No

Nutritional Supplement

Dietary supplement for those who cannot digest long chain fats; malabsorption associated with disorders such as pancreatic insufficiency, bile salt deficiency, and bacterial overgrowth of the small bowel; induce ketosis as a prevention for seizures (akinetic, clonic, and petit mal)

C

Central nervous system: May result in narcosis and coma in cirrhotic patients due to high levels of medium chain fatty acids in the serum which then enter the cerebral spinal fluid; electroencephalogram effects include slowing of the alpha wave (can occur during infusion of fatty acids of 2-6 carbon lengths)

Endocrine & metabolic:

MCT therapy does not produce recognized metabolic side effects of any clinical importance, nor do they interfere with the metabolism of other food stuffs or with the absorption of drugs; when administered in the form of a mixed diet with carbohydrates and protein, there is no clinical evidence of hyperketonemia; hyperketonemia may occur in normal or diabetic subjects in the absence of carbohydrates; has been reported that MCT may increase hepatic free fatty acid synthesis and reduce ketone clearance

Fecal water, sodium and potassium excretion are decreased in patients with steatorrhea who are treated with MCT; enhanced calcium absorption has been demonstrated in patients with steatorrhea who are given MCT

Gastrointestinal: Nausea, occasional vomiting, gastritis and distention, diarrhea, and borborygmi are common adverse reactions occurring in about 10% of the patients receiving supplements or diets containing MCT; these symptoms may be related to rapid hydrolysis of MCT, high concentrations of free fatty acids in the stomach and small intestine, hyperosmolarity causing influx of large amounts of fluid, and lactose intolerance; abdominal cramps, nausea and vomiting occurred despite cautionary administration of MCT in small sips throughout meals, but subsided with continued administration

Oral:

Seizures: About 39 mL with each meal or 50% to 70% (800-1120 kcal) of total calories (1600 kcal) as the oil will induce ketosis necessary for seizure control

Cystic fibrosis: 3 tablespoons/day is tolerated without adverse symptoms by most children

Adults: 15 mL 3-4 times/day

May be administered with meals

Possible gastrointestinal side effects from medication can be prevented if therapy is initiated with small supplements at meals and gradually increased according to patient's tolerance

No information available to require special precautions

No effects or complications reported

GI symptoms may occur during the first few days of administration and then disappear; it is important to continue therapy with at least the smallest dose; mix with at least equal volume of water or fruit juice (should not be cold) and sip slowly, no more than 15-20 mL at any one time; no more than 100 mL in any 24-hour period

Dilute with at least an equal volume of water or mix with some other vehicle such as fruit juice (flavoring may be added); mixture should be sipped slowly; administer no more than 15-20 mL at any one time (up to 100 mL may be administered in divided doses in a 24-hour period); formulas should not be cold; since the powdered formula diet provides a high osmolar load, it should be administered slowly by patients with previous gastric surgery

Possible gastrointestinal side effects from medication can be prevented if therapy is initiated with small supplements at meals and gradually increased according to patient's tolerance

Oil: 14 g/15 mL (960 mL)