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NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis

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About the medicine

How to use NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis

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This page provides general information and does not replace a doctor’s consultation. Always consult a doctor before taking any medication. Seek urgent medical care if symptoms are severe.

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Introduction

Package Leaflet: Information for the User

Nutrineal PD4 with 1.1% Amino Acids with Integrated Disconnection System, Solution for Peritoneal Dialysis

Read the entire package leaflet carefully before starting to use this medication, as it contains important information for you.

  • Keep this package leaflet, as you may need to read it again.
  • If you have any questions, consult your doctor.
  • If you experience side effects, consult your doctor, even if they are not listed in this package leaflet. See section 4.

Contents of the Package Leaflet:

  1. What is Nutrineal and what is it used for.
  2. What you need to know before starting to use Nutrineal
  3. How to use Nutrineal
  4. Possible side effects
  5. Storage of Nutrineal
  6. Package Contents and Additional Information

1. What is Nutrineal and what is it used for

Nutrineal is a peritoneal dialysis solution that does not contain glucose. It removes water and waste products from the blood and corrects abnormal levels of various blood components.

Nutrineal may be prescribed for you:

  • especially if you are malnourished.
Doctor consultation

Not sure if this medicine is right for you?

Discuss your symptoms and treatment with a doctor online.

2. What you need to know before starting to use Nutrineal

Your doctor will assess whether Nutrineal is a suitable solution for your peritoneal dialysis treatment. They will take into account any factors in your medical history that may exclude the use of peritoneal dialysis solutions.

Do not use Nutrineal

You should not use Nutrineal:

Warnings and Precautions

Consult your doctor before starting to use Nutrineal:

  • during peritoneal dialysis, your body may lose proteins, amino acids, and vitamins. Your doctor will determine if you need to replace these losses.
  • You should also be aware that a disorder called encapsulating peritoneal sclerosis (EPS) is a rare and known complication of peritoneal dialysis therapy. You, probably together with your doctor, should be aware of this possible complication. EPS causes:
  • abdominal inflammation (belly)
  • growth of the layers of fibrous tissue that cover and connect the organs, which will affect their normal movement. In rare cases, it has been fatal
  • your doctor will regularly check your potassium levels. If they drop too low, you may be given potassium chloride to compensate.
  • Your doctor will inform you of the specific precautions for you. Your doctor will monitor your blood parameters at regular intervals and ensure they are adequate during treatment.
  • You, probably together with your doctor, will keep a record of your protein intake in your diet, your fluid balance, and your body weight.

Using Nutrineal with other medications

  • Tell your doctor if you are using, have used, or may need to use any other medication. If you use other medications, your doctor may need to increase your dose since peritoneal dialysis treatment increases the elimination of certain medications.
  • Be careful if you use heart medications called cardiac glycosides (e.g., digoxin). Your heart medications may not be as effective or their toxicity may be increased. You may:
  • need potassium and calcium supplements
  • develop cardiac arrhythmias
  • Your doctor will closely monitor you during treatment, especially your potassium and magnesium levels.

Pregnancy and Breastfeeding

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor before using this medication. The use of Nutrineal is not recommended during pregnancy or breastfeeding, unless your doctor advises otherwise.

Driving and Using Machines:

This treatment can cause weakness, general discomfort, or decreased fluid volume in your body (hypovolemia). Do not drive or use machines if you are affected.

3. How to use Nutrineal

Nutrineal should be administered into your peritoneal cavity. This cavity is located in the abdomen (belly) between the skin and the peritoneum. The peritoneum is the membrane that surrounds the internal organs, such as the intestines or liver.

Nutrineal is not for intravenous use.

Follow your doctor's instructions for administering this medication exactly. If in doubt, ask your doctor.If the bag is damaged, it should be discarded.

Dose and Frequency

Your doctor will tell you the appropriate number of bags to use. Normally, it varies between one 2.0-liter bag and one 2.5-liter bag per day.

Use in Children and Adolescents

If you are under 18 years old, your doctor will carefully evaluate whether you should be given Nutrineal.

