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We do not require you to disclose any personally identifiable information for general access to our site. Any personally identifiable information you submit is used only to help us satisfy your requests and for internal marketing purposes. Website visitors may decide to send American Regent personally identifiable information, for example, in a message asking a question about an American Regent product or containing comments about the American Regent website. American Regent will use this information only to respond to the matter identified in the e-mail. Please note, however, that if you submit personally identifiable information about an adverse event or injury associated with the use of one of our products, we may be required to submit that information to FDA or other regulatory agencies.

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If you have any questions or comments about the American Regent Privacy Policy, please submit a message to cs@americanregent.com.

American Regent reserves the right to change our Privacy Policy from time to time. A revised Privacy Policy will apply to information collected after the date it is changed.

Additional American Regent Resources

TO REPORT ADVERSE DRUG EVENTS (ADEs)
Phone: 800-734-9236
Email: pv@americanregent.com

ADEs MAY ALSO BE REPORTED TO THE FDA
Phone: 800-FDA-1088
Web: fda.gov/safety/medwatch

TO REPORT PRODUCT QUALITY COMPLAINT
Phone: 800-354-4859
Email: pqc@americanregent.com

DRUG INFORMATION
888-354-4855 (9 AM—5 PM ET, Mon-Fri)
For medical information outside of normal business hours that cannot wait until the next business day, please call 877.845.6371.
Web: https://americanregent.com/medical-affairs

CUSTOMER SUPPORT
800-645-1706
(8:00 AM—6:00 PM ET, Mon-Thu; 8:00 AM—4:00 PM ET, Fri)

MAILING ADDRESS
American Regent, Inc.
265 Broadhollow Road, 4th Floor, Melville, NY 11747


IMPORTANT SAFETY INFORMATION

Tralement® (trace elements injection 4*, USP)

*Each mL of Tralement® contains zinc 3 mg, copper 0.3 mg, manganese 55 mcg, and selenium 60 mcg.

For intravenous use

INDICATIONS AND USAGE

Tralement® is indicated for adult and pediatric patients weighing at least 10 kg as a source of zinc, copper, manganese, and selenium for parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated.

IMPORTANT SAFETY INFORMATION

Important Administration Information

Tralement is supplied as a single-dose vial for admixture use only. It is not for direct intravenous infusion. Prior to administration, Tralement must be transferred to a separate parenteral nutrition container, diluted and used as an admixture in parenteral nutrition solution.

Overview of Dosing

  • Prior to administration of parenteral nutrition solution containing Tralement, correct severe fluid, electrolyte, and acid-base disorders.
  • The dosage of the final parenteral nutrition solution containing Tralement must be based on the concentrations of all components in the solution, the patient’s clinical condition, nutritional requirements, and the contribution of oral or enteral intake.

Tralement is recommended only for patients who require supplementation with all four of the individual trace elements (i.e., zinc, copper, manganese and selenium).

See Full Prescribing Information on preparation, administration and dosing.

CONTRAINDICATIONS

Tralement is contraindicated in patients with hypersensitivity to zinc or copper.

WARNINGS AND PRECAUTIONS

  • Pulmonary Embolism due to Pulmonary Vascular Precipitates: If signs of pulmonary distress occur, stop the infusion and initiate a medical evaluation.
  • Vein Damage and Thrombosis: Solutions with osmolarity of 900 mOsmol/L or more must be infused through a central catheter. The primary complication of peripheral access is venous thrombophlebitis.
  • Neurologic Toxicity with Manganese: Monitor patients receiving long-term parenteral nutrition solutions containing Tralement for neurologic signs and symptoms and routinely monitor whole blood manganese concentrations and liver function tests. Discontinue Tralement and consider brain magnetic resonance imaging (MRI) if toxicity suspected.
  • Hepatic Accumulation of Copper and Manganese: Assess for development of hepatic or biliary dysfunction. Monitor concentrations of copper and manganese in patients with cholestasis, biliary dysfunction or cirrhosis receiving Tralement long-term.
  • Aluminum Toxicity: Tralement contains aluminum that may be toxic. Increased risk in patients with renal impairment, including preterm infants.
  • Monitoring and Laboratory Tests: Monitor blood zinc, copper, manganese, and selenium concentrations, fluid and electrolyte status, serum osmolarity, blood glucose, liver and kidney function, blood count and coagulation parameters.
  • Hypersensitivity Reactions with Zinc and Copper: If reactions occur, discontinue Tralement and initiate appropriate medical treatment.

ADVERSE REACTIONS

The following adverse reactions were identified in clinical studies or post-marketing reports. Given that some of these reactions were reported voluntarily from a population of uncertain size, it is not always possible to reliably estimate their frequency or establish a causal relationship to drug exposure.

