A.S.P.E.N. position paper: recommendations for changes in commercially available parenteral multivitamin and multi-trace element products

Nutr Clin Pract. 2012 Aug;27(4):440-91. doi: 10.1177/0884533612446706. Epub 2012 Jun 22.


The parenteral multivitamin preparations that are commercially available in the United States (U.S.) meet the requirements for most patients who receive parenteral nutrition (PN). However, a separate parenteral vitamin D preparation (cholecalciferol or ergocalciferol) should be made available for treatment of patients with vitamin D deficiency unresponsive to oral vitamin D supplementation. Carnitine is commercially available and should be routinely added to neonatal PN formulations. Choline should also be routinely added to adult and pediatric PN formulations; however, a commercially available parenteral product needs to be developed. The parenteral multi-trace element (TE) preparations that are commercially available in the U.S. require significant modifications. Single-entity trace element products can be used to meet individual patient needs when the multiple-element products are inappropriate (see Summary/A.S.P.E.N. Recommendations section for details of these proposed modifications).

MeSH terms

  • Avitaminosis / drug therapy
  • Carnitine / administration & dosage
  • Choline / administration & dosage
  • Dietary Supplements*
  • Dietetics / standards
  • Guidelines as Topic
  • Humans
  • Nutritional Requirements
  • Parenteral Nutrition / standards*
  • Parenteral Nutrition Solutions / standards*
  • Trace Elements / administration & dosage*
  • Trace Elements / deficiency
  • United States
  • United States Food and Drug Administration
  • Vitamins / administration & dosage*


  • Parenteral Nutrition Solutions
  • Trace Elements
  • Vitamins
  • Choline
  • Carnitine