Your doctor will re-evaluate the treatment after 3 months if your nutritional status does not improve.

Method of Administration

Before use:

  • Warm the bag to 37 °C. Use the specially designed heating plate for this purpose. Never submerge the bag in water to warm it. Never use a microwave oven to warm the bag.
  • Remove the overbag and administer the solution immediately.
  • Only use the solution if it is transparent and the packaging is not damaged.
  • Use each bag only once. Discard any unused solution.

You should use an aseptic technique during the entire administration of the solution, as you have been taught.

Compatibility with other medications

Your doctor may prescribe other injectable medications to add directly to the Nutrineal bag. In this case, add the medication through the medication addition site. Use the product immediately after adding the medication. Consult your doctor if you are unsure.

If you use more than one Nutrineal bag in 24 hours

If you are given an excessive dose of Nutrineal, you may experience:

  • abdominal distension
  • stomach heaviness

Contact your doctor immediately. They will inform you of what to do.

If you interrupt treatment with Nutrineal

Do not interrupt peritoneal dialysis without your doctor's consent. Interrupting treatment can have life-threatening consequences.

If you have any further questions about using this medication, ask your doctor.

Medicine questions

Started taking the medicine and have questions?

Discuss your symptoms and treatment with a doctor online.

4. Possible side effects

Like all medications, this medication can cause side effects, although not everyone experiences them.

If you experience side effects, consult your doctor, even if they are not listed in this package leaflet.

If you notice any of the following side effects, inform your doctor or peritoneal dialysis unit immediately:

  • Abdominal pain

Very common side effects (affect more than 1 in 10 patients treated with Nutrineal):

  • Nausea, vomiting
  • Anorexia (prolonged eating disorder due to loss of appetite)
  • Gastritis (stomach inflammation)
  • Feeling of weakness
  • Increased fluid volume in the body (hypervolemia)
  • High levels of acidic substances in the body (acidosis)

Common side effects (affect more than 1 in 100 patients treated with Nutrineal):

  • Anemia
  • Depression
  • Breathing difficulties
  • Abdominal pain
  • Decreased fluid volume in the body (hypovolemia)
  • Decreased potassium levels in the blood (hypokalemia)
  • Infection

Side effects that have been reported (affect an unknown number of patients treated with Nutrineal):

  • Peritonitis
  • Cloudy peritoneal effluent
  • Abdominal discomfort
  • Fever
  • General discomfort
  • Itching
  • Hypersensitivity reaction (an allergic reaction)
  • Severe allergic reactions that cause inflammation of the face or throat (angioedema)

Other side effects related to the peritoneal dialysis procedure:

  • Infection around the catheter exit site
  • Catheter-related complications
  • Decreased calcium levels (hypocalcemia) in the blood.

Reporting side effects

If you experience any side effects, consult your doctor, pharmacist, or nurse, even if they are not listed in this package leaflet. You can also report them directly through the Spanish Medicines Monitoring System for Human Use*. By reporting side effects, you can help provide more information on the safety of this medication.

5. Storage of Nutrineal

  • Keep this medication out of sight and reach of children.
  • Store in the original package.
  • Store below 30 °C and protect from light.
  • Do not use this medication after the expiration date shown on the carton and on the bag after EXP. The expiration date is the last day of the month indicated.

Discard Nutrineal as instructed.

Medications should not be disposed of through wastewater or household waste. Ask your pharmacist how to dispose of the packaging and medications you no longer need. This will help protect the environment.

6. Package Contents and Additional Information

This package leaflet does not contain all the information about this medication. If you have any questions, ask your doctor.

Composition of Nutrineal PD4 with 1.1% Amino Acids

The active substances are:

Nutrineal PD4 with 1.1% Amino Acids

Composition in mg/l

Amino acid mixture:

Alanine

951

Arginine

1071

Glycine

510

Histidine

714

Isoleucine

850

Leucine

1020

Lysine, HCl

955

Methionine

850

Phenylalanine

570

Proline

595

Serine

510

Threonine

646

Tryptophan

270

Tyrosine

300

Valine

1393

Sodium chloride

5380

Calcium chloride dihydrate

184

Magnesium chloride hexahydrate

51

Sodium lactate

4480

Composition in mmol/l

Amino acids

87.16

Sodium

132

Calcium

1.25

Magnesium

0.25

Lactate

40

Chloride

105

The other components are:

  • Water for injectable preparations
  • Concentrated hydrochloric acid.

