea and vomiting, excess fat (lipids) in the blood, high blood sugar, low levels of protein in the blood and abnormal liver function tests.
Clinolipid is not indicated for use in preterm infants. The product carries a warning in its label about the risk of death in preterm infants after infusion of intravenous lipid emulsions such as Clinolipid. Clinolipid is also not indicated for use in other pediatric patients because it is not known whether the amount of essential fatty acids found in Clinolipid is enough to meet the nutritional needs of children.