Adverse reactions with other components of parenteral nutrition solutions:

  • Pulmonary embolism due to pulmonary vascular precipitates
  • Vein damage and thrombosis
  • Aluminum toxicity

Adverse reactions with the use of trace elements administered parenterally or by other routes of administration:

  • Neurologic toxicity with manganese
  • Hepatic accumulation of copper and manganese
  • Hypersensitivity reactions with zinc and copper

USE IN SPECIFIC POPULATIONS

Pregnancy - Risk Summary - Deficiency of trace elements may result in adverse pregnancy and fetal outcomes.

Lactation - Risk Summary - Zinc, copper, manganese, and selenium are present in human milk. The developmental and health benefits of breastfeeding should be considered, along with the mother’s clinical need for Tralement and any potential adverse effects on the breastfed infant from Tralement or from the underlying maternal condition.

Pediatric Use - Refer to Full Prescribing Information for dosing. Do not supplement Tralement with additional manganese. Tralement is not approved for use in pediatric patients weighing less than 10 kg.

Hepatic Impairment - Hepatic accumulation of copper and manganese have been reported with long-term administration in parenteral nutrition. For patients with cholestasis, biliary dysfunction, or cirrhosis, monitor hepatic and biliary function during long-term administration of Tralement.

OVERDOSAGE - There are reports on overdosage in the literature for the individual trace elements. Management of overdosage is supportive care based on presenting signs and symptoms.

For additional safety information, please see Full Prescribing Information.

You are encouraged to report Adverse Drug Events (ADEs) to American Regent, Inc. at 1-800-734-9236, or to the FDA by visiting fda.gov/safety/medwatch or calling 1-800-FDA-1088.

REF-1535 (v6.0) 2/2021

Multrys™ (trace elements injection 4*, USP)

*Each mL of Multrys™ contains zinc 1,000 mcg, copper 60 mcg, manganese 3 mcg, and selenium 6 mcg.

For intravenous use

INDICATIONS AND USAGE

Multrys™ is a combination of trace elements (zinc sulfate, cupric sulfate, manganese sulfate, and selenious acid) indicated in neonatal and pediatric patients weighing less than 10 kg as a source of zinc, copper, manganese, and selenium for parenteral nutrition when oral or enteral nutrition is not possible, insufficient, or contraindicated.

IMPORTANT SAFETY INFORMATION

DOSAGE AND ADMINISTRATION

Important Administration Information

Multrys is supplied as a single-dose vial. Prior to administration, Multrys must be transferred to a separate parenteral nutrition container, diluted, and used as an admixture in parenteral nutrition solution.

Overview of Dosing

Prior to administration of parenteral nutrition solution containing Multrys, correct severe fluid, electrolyte and acid-base disorders. It is recommended only for patients who require supplementation with all four of the individual trace elements (zinc, copper, manganese and selenium). Multrys is not recommended for patients who may require a lower dosage of one or more of the individual trace elements. Avoid additional manganese supplementation with Multrys use.

CONTRAINDICATIONS

Contraindicated in patients with hypersensitivity to zinc or copper.

WARNINGS AND PRECAUTIONS

Pulmonary Embolism due to Pulmonary Vascular Precipitates: If signs of pulmonary distress occur, stop the parenteral nutrition infusion and initiate a medical evaluation.

Vein damage and thrombosis: Solution with an osmolarity of 900 mOsmol/L or greater must be infused through a central catheter.

Neurologic Toxicity with Manganese: Monitor for clinical signs and symptoms of neurotoxicity, whole blood manganese concentrations, and liver function tests. Discontinue Multrys and consider brain magnetic resonance imaging (MRI) if toxicity is suspected. Monitor patients for cholestasis or other biliary liver disease.

Hepatic Accumulation of Copper and Manganese: Assess for development of hepatic accumulation. Monitor concentrations of copper and manganese in patients with cholestasis or cirrhosis.

Aluminum Toxicity: Multrys contains aluminum that may be toxic. Patients with renal impairment and preterm infants, including preterm neonates, are particularly at risk.

Monitoring and Laboratory Tests: Monitor blood zinc, copper and selenium serum concentrations, whole blood manganese concentration, fluid and electrolyte status, serum osmolarity, blood glucose, liver and kidney function, blood count, and coagulation parameters.

Hypersensitivity Reactions with Zinc and Copper: If hypersensitivity reactions occur, discontinue and initiate appropriate medical treatment.

ADVERSE REACTIONS

The following adverse reactions were identified in clinical studies or post-marketing reports:

  • Neurologic toxicity with manganese
  • Hepatic accumulation of copper and manganese
  • Hypersensitivity reactions with zinc and copper

OVERDOSAGE

There are reports on overdosage in the literature for the individual trace elements.

For additional safety information, please see Full Prescribing Information.

You are encouraged to report Adverse Drug Events to American Regent, Inc. at 1-800-734-9236, or to the FDA by visiting fda.gov/safety/medwatch or by calling 1-800-FDA-1088.

REF-1826 (v3.0) 6/2021

American Regent is proud to be an American manufacturer with more than 50 years of experience developing and supplying high-quality sterile injectables for healthcare professionals and their patients.

Tralement® is a registered trademark of American Regent, Inc.
Multrys is a trademark of American Regent, Inc.
Patents pending.

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