Addamel N Special Precautions

Care should be taken in the administration of Addamel N to patients with impaired liver function (especially cholestasis). Manganese toxicity is more likely to occur in patients with impaired liver function and cholestasis as manganese is almost entirely dependent on the biliary route for excretion. Manganese blood levels and liver function should be monitored regularly (monthly) in such patients. Addamel N should be stopped if manganese levels rise to the potentially toxic range.
Addamel N should be used with caution in patients with impaired renal function when the excretion of some trace elements (zinc, selenium, fluoride, chromium and molybdenum) may be significantly decreased.
Use in pregnancy & lactation: Addamel N is a solution of trace elements indicated as a supplement in total parenteral nutrition (TPN) regimens and contains the elements: Fe³⁺, Zn²⁺, Mn²⁺, Cu²⁺, Cr³⁺, Se⁴⁺, Mo⁶⁺, F^-, I^- in amounts not exceeding the recommended daily requirements where these exist. No hazard is expected if used in pregnancy at the recommended dosage. No animal studies have been performed. There are, however, published reports on safe and successful use of trace elements as part of a TPN regimen during pregnancy in the human.