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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Sodium Acetate, Dibasic Potassium Phosphate, Magnesium Chloride, Sodium Chloride, Calcium Chloride, Dextrose
Brand Name
Clinimix E
Generic Name
Leucine, Phenylalanine, Lysine, Methionine, Isoleucine, Valine, Histidine, Threonine, Tryptophan, Alanine, Glycine, Arginine, Proline, Serine, Tyrosine, Sodium Acetate, Dibasic Potassium Phosphate, Magnesium Chloride, Sodium Chloride, Calcium Chloride, Dextrose
Active Ingredient
AlanineCategory
Amino Acid [EPC]
Variants
18
This page is for informational purposes only and does not replace medical advice. Before using any prescription or over-the-counter medication for Clinimix E, you must consult a qualified healthcare professional.
| 570 mg/100mL | INJECTION | INTRAVENOUS | 0338-1142 |
| 1035 mg/100mL | INJECTION | INTRAVENOUS | 0338-1147 |
| 880 mg/100mL | INJECTION | INTRAVENOUS | 0338-7026 |
| 1035 mg/100mL | INJECTION | INTRAVENOUS | 0338-1123 |
| 1035 mg/100mL | INJECTION | INTRAVENOUS | 0338-7036 |
| 880 mg/100mL | INJECTION | INTRAVENOUS | 0338-1113 |
| 570 mg/100mL | INJECTION | INTRAVENOUS | 0338-7020 |
| 880 mg/100mL | INJECTION | INTRAVENOUS | 0338-7024 |
| 880 mg/100mL | INJECTION | INTRAVENOUS | 0338-7028 |
+ 6 more variants
Detailed information about Clinimix E
Alanine is a non-essential amino acid primarily used in parenteral nutrition and metabolic support. It plays a critical role in the glucose-alanine cycle and nitrogen transport.
Dosage of Alanine in clinical settings is almost always calculated as part of a total amino acid requirement. For adults receiving parenteral nutrition, the standard protein requirement ranges from 0.8 to 2.0 grams of amino acids per kilogram of body weight per day.
In these mixtures, Alanine typically comprises approximately 6% to 20% of the total amino acid content, depending on the specific brand (e.g., Aminosyn vs. Travasol). For example, if a patient is prescribed 100g of amino acids, they may receive between 6g and 16g of L-alanine daily.
Pediatric requirements for amino acids are significantly higher than adult requirements due to the demands of growth and development.
Precise Alanine intake is adjusted by the healthcare provider based on the child's age, weight, and metabolic status. Excessive amino acid intake in neonates can lead to hyperammonemia (high blood ammonia), so careful titration is mandatory.
In patients with significant renal dysfunction, the ability to excrete urea (the byproduct of alanine metabolism) is compromised. Healthcare providers may reduce the total amino acid dose or use specialized 'renal' formulations that contain a higher proportion of essential amino acids and fewer non-essential amino acids like Alanine to prevent uremia (buildup of toxins in the blood).
Patients with severe liver disease or hepatic encephalopathy may require adjustments. While Alanine is metabolized in the liver, the primary concern is the liver's inability to process the resulting ammonia. Specialized 'hepatasol' formulations may be used, which alter the ratio of branched-chain amino acids to aromatic amino acids.
Dosing in the elderly should be cautious, usually starting at the lower end of the dosing range. This accounts for the higher frequency of decreased hepatic, renal, or cardiac function and concomitant disease or other drug therapy.
If you are receiving Alanine via intravenous infusion:
If taking oral Alanine supplements:
In a clinical setting (IV), missed doses are rare as the infusion is continuous. If an oral dose is missed, take it as soon as you remember. If it is almost time for the next dose, skip the missed dose. Do not double the dose to catch up.
An overdose of Alanine, particularly via IV, can lead to 'amino acid toxicity.' Symptoms may include:
In case of suspected overdose, the infusion should be stopped immediately, and the patient's electrolyte and fluid status should be re-evaluated. Emergency measures focus on supporting renal function and correcting acid-base imbalances.
> Important: Follow your healthcare provider's dosing instructions exactly. Do not adjust your dose or stop the treatment without medical guidance.
Because Alanine is a naturally occurring amino acid, side effects are generally minimal when used at physiological doses. However, when administered as part of a concentrated intravenous solution, the following may occur:
Alanine should only be used under the direct supervision of a healthcare professional experienced in clinical nutrition and metabolic management. Because Alanine contributes to the body's nitrogen load, it can exacerbate conditions where nitrogen processing is impaired. Patients must be monitored closely for signs of fluid and electrolyte imbalances, as well as changes in organ function.
