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As an antioxidant, lipoic acid is widely used in Japan, Europe and the United States to treat diabetic peripheral neuropathy, and is also used to improve metabolism, enhance immunity, lose weight, beauty and health care. At present, it is only approved for the treatment of diabetic peripheral neuropathy in China.
How is lipoic acid properly administered? What do I need to pay attention to when taking medication? Jiexiaoyao sorted it out as follows for clinical reference.
How to determine the dosage?
▌ Injections
Lipoic acid can be given intravenously or intramuscularly, and the intravenous injection should be slow, with a maximum rate of 50 mg or 2 mL per minute. This product can also be added to normal saline intravenous infusion, such as 250-500mg of lipoic acid is equivalent to 10-20mL of injection, added to 100-250mL of normal saline, intravenous infusion time is about 30 minutes[1-6].
Unless otherwise advised, patients with paresthesias caused by severe diabetic peripheral neuropathy can be administered by intravenous infusion, 300-600mg per day, which is equivalent to 12-24mL of this product. Treatment is a two- to four-week course [1-6].
▌Tablets, capsules
Oral, 0.2g/time, 3 times/day, or 0.6g/time, 1 time/day, taken half an hour before breakfast. For more severe symptoms, it is recommended to start with injections. Because diabetic peripheral neuropathy is a chronic disease, it is generally necessary to take it for a long time, and the specific duration of use depends on individual characteristics [1-6].
This product can only be mixed with salt!
1. Lipoic acid cannot be used in combination with glucose solution, Ringer's solution and all solutions that may react with sulfur-based or disulfide bonds. This product can only be diluted with normal saline during infusion.
2. Food will affect the absorption of this product, so lipoic acid and food should be taken separately.
3. Lipoic acid may enhance the hypoglycemic effect of insulin and oral hypoglycemic drugs. Therefore, blood glucose should be monitored closely, especially when starting treatment with this product. To avoid excessive lowering of blood sugar levels, doctors may need to lower the dose of insulin and oral hypoglycemic drugs in some people.
4. Regular alcohol consumption is a significant risk factor for the occurrence and development of neurological diseases, and can counteract the efficacy of the drug. Patients with diabetic peripheral neuropathy are advised to avoid alcohol if possible, even at drug-free intervals [1-6].
How can adverse reactions be avoided?
Through the analysis of relevant researchers, it was found that the occurrence of adverse reactions (ADRs) of lipoic acid injection was related to a variety of factors, such as the patient's history of drug allergy, whether the patient was accompanied by cardiovascular diseases such as hypertension and hyperlipidemia, the indications for off-label drug instructions, usage and dosage, solvent dosage, drug concentration, intravenous infusion speed, the quality of the preparation of lipoic acid injection, whether it was prepared and used, and whether it was used and stored in light [7].
Based on the results of the analysis, several suggestions are made:
(1) Before using the drug, the patient should be carefully asked whether he has a history of food or drug allergies, and if so, the patient should be closely observed during the infusion process. For patients with hypertension and hyperlipidemia, please focus on monitoring their drug reactions when using this drug to avoid serious ADR events.
(2) It is recommended that physicians strictly follow the indications, usage and dosage specifications in the instructions, and try not to use drugs off-label to reduce the occurrence of ADR without obtaining high-level evidence-based medical evidence.
(3) Ensure the appropriate infusion speed and drug concentration, and ensure that the intravenous infusion time of lipoic acid injection is greater than 30min according to the instructions, and pay attention to the use of light. The medicine you want
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References: [1] Drug information: Lipoic acid injection, Yabao Pharmaceutical Group Co., Ltd., Sinopharm Zhunzi H20055869; 2020/12/09.
[2] Drug information: lipoic acid injection, Germany Shistade Pharmaceutical Factory, Sinopharm Zhun Zi H20150670; 2015/12/10.
[3] Drug information: lipoic acid for injection, Yantai Zhichu Pharmaceutical Co., Ltd., Sinopharm Zhun Zi H20080523; 2011/8/19.
[4] Drug information: lipoic acid tablets, Shandong Qidu Pharmaceutical Co., Ltd., Guoyao Zhunzi H20100152; 2011/06/29.
[5] Drug information: lipoic acid capsules, Penglai Nuokang Pharmaceutical Co., Ltd., Sinopharm Zhunzi H20133253; 2014/07/09.
[6] Drug information: lipoic acid capsules, Jiangsu Wanhe Pharmaceutical Co., Ltd., Guoyao Zhunzi H20100158; 2010/10/19.
[7] Yang Xiuting, Chen Honghong, Liu Guifeng, et al. Retrospective analysis of 29 cases of adverse reactions to lipoic acid injection in a hospital[J].Drug Evaluation, 2021.
