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Dear Readers! I started this blog when my daughter was in the NICU. She had ventriculitis. Her CSF report grew E.coli. But, she was injected Teicoplanin directly into her brain. The doctors made two errors here:

Teicoplanin is for gram-positive bacteria only. It does not treat E.coli.
Teicoplanin is not for intraventricular use. The manufacturer strongly discourage injecting Teicoplanin into the brain.

My daughter bled into the brain. She lived for another two years and ultimately died.

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Selenium Food Supplements: Uses, Dose, MOA, Brands, Side effects

Selenium is a trace mineral that is used by the human body for the proper functioning of enzymatic processes. It is used as a cofactor in various enzyme-related metabolic pathways. Selenium is especially being used as a supplement in individuals with impotence, sexual dysfunction, and infertility.

Selenium Uses:

It is a trace mineral supplement used for the proper functioning of enzymatic processes.

Vitamin B complex (Neurobion) Brands

Selenium Dose in Adults

Dose as an additive in parenteral nutrition:

IV: It is administered intravenously in a dose of 60 to 100 mcg/day.

Dose in the Deficiency from prolonged parenteral nutrition:

IV: It is given intravenously once daily at a dose of 100 mcg.

Selenium Dose in Children

Selenium Oral dose in children for adequate nutrition:

7-12 months: 20 mcg per day
1-6 months: 15 mcg per day

Recommended daily allowance (RDA) of Selenium:

9-13 years: 40 mcg per day orally
4-8 years: 30 mcg per day orally
14-18 years: 55 mcg per day orally
1-3 years: 20 mcg per day orally

Dose as a maintenance requirement in parenteral nutrition: IV:

Infants, Children, and Adolescents:
- Manufacturer's labeling:
  - 3 mcg per kg per day intravenously;
  - The daily intake shouldn't be more than 40 mcg.

ASPEN recommendations:

Age-directed dosing:
- Infants, Children, and Adolescents:
  - 1 to 3 mcg/kg/day intravenously;
  - The maximum daily dose should not exceed 100 mcg/day
Weight-directed dosing:
- Children 10-40 kg:
  - 1 to 2 mcg/kg/day;
  - The daily dose shouldn't be more than 60 mcg/day
- Infants less than 10 kg:
  - 2 mcg per kg per day
- Adolescents more than 40 kg:
  - 40 to 60 mcg per day

Pregnancy Risk Category: C

High doses of drugs were associated with adverse events in animal studies.
It can be found in cord blood and the placenta. Nontoxic doses of non-toxic substances in humans have not shown any teratogenic effects.

Use during breastfeeding:

Breast milk contains selenium. The time after birth and maternal intake affect the concentrations.
Nontoxic maternal intake has not been associated with adverse events in humans

Dose in kidney disease:

The manufacturer has made no recommendations on dosage changes.

Dose in Liver disease:

In individuals with liver disorders, the manufacturer has not suggested changing the dosage.

Side effects of Selenium:

Local:
- Local irritation when administered IV.

Contraindications to Selenium:

Administration of undiluted solution into the peripheral vein should be avoided.

Warnings and Precautions

Gastrointestinal dysfunction:
- Patients with GI impairment should be cautious.
Renal impairment
- Patients with impaired renal function should be cautious.

Selenium: Drug Interaction

Risk Factor C (Monitor therapy)
Bictegravir	Products containing polyvalent cations may lower bictegravir's serum levels. Treatment: Bicategravir should be administered while fasting at least two hours before or six hours after using products containing polyvalent cations. It is not advised to take bictegravir at the same time as or two hours after most polyvalent cation products.
Bisphosphonate Derivatives	Products containing polyvalent cations may lower the level of bisphosphonate derivatives in the serum. The following oral drugs should not be used within the following time frames: 2 hours before or after tiludronate/clodronate/etidronate; 60 minutes after oral ibandronate; or 30 minutes after alendronate/risedronate. Pamidronate and zoledronic acid are exceptions.
Deferiprone	Products containing polyvalent cations may lower the level of deferiprone in the serum. Treatment: Give deferiprone at least four hours apart from oral drugs or dietary supplements containing polyvalent cations.
Dolutegravir	Selenium may lower the level of dolutegravir in the serum. Treatment: Dolutegravir should be administered at least two hours before or six hours after oral selenium. Dolutegravir/rilpivirine combo products should be administered at least 4 hours before or 6 hours after oral selenium.
Eltrombopag	Products containing polyvalent cations may lower the serum concentration of eltrombopag. Treatment: Give eltrombopag at least two hours before or four hours after taking any oral medication containing polyvalent cations.
PenicillAMINE	Products containing polyvalent cations may lower the level of penicillAMINE in the serum. Treatment: Give oral medications containing polyvalent cations and penicillamine at least an hour apart.
Raltegravir	Products containing polyvalent cations may lower the level of raltegravir in the blood. Treatment: Give raltegravir 2 hours prior to or 6 hours following the polyvalent cations. The impact of this interaction might not be sufficiently reduced by dose separation.
Trientine	Products containing polyvalent cations may lower the level of trientine in the serum. Management: Steer clear of combining the use of oral medications containing polyvalent cations with trientine. If you need to take oral iron supplements, space out the administration by two hours. Separate administration of other oral polyvalent cations by one hour if necessary.
Risk Factor X (Avoid combination)
Baloxavir Marboxil	Products containing polyvalent cations may lower the level of baloxavir marboxil in the serum.

Monitoring parameters:

Monitor Plasma selenium concentration every three to six months for patients receiving long-term parenteral nutrition.
Some patients such as those who have undergone a hematopoietic stem cell transplantation and are receiving parenteral nutrition may require more frequent monitoring).

How to administer Selenium?

Selenium is given as an oral supplement or administered intravenously.
Oral capsules, tablets, or syrups may be administered without regard to meals.
When it is administered as a part of parenteral nutrition, it should not be given as an intravenous bolus.
It is usually given in combination with other nutrients as a slow intravenous infusion that is administered over 4 to 8 hours.