KabiPro

Approved Indications:

• General Nutritional Deficiency:
  Supports dietary intake in individuals with poor nutrition, malabsorption syndromes, or increased metabolic demand.
• Protein-Energy Malnutrition (PEM):
  For the treatment and prevention of moderate to severe malnutrition, particularly in undernourished adults, children, and elderly.
• Post-Surgical Recovery:
  Helps in tissue repair, wound healing, and immune support post-surgery or trauma.
• Chronic Illnesses:
  Used in cancer, renal disease, HIV/AIDS, tuberculosis, and gastrointestinal diseases causing malnutrition or cachexia.
• Pregnancy & Lactation:
  Ensures adequate maternal micronutrient and macronutrient intake for fetal growth and milk production.
• Growth Support in Pediatrics:
  Supports physical and cognitive development in children with poor growth or failure to thrive.
• Elderly Nutrition:
  Maintains energy balance and prevents sarcopenia, osteoporosis, and vitamin/mineral deficiencies.

Important Off-label/Clinically Accepted Uses:

• Meal Replacement in Restricted Diets:
  For patients with diabetes, celiac disease, or metabolic disorders requiring tailored nutrient supplementation.
• Athletic Recovery & Muscle Maintenance:
  As part of sports nutrition to enhance protein synthesis, energy replenishment, and recovery.

Route: Oral (powder, liquid, or ready-to-drink formulations)

Adults:

• General Supplementation:
  1–2 servings daily, or as prescribed (each serving typically provides 200–400 kcal).
• Malnutrition or Cachexia:
  Up to 3–4 servings/day based on energy and protein requirements.

Pediatrics:

• Children 1–3 years:
  1–2 servings/day (based on weight and energy needs)
• Children 4–12 years:
  2–3 servings/day, adjusted based on clinical condition

Pregnant/Lactating Women:

• Typically 1–2 servings/day to meet increased energy, protein, and micronutrient demands

Elderly:

• 1–3 servings/day depending on nutritional status, sarcopenia risk, and comorbidities

Renal or Hepatic Impairment:

• Renal Disease:
  Use renal-specific formulations with reduced protein, potassium, phosphorus, and sodium.
• Hepatic Impairment:
  May require altered amino acid profiles (e.g., branched-chain amino acids in hepatic encephalopathy).

Administration Tips:

• Can be consumed between meals or as a meal replacement.
• Mix powder with milk/water as directed. Shake liquid forms well before use.
• Best taken chilled to improve palatability.

This comprehensive supplement provides macronutrients (proteins, fats, carbohydrates) for energy production, cellular repair, and anabolic processes, alongside micronutrients (vitamins and minerals) that serve as essential cofactors in metabolic pathways. Proteins support muscle repair, enzymes, and immune function; fats deliver essential fatty acids and aid in hormone synthesis and cell membrane structure; carbohydrates supply immediate energy. Vitamins and minerals function in antioxidant defense, neurological health, bone integrity, and immune regulation, ensuring optimal physiological function and recovery during nutritional deficits.

This is a nutritional product, not a pharmacologic drug, but individual component pharmacokinetics are noted below:

• Protein (Amino Acids):
  Absorbed in the small intestine as peptides and amino acids; utilized for protein synthesis.
• Carbohydrates:
  Digested into glucose, absorbed rapidly; stored as glycogen or used for energy.
• Fats (Lipids):
  Digested by lipases into free fatty acids and monoglycerides; absorbed via lymphatics.
• Vitamins:
• Water-soluble (B-complex, C): Rapidly absorbed, not stored significantly; excess excreted in urine.
• Fat-soluble (A, D, E, K): Absorbed with dietary fat, stored in liver and adipose tissue.
• Minerals (e.g., calcium, iron, zinc):
  Absorbed via specific transporters; homeostasis regulated by hormonal control (e.g., PTH for calcium).

Onset of clinical improvement may take days to weeks depending on the severity of deficiency.

• Pregnancy:
  Nutritional supplements are considered safe and essential during pregnancy when taken in appropriate amounts. They provide critical macro- and micronutrients for fetal growth and maternal health.
• Lactation:
  Safe during breastfeeding. Provides essential nutrients to support milk production and maternal-infant nutritional balance.

Caution: Avoid megadoses of fat-soluble vitamins (A, D, E, K) unless medically indicated.

• Primary Class: Nutritional Supplement
• Subcategory: Oral Nutritional Therapy (Macronutrient & Micronutrient formulation)

• Known hypersensitivity to any component of the formulation
• Metabolic disorders requiring restricted intake, such as:
• Galactosemia (for milk-based products)
• Maple syrup urine disease (for some amino acid-based supplements)
• Severe renal or hepatic failure, unless using condition-specific formulas
• Hypervitaminosis A or D (for fat-soluble vitamin-enriched products)

• Diabetic patients: Monitor carbohydrate content; use diabetic-friendly formulas if needed.
• Renal failure: Use protein-modified or electrolyte-restricted formulations.
• Hepatic dysfunction: May require BCAA-enriched, aromatic amino acid-restricted formulas.
• Allergies: Watch for lactose, soy, gluten, or nut-containing ingredients in commercial products.
• Tube feeding: Ensure appropriate viscosity and osmolarity for enteral use.
• Vitamin overdose risk: Particularly with fat-soluble vitamins (A, D, E, K) in chronic overuse.

Common (usually mild and transient):

• Gastrointestinal: Bloating, flatulence, nausea, mild diarrhea, or constipation
• Taste-related: Metallic or unpleasant aftertaste (especially in multivitamin formulations)

Serious/Rare:

• Allergic Reactions: Rash, itching, facial swelling, or anaphylaxis (rare)
• Fat-soluble Vitamin Toxicity (with chronic overuse):
• Hypervitaminosis A: Headache, blurred vision, liver toxicity
• Hypervitaminosis D: Hypercalcemia, nephrocalcinosis

Onset: Typically within hours to days
Severity: Generally mild; serious effects are rare and dose-related

• Minerals like calcium, iron, and magnesium:
  May interfere with absorption of tetracyclines, quinolones, and levothyroxine. Space dosing by 2–4 hours.
• Vitamin K-containing products:
  May reduce warfarin efficacy—monitor INR if co-administered.
• Fat-soluble vitamins:
  Absorption may decrease with cholestyramine, orlistat, and mineral oil.
• Zinc or Iron supplements:
  High doses may interfere with copper absorption; balance required in long-term use.
• Carbohydrates:
  May increase glycemic load in diabetic patients.

No major CYP450 enzyme interactions reported.

• ESPEN (2023):
  Emphasizes early nutritional intervention in hospitalized patients at risk of malnutrition.
• WHO/UNICEF Guidance (2023):
  Advocates for micronutrient powders in children under 5 in malnourished regions.
• Updated RDA/AI (USDA & EFSA, 2023):
  Slightly increased protein intake recommendations for elderly and critically ill patients.
• Special Formulas Introduced (2024):
  Condition-specific formulas now widely available (renal, hepatic, diabetes, high-protein for sarcopenia).

• Powder Form:
• Store at 20°C to 25°C (68°F to 77°F)
• Keep in a dry place; protect from moisture and light
• Reseal tightly after opening
• Use within 30 days of opening the container
• Liquid Form (RTD):
• Store unopened bottles at room temperature
• Once opened, refrigerate and consume within 24 hours
• Reconstitution:
• Mix with cooled boiled water or milk as directed
• Consume immediately or store refrigerated for up to 24 hours
• Handling:
• Do not freeze
• Shake well before use (liquids)
• Use clean utensils to avoid contamination