Appearance of the Product and Package Contents

  • Nutrineal is packaged in a 1.5, 2.0, or 2.5-liter PVC plastic bag.
  • Each bag is wrapped in an overbag and supplied in cardboard boxes.

Volume

Number of units per box

Product Presentation

1.5 l

6

Double bag

2.0 l

5

Double bag

2.0 l

6

Double bag

2.0 l

8

Double bag

2.5 l

4

Double bag

Not all types of bags may be marketed.

Marketing Authorization Holder and Manufacturer

Marketing Authorization Holder:

VANTIVE HEALTH S.L.

Calle Pouet de Camilo, 2 - Polígono Industrial Sector 14

46394 Ribarroja del Turia (Valencia) Spain

Manufacturer:

Vantive Manufacturing Limited

Moneen Road

Castlebar

County Mayo, Ireland

Date of the last revision of this package leaflet: May 2016.

Detailed and updated information on this medication is available on the website of the Spanish Agency for Medicines and Health Products (AEMPS). http://www.aemps.gob.es/

Online doctors for NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis

Discuss questions about NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis, including use, safety considerations and prescription review, subject to medical assessment and local regulations.

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Tarek Agami

General medicine 11 years exp.

Dr. Tarek Agami is a general practitioner registered in both Portugal and Israel, with broad experience in family and preventive medicine. He offers online consultations for adults and children, providing personalised support for primary care needs, chronic disease management, and everyday health concerns.

Dr. Agami received clinical training and worked in leading medical institutions in Israel (Kaplan Medical Center, Barzilai Medical Center, Wolfson Medical Center) and Portugal (European Healthcare City, Viscura Internacional, Hospital Dr. José Maria Grande, Hospital Vila Franca de Xira). His approach combines international medical standards with individualised attention to each patient.

Main areas of consultation:

  • Diagnosis and treatment of acute and chronic conditions (high blood pressure, diabetes, respiratory infections, cardiovascular symptoms)
  • Evaluation of symptoms and guidance on further diagnostic testing
  • Preventive check-ups and regular health monitoring
  • Medical support during travel or after relocation
  • Treatment adjustments and lifestyle recommendations based on your personal history
Dr. Agami provides medical support for patients using GLP-1 medications (such as Ozempic or Mounjaro) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Portugal and Israel.

Dr. Agami is committed to evidence-based, patient-centred care, ensuring that each person receives trusted medical support tailored to their health goals.

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Nuno Tavares Lopes

Family medicine 18 years exp.

Dr. Nuno Tavares Lopes is a licensed physician in Portugal with 17 years of experience in emergency medicine, family and general practice, and public health. He is the Director of Medical and Public Health Services at an international healthcare network and serves as an external consultant for the WHO and ECDC.

  • Emergency care: infections, fever, chest/abdominal pain, minor injuries, paediatric emergencies
  • Family medicine: hypertension, diabetes, cholesterol, chronic disease management
  • Travel medicine: pre-travel advice, vaccinations, fit-to-fly certificates, travel-related illnesses
  • Sexual and reproductive health: PrEP, STD prevention, counselling, treatment
  • Weight management and wellness: personalised weight loss programmes, lifestyle guidance
  • Skin and ENT issues: acne, eczema, allergies, rashes, sore throat, sinusitis
  • Pain management: acute and chronic pain, post-surgical care
  • Public health: prevention, health screenings, long-term monitoring
  • Sick leave (Baixa médica) connected to Segurança Social in Portugal
  • IMT medical certificates for driving licence exchange
Dr. Nuno Tavares Lopes provides medical support for patients using GLP-1 medications (Mounjaro, Wegovy, Ozempic, Rybelsus) as part of a weight loss strategy. He offers individualised treatment planning, regular follow-up, dose adjustment, and advice on combining medication with sustainable lifestyle changes. Consultations follow the medical standards accepted in Europe.

