Trace Elements

Name: Trace Elements

Brand Names U.S.

  • Addamel N [DSC]
  • Multitrace-4
  • Multitrace-4 Concentrate
  • Multitrace-4 Neonatal
  • Multitrace-4 Pediatric
  • Multitrace-5
  • Multitrace-5 Concentrate
  • Peditrace [DSC]
  • Trace Elements 4 Pediatric


Chromium: Helps to maintain normal glucose metabolism and peripheral nerve function and prevents development of impaired glucose tolerance, ataxia, peripheral neuropathy, and a confusional state similar to mild/moderate hepatic encephalopathy.

Copper: Cofactor for serum ceruloplasmin, an oxidase necessary for proper formation of the iron carrier protein, transferrin; also helps maintain normal rates of red and white blood cell formation and prevents development of leukopenia, neutropenia, anemia, depressed ceruloplasmin levels, impaired transferrin formation and secondary iron deficiency.

Manganese: Activator for enzymes such as polysaccharide polymerase, liver arginase, cholinesterase and pyruvate carboxylase and prevents development of nausea and vomiting, weight loss, dermatitis, and changes in growth and hair color.

Selenium: Protects cell components from oxidative damage due to peroxides produced in cellular metabolism and prevents development of muscle pain and tenderness.

Zinc: Facilitates wound healing, helps maintain normal growth rates, normal skin hydration and senses of taste and smell and prevents development of parakeratosis, hypogeusia, anorexia, dysosmia, geophagia, hypogonadism, growth retardation and hepatosplenomegaly.


Chromium: Urine and bile

Copper: Feces

Manganese: Feces (primarily); ancillary routes via pancreatic secretions or reabsorption into the intestinal lumen

Selenium: Urine, feces

Zinc: Urine, feces


Administration of undiluted solutions by direct injection into a peripheral vein.

Dosing Hepatic Impairment

There are no dosage adjustments provided in the manufacturer's labeling; decrease dose or omit copper and manganese in pediatric patients with severe hepatic impairment and/or biliary tract obstruction.


For IV use only. Must be diluted prior to use and infused as component of parenteral nutrition or parenteral solutions. Do not administer undiluted solutions by direct injection into a peripheral vein. Multitrace 4 Neonatal solution is acidic; do not use syringes with aluminum needles or hubs.

Patient Education

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.