No FDA black box warnings for Alanine. However, users should be aware of the general warnings associated with parenteral nutrition, including the risk of infection at the catheter site and the potential for severe metabolic complications if the infusion is not managed correctly.
While rare, hypersensitivity to amino acid solutions can occur. If you have a known allergy to any components of the infusion (such as certain sulfites sometimes used as preservatives), notify your doctor immediately. Symptoms of an allergic reaction include skin rash, itching, and respiratory distress.
There are no drugs that are strictly contraindicated with Alanine in the same way that certain antidepressants interact with MAO inhibitors. However, Alanine should never be mixed in the same IV line with medications that are known to be physically or chemically incompatible with amino acid solutions, such as certain antibiotics or alkaline drugs, as this can cause the amino acids to precipitate (form solids), which can be fatal if injected.
Corticosteroids promote protein breakdown (catabolism) and can interfere with the nitrogen-sparing effects of Alanine. This may lead to an increase in blood urea nitrogen (BUN) levels. Healthcare providers should monitor nitrogen balance and adjust the Alanine dose accordingly.
Tetracyclines can have an anti-anabolic effect, which may reduce the efficiency with which the body utilizes Alanine for protein synthesis. This interaction can also lead to increased BUN levels.
Alanine must NEVER be used in the following circumstances:
Alanine is a naturally occurring amino acid and is a normal component of the maternal diet and fetal blood supply.
Alanine is a natural component of human breast milk. Supplemental Alanine taken by the mother is not expected to cause any adverse effects in the nursing infant. However, mothers receiving TPN should be monitored for overall nutritional balance to ensure the milk composition remains optimal for the infant's growth.
L-alanine is a neutral, non-polar amino acid. Its primary molecular mechanism involves serving as a substrate for the enzyme Alanine Aminotransferase (ALT). This enzyme facilitates the reversible transfer of the amino group from alanine to alpha-ketoglutarate.
In the muscle, this allows for the disposal of nitrogen produced during protein catabolism. In the liver, the resulting pyruvate enters the gluconeogenic pathway, where it is converted into glucose-6-phosphate and eventually free glucose. This 'Glucose-Alanine Cycle' is a major pathway for endogenous glucose production, especially during periods of stress or starvation. Additionally, Alanine stimulates the alpha-cells of the pancreas to release glucagon, further supporting blood sugar levels.
The pharmacodynamic effect of Alanine is primarily nutritional and metabolic. There is a direct dose-response relationship between Alanine intake and nitrogen retention, up to a physiological ceiling. The onset of metabolic effect is rapid when given intravenously, with changes in plasma amino acid profiles occurring within minutes. The duration of effect lasts as long as the infusion continues, with metabolic byproducts being cleared within hours of cessation.
Common questions about Clinimix E
Alanine is primarily used in a medical setting as a component of intravenous nutritional fluids for patients who cannot eat or absorb nutrients through their digestive tract. It provides a source of nitrogen for protein synthesis and serves as a vital building block for creating glucose in the liver. Healthcare providers also use it to help maintain muscle mass in patients recovering from severe trauma, surgery, or burns. In some specialized cases, it has been studied for managing low blood sugar (hypoglycemia). It is rarely used as a standalone medication and is usually part of a balanced amino acid mixture.
When administered intravenously, the most common side effects include redness or irritation at the injection site, a feeling of warmth or flushing, and mild nausea. These symptoms are often related to the speed of the infusion rather than the amino acid itself. If taken orally as a supplement, some people may experience minor digestive upset or a tingling sensation in the skin (paresthesia), though this is more common with beta-alanine than the L-alanine used in clinical settings. Most side effects are temporary and resolve once the body adjusts to the treatment. Always report any persistent discomfort to your healthcare provider.
It is generally recommended to avoid alcohol while receiving clinical Alanine therapy, especially if it is being used for nutritional support. Alcohol can strain the liver, which is the primary organ responsible for processing Alanine into glucose and urea. Furthermore, alcohol can interfere with blood sugar regulation and may increase the risk of metabolic imbalances. Since many patients receiving Alanine are already in a weakened state or have underlying health issues, alcohol can complicate the recovery process. Always discuss your alcohol consumption with your doctor to ensure it does not interfere with your treatment plan.