Dr. Lopes also provides interpretation of medical tests, follow-up care for complex patients, and multilingual support. Whether for urgent concerns or long-term care, he helps patients act with clarity and confidence.

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Anastasiia Shalko

Family medicine 13 years exp.

Dr. Anastasiia Shalko is a general practitioner with a background in both paediatrics and general medicine. She graduated from Bogomolets National Medical University in Kyiv and completed her paediatric internship at the P.L. Shupyk National Medical Academy of Postgraduate Education. After working as a paediatrician in Kyiv, she relocated to Spain, where she has been practising general medicine since 2015, providing care for both adults and children.

Her work focuses on urgent, short-term medical concerns – situations where patients need quick guidance, symptom assessment and clear next steps. She helps people understand whether their symptoms require in-person evaluation, home management or a change in treatment. Common reasons for booking an online consultation include:

  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
  • gastrointestinal complaints (nausea, diarrhoea, abdominal pain, gastroenteritis)
  • sudden changes in how a child or adult feels
  • questions about existing treatment and whether adjustments are needed
  • renewal of prescriptions when clinically appropriate
Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.

She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.

With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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Daniel Cichi

Family medicine 24 years exp.

Dr Daniel Cichi is a family medicine doctor with over 20 years of clinical experience. He provides online consultations for adults, supporting patients with acute symptoms, chronic conditions, and everyday health concerns that require timely medical guidance.

His background includes work in emergency care, ambulance services, and family medicine, which allows him to assess symptoms quickly, identify warning signs, and help patients choose the safest next steps – whether that means home care, treatment adjustment, or in-person evaluation.

Patients commonly consult Dr Daniel Cichi for:

  • acute symptoms: fever, infections, flu-like illness, cough, sore throat, shortness of breath;
  • chest discomfort, palpitations, dizziness, fatigue, and blood pressure concerns;
  • digestive problems: abdominal pain, nausea, diarrhoea, constipation, reflux;
  • muscle, joint, and back pain, minor injuries, post-traumatic symptoms;
  • chronic conditions: hypertension, diabetes, high cholesterol, thyroid disorders;
  • review and interpretation of lab tests, imaging reports, and medical documents;
  • medication review and treatment adjustment;
  • medical advice while travelling or living abroad;
  • second opinions and guidance on whether in-person care is needed.
Dr Cichi’s consultations are structured and practical. He focuses on clear explanations, risk assessment, and actionable recommendations, helping patients understand their symptoms and make informed decisions about their health.
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Frequently Asked Questions

Is a prescription required for NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis?
NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis requires a prescription in Spain. You can check with a doctor online whether this medicine may be appropriate for your situation.
Who manufactures NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis?
NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis is manufactured by Vantive Health S.L.. Pharmacy brands and packaging may differ depending on the distributor.
Which doctors can assess the use of NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis online?
Doctors such as Family doctors, Psychiatrists, Dermatologists, Cardiologists, Endocrinologists, Gastroenterologists, Pulmonologists, Nephrologists, Rheumatologists, Hematologists, Infectious disease physicians, Allergists, Geriatricians, Paediatricians, Oncologists may assess whether NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis is appropriate, depending on your situation and local regulations. You can book an online consultation to discuss your symptoms and possible next steps.
What are the alternatives to NUTRINEAL PD4 with 1.1% Amino Acids with Integrated Disconnect System, Solution for Peritoneal Dialysis?
Other medicines with the same active substance () include NUTRINEAL PD4 WITH 1.1% AMINO ACIDS, SOLUTION FOR PERITONEAL DIALYSIS, BICAVERA GLUCOSA 1.5%, Calcium 1.75 mmol/l SOLUTION FOR PERITONEAL DIALYSIS, BICAVERA GLUCOSA 2.3%, Calcium 1.75 mmol/l SOLUTION FOR PERITONEAL DIALYSIS. These may have different brand names or formulations but contain the same therapeutic ingredient. Always consult a doctor before switching or starting a new medicine.
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