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Common (Generally Mild) Nausea Vomiting Headache Mild sedation GI discomfort related to PN Metabolic Effects Elevated homocysteine (risk factor for thrombosis) Metabolic acidosis Hyperammonemia (especially in hepatic dysfunction) Elevated BUN/creatinine Hyperglycemia (from PN carbohydrates) Rare / Serious Hepatic dysfunction Allergic reactions to PN components Central line complications (infection, thrombosis) Refeeding syndrome (hypophosphatemia, hypokalemia, hypomagnesemia) Neurologic symptoms if severe ammonia elevation occurs Pregnancy & Breastfeeding Pregnancy Methionine is naturally required in pregnancy, and PN is considered safe and appropriate when medically indicated

Iyer KS, McCann SM

Unverified sources can contain impurities, be incorrectly dosed, and produce unpredictable reactions that end up costing far more to treat