Alanine is a naturally occurring amino acid that is essential for both the mother and the developing fetus. In clinical settings, it is considered safe when used as part of a supervised parenteral nutrition program for pregnant women who cannot maintain adequate nutrition orally. While it is classified as FDA Pregnancy Category C, this is largely due to a lack of extensive clinical trials rather than evidence of harm. Your doctor will weigh the benefits of providing essential nutrition against any potential risks. It is important to ensure that Alanine is part of a balanced nutritional profile tailored for pregnancy.
The metabolic effects of Alanine begin almost immediately after it enters the bloodstream, especially when given intravenously. Within minutes, the liver begins processing the amino acid for energy or protein synthesis. However, the visible clinical benefits, such as improved nitrogen balance or muscle preservation, may take several days of consistent therapy to become apparent. For patients using it to manage hypoglycemia, the effect on blood sugar can be seen within 30 to 60 minutes. Your healthcare provider will use regular blood tests to monitor how well the treatment is working for your specific needs.
If you are receiving Alanine as part of an intravenous nutrition (TPN) program, you should not stop it suddenly. Abruptly ending a high-nutrient infusion can cause your blood sugar levels to drop rapidly (rebound hypoglycemia) because your body has adjusted its insulin production to the constant supply of nutrients. Healthcare providers typically 'taper' the infusion by slowly reducing the rate over several hours to allow the body to adjust. If you are taking oral Alanine supplements, stopping suddenly is generally safe but should still be discussed with your doctor. Always follow the specific discontinuation plan provided by your medical team.
In a hospital setting, your nurse or doctor manages the administration, so missed doses are unlikely. If you are using Alanine supplements at home and miss a dose, take it as soon as you remember. However, if it is nearly time for your next scheduled dose, skip the missed one and continue with your regular schedule. You should never take two doses at once to make up for a missed one, as this can cause a temporary spike in nitrogen levels. If you are unsure what to do, contact your pharmacist or healthcare provider for guidance.
Alanine itself is not a significant source of calories and is unlikely to cause fat gain when used in standard clinical doses. However, because it is used to support nutrition and prevent muscle wasting, it may lead to an increase in 'lean body mass' or help a patient regain weight lost during a severe illness. In the context of total parenteral nutrition, weight gain is often a goal of the therapy, indicating that the patient is receiving adequate calories and protein. Any significant or rapid weight change should be discussed with your doctor to ensure it is due to healthy recovery and not fluid retention.
Alanine can interact with certain medications, so it is vital to provide your doctor with a full list of everything you take. It may interact with corticosteroids, which can increase nitrogen levels, or with certain antibiotics like tetracycline. Additionally, because Alanine is an amino acid, it can compete with the Parkinson's medication Levodopa for absorption into the brain. If you have diabetes, Alanine may affect your blood sugar levels, requiring adjustments to your insulin or other medications. Your healthcare provider will monitor these interactions and adjust your treatment plan to ensure all your medications work together safely.
Yes, Alanine is widely available as a generic component of amino acid solutions. It is rarely sold as a branded, standalone prescription drug but is a standard ingredient in many different brands of parenteral nutrition, such as Aminosyn, Travasol, and FreAmine. Generic versions are required by the FDA to have the same quality and strength as branded versions. If you are buying Alanine as a dietary supplement, it is available from many different manufacturers, but these are not regulated as strictly as prescription drugs. Always choose a reputable brand and consult your doctor before starting any new supplement.
Other drugs with the same active ingredient (Alanine)
> Warning: Stop taking Alanine and call your doctor immediately if you experience any of the following serious symptoms. These may indicate a severe allergic reaction or a dangerous metabolic shift.
Prolonged use of Alanine as part of parenteral nutrition can lead to several chronic conditions:
There are currently no FDA black box warnings specifically for Alanine as a standalone ingredient. However, many amino acid injections carry warnings regarding the risk of 'Aluminum Toxicity' in patients with impaired kidney function, especially in premature neonates. This is due to the trace amounts of aluminum that can be present in the glass vials or the manufacturing process of the IV solutions.
Report any unusual symptoms to your healthcare provider. Monitoring of blood chemistry is a standard part of Alanine therapy to ensure these side effects are caught early.
Long-term administration of amino acids like Alanine can lead to parenteral nutrition-associated liver disease (PNALD). Healthcare providers must monitor liver enzymes (ALT, AST) and bilirubin levels regularly. If liver function declines, the composition of the nutritional support may need to be altered.
In patients with pre-existing kidney disease, the nitrogen from Alanine can lead to an accumulation of urea in the blood (uremia). This can cause further damage to the kidneys and lead to systemic toxicity. Regular monitoring of BUN and creatinine is essential.
