Monday, September 26, 2016

Manganese Sulfate Injection





Dosage Form: injection, solution
Manganese Sulfate Injection, USP

Rx Only


STERILE, NONPYROGENIC, TRACE ELEMENT ADDITIVE

FOR IV USE AFTER DILUTION

(MANGANESE 0.1 mg/mL)

PRESERVATIVE FREE



DESCRIPTION


Manganese Sulfate Injection, USP is a sterile, nonpyrogenic solution intended for use as an additive to solutions for Total Parenteral Nutrition (TPN). Each mL contains 0.308 mg of Manganese Sulfate Monohydrate, USP, Water for Injection q.s. pH adjusted with Sulfuric Acid. It delivers elemental manganese 0.1 mg/mL. It is a single dose preservative free vial. Discard any unused portion.



CLINICAL PHARMACOLOGY


Manganese is an activator for enzymes such as polysaccharide polymerase, liver arginase, cholinesterase and pyruvate carboxylase. Providing manganese during TPN prevents development of the following deficiency symptoms: nausea and vomiting, weight loss, dermatitis and changes in growth and color of hair.



INDICATIONS AND USAGE


Manganese Sulfate Injection, USP is indicated for use as a supplement to intravenous solutions given for Total Parenteral Nutrition (TPN). Administration helps to maintain plasma levels and to prevent depletion of endogenous stores and subsequent deficiency symptoms.



CONTRAINDICATIONS


Manganese Sulfate Injection, USP should not be given undiluted by direct injection into a peripheral vein because of the potential for infusion phlebitis.



WARNINGS


This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.


Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.



PRECAUTIONS


Manganese is eliminated via the bile. The possibility of manganese retention should be considered in patients with biliary tract obstruction. Decreasing or omitting manganese supplements entirely may be necessary for such patients. However, ancillary routes of manganese excretion include pancreatic juice, or reabsorption into the lumen of the duodenum, jejunum or ileum.



Use in Pregnancy


Safety for use in pregnancy has not been established. Use of manganese in women of childbearing potential requires that anticipated benefits be weighed against possible hazards.



ADVERSE REACTIONS


Adverse reactions to manganese at the dosage levels recommended have not been reported.



DOSAGE AND ADMINISTRATION


Manganese Sulfate Injection, USP provides 0.1 mg manganese/mL. For the metabolically stable adult receiving TPN, the suggested additive dosage level for manganese is 0.15 to 0.8 mg/day. For pediatric patients, a dosage level of 2 to 10 mcg manganese/kg/day is recommended.


Aseptic addition of Manganese Sulfate Injection, USP to the TPN solution under a laminar flow hood is recommended. Manganese is physically compatible with the electrolytes and vitamins usually present in the amino acid/dextrose solution used for TPN. Periodic monitoring of manganese plasma levels is suggested as a guideline for subsequent administration.


Parenteral drug products should be inspected visually for particulate matter and discoloration, whenever solution and container permit.



OVERDOSAGE


Manganese toxicity has not been reported in patients receiving TPN. Neither have reports of manganese toxicity from excessive intake in foods and/or beverages been published.



HOW SUPPLIED


Manganese Sulfate Injection, USP 0.1 mg/mL


NDC 0517 - 6410 - 25                                 10 mL SDV                        packed in a box of 25


Store at 20° to 25°C (68° to 77°F); excursions permitted to 15° to 30°C (59° to 86°F) (See USP Controlled Room Temperature).


IN6410


Rev. 1/09


MG #14479


AMERICAN

REGENT, INC.

SHIRLEY, NY 11967



PACKAGE LABEL.PRINCIPAL DISPLAY PANEL


PRINCIPAL DISPLAY PANEL – 10 mL Container


NDC 0517-6410-25


Manganese Sulfate Injection, USP


Manganese 1 mg/10 mL


(0.1 mg/mL)


10 mL SINGLE DOSE VIAL


Trace Element Additive


FOR IV USE AFTER DILUTION


PRESERVATIVE FREE


Rx Only


AMERICAN

REGENT, INC.

SHIRLEY, NY 11967


Rev. 11/05










MANGANESE SULFATE 
manganese sulfate  injection, solution










Product Information
Product TypeHUMAN PRESCRIPTION DRUGNDC Product Code (Source)0517-6410
Route of AdministrationINTRAVENOUSDEA Schedule    








Active Ingredient/Active Moiety
Ingredient NameBasis of StrengthStrength
MANGANESE SULFATE (MANGANESE CATION (2+))MANGANESE SULFATE0.308 mg  in 1 mL








Inactive Ingredients
Ingredient NameStrength
SULFURIC ACID 
WATER 


















Product Characteristics
Color    Score    
ShapeSize
FlavorImprint Code
Contains      














Packaging
#NDCPackage DescriptionMultilevel Packaging
10517-6410-2525 VIAL In 1 TRAYcontains a VIAL, SINGLE-DOSE
110 mL In 1 VIAL, SINGLE-DOSEThis package is contained within the TRAY (0517-6410-25)










Marketing Information
Marketing CategoryApplication Number or Monograph CitationMarketing Start DateMarketing End Date
Unapproved drug other09/30/1990


Labeler - American Regent, Inc. (622781813)
Revised: 12/2011American Regent, Inc.

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