Lipid Emulsion
Intravenous Lipid Emulsion (ILE)
Also known as: Intralipid · ClinOleic · Lipofundin · Omegaven · ILE · Intravenous Lipid Emulsion · Lipid Rescue
Reviewed by the VetSheet Veterinary TeamUpdated Apr 5, 2026Evidence-based veterinary reference
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Dosing by species
🌎 NA — North America🌍 EU — Europe
Dogs
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Parenteral nutrition | Supply 30% (partial peripheral) to 40-60% of energy requirements | IV | continuous | As required | 🌍 EU |
| Treatment of lipid-soluble toxicosis (e.g., ivermectin, moxidectin) | 1.5-5 ml/kg of 20% lipid solution as bolus, followed by 0.25-0.50 ml/kg/min infusion. Boluses of 1.5 ml/kg can be repeated. | IV | bolus followed by continuous infusion | Infusion for 30-60 min (maximum 24 hours) | 🌍 EU |
- Parenteral nutrition: Amount governed by physiological status
- Treatment of lipid-soluble toxicosis (e.g., ivermectin, moxidectin): Infusions of 0.5 ml/kg/min can be administered for a maximum of 24 hours.
Cats
| Indication | Dose | Route | Frequency | Duration | Region |
|---|---|---|---|---|---|
| Parenteral nutrition | Supply 40-60% of energy requirements | IV | continuous | As required | 🌍 EU |
| Treatment of lipid-soluble toxicosis (e.g., ivermectin, moxidectin) | 1.5-5 ml/kg of 20% lipid solution as bolus, followed by 0.25-0.50 ml/kg/min infusion. Boluses of 1.5 ml/kg can be repeated. | IV | bolus followed by continuous infusion | Infusion for 30-60 min (maximum 24 hours) | 🌍 EU |
- Parenteral nutrition: Generally used as an energy source in a nutrient admixture for infusion through central venous access (total parenteral nutrition).
- Treatment of lipid-soluble toxicosis (e.g., ivermectin, moxidectin): Infusions of 0.5 ml/kg/min can be administered for a maximum of 24 hours.
Doses are a clinical reference for licensed veterinary professionals. Always confirm against the current label and the individual patient.
Overview
Intravenous lipid emulsions (ILE) are sterile, non-pyrogenic fat emulsions used primarily for parenteral nutrition to provide a dense source of calories and essential fatty acids. In emergency veterinary medicine, they are increasingly utilized as an antidote for lipophilic drug toxicities (e.g., avermectins, local anesthetics like bupivacaine).
Clinical Warning: Use with extreme caution in patients with insulin resistance (e.g., diabetes mellitus) or those at risk of pancreatitis. Strict aseptic technique is mandatory as the emulsion strongly supports microbial growth.
Clinical Pearl: The use of ILE for toxicosis is often referred to as 'Lipid Rescue' therapy.
Mechanism of action
As a nutritional supplement, lipid emulsions provide triglycerides which are hydrolyzed by lipoprotein lipase into free fatty acids and glycerol, entering cellular metabolism via beta-oxidation to produce ATP.
As an antidote, the primary mechanism is the 'lipid sink' theory: the infusion creates an expanded intravascular lipid phase that sequesters highly lipophilic toxins (e.g., bupivacaine, ivermectin) away from target organs (brain, heart) → reducing clinical toxicity.
Safety & warnings
Contraindications
- Insulin resistance (e.g., diabetes mellitus)
- Hyperlipidaemia
- Disrupted fat metabolism
Adverse effects
- Febrile episodes (mainly with 20% emulsions)
- Vasculitis
- Thrombosis
- Anaphylaxis (rare)
- Hepatic failure (with prolonged treatment)
- Pancreatitis (with prolonged treatment)
- Cardiac arrest (with prolonged treatment)
- Thrombocytopenia (with prolonged treatment)
Precautions
Do not use if separation of the emulsion occurs. Lines for IV parenteral feeding must be dedicated for that use alone. Daily checks are necessary to ensure complete clearance from the plasma. 20% and 30% lipid products have a higher rate of complications for nutritional use and are generally not recommended for standard parenteral nutrition.
Drug interactions
Physical incompatibility; requires dedicated IV line for parenteral feeding
Lipaemia interferes with blood gas and calcium measurements if samples are taken before fat is cleared
Monitoring
- Plasma clearance (visual lipaemia or serum triglycerides daily)
- Blood glucose
- Pancreatic enzymes
- Coagulation profile (if prolonged use)
Pharmacokinetics
Half-life
Absorption
100% bioavailable via intravenous administration.
Distribution
Confined to the plasma compartment initially, acting as a lipid sink for lipophilic drugs.
Metabolism
Metabolized via normal lipid pathways (lipoprotein lipase) into free fatty acids and glycerol.
Elimination
Cleared from plasma by cellular uptake and metabolism.
Overdose
Overdosage or failure to clear lipids can lead to fat overload syndrome, characterized by hyperlipidaemia, fever, jaundice, hepatosplenomegaly, and coagulopathy. Treatment involves immediate cessation of the infusion and supportive care.
Available products
Formulations
- Injectable: 10% solution (contains soya oil emulsion, glycerol, purified egg phospholipids, phosphate 15 mmol/l; 2 kcal/ml, 268 mOsm/l)
- Injectable: 20% solution
- Injectable: 30% solution
Human-labeled
- ClinOleic
- Intralipid
- Ivelip
- Lipidem
- Lipofundin
- Omegaven
Regulatory status
Human registered products used under the cascade.
Human registered products used under the cascade (POM).
No regulatory data for: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Storage & stability
Store according to manufacturer instructions, typically at room temperature (do not freeze). Discard immediately if the emulsion separates or shows signs of contamination. Strict aseptic handling is required.
Client information
This medication is administered intravenously in a hospital setting. It is used either to provide essential nutrition when your pet cannot eat or absorb food normally, or as a life-saving emergency treatment to draw certain toxins out of your pet's system. Your veterinary team will closely monitor your pet's bloodwork to ensure their body is processing the fats correctly.
VetSheet drug reference is intended for licensed veterinary professionals as a clinical decision-support aid, not a substitute for professional judgement or the manufacturer’s current label.