Amino acid solutions are often hypertonic and can cause fluid shifts. Patients with congestive heart failure or pulmonary edema must be monitored for signs of worsening fluid retention, such as swelling in the ankles (edema) or increased shortness of breath.
Patients receiving Alanine clinically will require frequent laboratory testing, including:
Alanine itself does not typically cause sedation or cognitive impairment. However, the underlying conditions requiring Alanine therapy (such as severe illness or recovery from surgery) may affect your ability to drive or operate machinery. Always consult your doctor regarding your physical readiness for these activities.
Alcohol can interfere with the liver's ability to process amino acids and can exacerbate the risk of hypoglycemia or liver stress. It is generally advised to avoid alcohol consumption while receiving clinical nutritional support involving Alanine.
Alanine infusions should not be stopped abruptly, especially if they are providing a significant portion of the patient's caloric intake. Abrupt discontinuation can lead to 'rebound hypoglycemia' as the body's insulin levels may be elevated in response to the continuous glucose/amino acid load. The infusion rate is typically tapered down over several hours.
> Important: Discuss all your medical conditions, especially liver or kidney disease, with your healthcare provider before starting Alanine.
Alanine can be converted into glucose in the liver. In patients with diabetes, supplemental Alanine may increase blood sugar levels, requiring an adjustment in insulin or oral hypoglycemic dosages. Conversely, Alanine has been shown in some studies to stimulate glucagon secretion, which also raises blood sugar.
Amino acids compete with Levodopa for transport across the blood-brain barrier. High protein or amino acid intake (including Alanine) can reduce the effectiveness of Levodopa in treating Parkinson's disease. Patients should maintain a consistent protein intake and discuss timing with their doctor.
If taking Alanine supplements, a diet extremely high in other proteins may overwhelm the body's ability to process nitrogen, leading to fatigue or kidney strain.
For oral Alanine, high-fat meals may slow gastric emptying and delay the absorption of the amino acid, though this is rarely clinically significant.
Taking large amounts of other single amino acids alongside Alanine can create an 'amino acid imbalance,' where the absorption of one interferes with the others. It is best to take balanced amino acid complexes unless otherwise directed.
While there is no direct metabolic interaction, St. John's Wort can affect liver enzymes. Although Alanine doesn't use the CYP system, the overall metabolic state of the liver is important for Alanine processing.
For each major interaction, the management strategy involves regular blood monitoring and dosage titration by a medical professional.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking, including over-the-counter vitamins.
These conditions require a careful risk-benefit analysis by a healthcare provider:
Patients who are sensitive to other neutral amino acids (like Glycine or Serine) should be monitored closely, although true cross-sensitivity is rare because these are naturally occurring substances in the human body. The more common concern is sensitivity to preservatives or stabilizers used in the liquid formulations.
> Important: Your healthcare provider will evaluate your complete medical history, including genetic screenings if necessary, before prescribing Alanine-containing therapies.
Alanine is essential for the growth of children.
In elderly patients, the use of Alanine requires caution due to the higher prevalence of:
For patients with a Glomerular Filtration Rate (GFR) below 30 mL/min, the dose of Alanine should be significantly reduced. If the patient is on hemodialysis or peritoneal dialysis, higher doses may be tolerated because the dialysis process removes the excess urea and nitrogen. However, the timing of the infusion relative to dialysis is critical.
In patients with Child-Pugh Class B or C cirrhosis, Alanine should be used with extreme caution. The liver's reduced capacity for gluconeogenesis and urea synthesis means that Alanine may not be metabolized correctly, leading to an imbalance in the plasma amino acid profile and potentially triggering hepatic encephalopathy.
> Important: Special populations require individualized medical assessment and frequent laboratory monitoring to ensure safety.
| Parameter | Value |
|---|---|
| Bioavailability | 100% (IV); ~70-90% (Oral) |
| Protein Binding | Negligible |
| Half-life | 30 to 60 minutes |
| Tmax (Oral) | 0.5 to 1.5 hours |
| Metabolism | Hepatic (Transamination via ALT) |
| Excretion | Renal (as Urea) |
Alanine is classified as a Non-Essential Amino Acid. Within the therapeutic hierarchy, it is part of the 'Amino Acid Injections' group used for parenteral nutrition. It is often grouped with other neutral amino acids like Leucine, Isoleucine, and Valine, although its metabolic pathway is distinct from these branched-chain amino acids.