Selenious Acid

Selenium injection is a sterile, nonpyrogenic solution for use as an additive to solutions for total parenteral nutrition (TPN).1

Each mL contains selenious acid 65.4 mcg (equivalent to elemental selenium 40 mcg/mL) and water for injection. pH may be adjusted with nitric acid to 1.8 to 2.4.1

Selenium has the following uses:

Selenium injection is indicated for use as a supplement to intravenous solutions given for total parenteral nutrition (TPN). Administration of selenium in TPN solutions helps to maintain plasma selenium levels and to prevent depletion of endogenous stores and subsequent deficiency symptoms.1

General

Selenium is available in the following dosage form(s) and strength(s):

Selenium injection containing selenious acid 65.4 mcg/mL (equivalent to elemental selenium 40 mcg/mL).1

Dosage

Selenium injection provides 40 mcg selenium/mL. For metabolically stable adults receiving TPN, the suggested additive dosage level is 20 to 40 mcg selenium/day. For pediatric patients, the suggested additive dosage level is 3 mcg/kg/day.1

In adults with selenium deficiency states resulting from long-term TPN support, selenium as selenomethionine or selenious acid, administered intravenously at 100 mcg/day for a period of 24 and 31 days, respectively, has been reported to reverse deficiency symptoms without toxicity.1

Aseptic addition of selenium injection to the TPN solution under laminar flow hood is recommended. Selenium is physically compatible with the electrolytes and other trace elements usually present in amino-acid/dextrose solution used for TPN. Frequent monitoring of plasma selenium levels is suggested as a guideline for subsequent administration. The normal whole blood range for selenium is approximately 10 to 37 mcg/100 mL.1

Parenteral drug products should be inspected visually for particulate matter and discoloration whenever solution and container permit.1

Selenium is part of glutathione peroxidase, which protects cell components from oxidative damage due to peroxides produced in cellular metabolism.1

Prolonged TPN support in humans has resulted in selenium deficiency symptoms which include muscle pain and tenderness. The symptoms have been reported to respond to supplementation of TPN solutions with selenium.1

Pediatric conditions, Keshan disease, and kwashiorkor have been associated with low dietary intake of selenium. The conditions are endemic to geographical areas with low selenium soil content. Dietary supplementation with selenium salts has been reported to reduce the incidence of the conditions among affected children.1

Normal blood levels of selenium in different human populations have been found to vary and depend on the selenium content of the food consumed.1

Plasma selenium levels of 0.3 and 0.9 mcg/100 mL have been reported to produce deficiency symptoms in humans.1

Selenium is eliminated primarily in urine. However, significant endogenous losses through feces also occur. The rate of excretion and the relative importance of two routes varies with the chemical form of selenium used in supplementation. Ancillary routes of elimination are lungs and skin.1

Excipients in commercially available drug preparations may have clinically important effects in some individuals; consult specific product labeling for details.

Please refer to the ASHP Drug Shortages Resource Center for information on shortages of one or more of these preparations.