Version May 2024
Chromium, parenteral nutrition supplement: Note: Chromium contamination is common with other parenteral nutrition products (eg, sodium phosphate, potassium phosphate, and magnesium sulfate), which decrease or eliminate the need for routine supplementation (Olson 2019).
Routine supplement: IV: No addition of chromium (or a maximum of 1 mcg/day), due to potential accumulation (Vanek 2012).
Deficiency, prevention: Note: For patients with high intestinal fluid loss who are receiving long-term parenteral nutrition (Jeejeebhoy 1977).
IV: 20 mcg/day added to parenteral nutrition (Jeejeebhoy 1977).
Deficiency, treatment: IV: 150 to 200 mcg/day for up to 2 weeks added to parenteral nutrition, then resume maintenance dose of 20 mcg/day added to parenteral nutrition (Brown 1986; Freund 1979).
There are no dosage adjustments provided in the manufacturer's labeling; use with caution; omit dose in patients with severe kidney disease (Gallieni 1996).
There are no dosage adjustments provided in the manufacturer's labeling.
Refer to adult dosing; use with caution.
(For additional information see "Chromium injection: Pediatric drug information")
Parenteral nutrition (PN) additive, maintenance requirement: Note: Chromium contamination is common with other PN products (eg, sodium phosphate, magnesium sulfate), which decreases or eliminates the need for routine supplementation; international guidelines recommend no additional supplementation is necessary (ASPEN [Corkins 2015]; ASPEN [Mirtallo 2004]; ESPGHAN/ESPEN/ESPR/CSPEN [Domellöf 2018]; Olson 2019; Srikrishnaraj 2021).
Infants, Children, and Adolescents: Note: Doses are expressed as elemental chromium, not chromic chloride.
ASPEN recommendations (ASPEN 2020):
≤40 kg: IV: 0.2 mcg/kg/day; maximum daily dose: 5 mcg/day.
>40 kg: IV: 5 to 15 mcg/day.
There are no dosage adjustments provided in the manufacturer's labeling; use with caution; chromium is renally eliminated; consider reducing or omitting chromium in patients with severe kidney disease.
There are no dosage adjustments provided in the manufacturer's labeling.
There are no adverse reactions listed in the manufacturer's labeling.
Direct IM or IV injection.
Concerns related to adverse effects:
• Aluminum toxicity: Contains aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or in patients with renal impairment. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of greater than 4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses.
Disease-related concerns:
• Renal impairment: Use with caution in patients with renal impairment; omit dose in patients with severe kidney disease (Gallieni 1996).
Strength of chromic chloride injection is expressed as elemental chromium
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Intravenous:
Generic: 40 mcg/10 mL (10 mL)
Yes
Solution (Chromic Chloride Intravenous)
40MCG/10ML (per mL): $2.38
Disclaimer: A representative AWP (Average Wholesale Price) price or price range is provided as reference price only. A range is provided when more than one manufacturer's AWP price is available and uses the low and high price reported by the manufacturers to determine the range. The pricing data should be used for benchmarking purposes only, and as such should not be used alone to set or adjudicate any prices for reimbursement or purchasing functions or considered to be an exact price for a single product and/or manufacturer. Medi-Span expressly disclaims all warranties of any kind or nature, whether express or implied, and assumes no liability with respect to accuracy of price or price range data published in its solutions. In no event shall Medi-Span be liable for special, indirect, incidental, or consequential damages arising from use of price or price range data. Pricing data is updated monthly.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Solution, Intravenous:
Micro-Cr: 40 mcg/10 mL (10 mL)
IV: For IV use only. Must be diluted prior to use in a volume of fluid not less than 100 mL. Do not administer undiluted by direct injection into a peripheral vein. Solution is acidic; direct intramuscular (IM) or intravenous (IV) injection is contraindicated.
Parenteral: IV: For IV use only. Must be diluted in parenteral nutrition solution prior to administration. Do not administer undiluted by direct injection into a peripheral vein. Solution is acidic; direct IM or IV injection is contraindicated.
Chromium, parenteral nutrition supplement: Chromium supplement for parenteral nutrition to maintain chromium serum levels and to prevent depletion of endogenous stores and subsequent deficiency symptoms.
None known.
There are no known significant interactions.
Animal reproduction studies have not been conducted.
It is not known if chromic chloride is present in breast milk. The manufacturer recommends that caution be exercised when administering chromic chloride to nursing women.
Dietary adequate intake (IOM 2001):
1 to 6 months: 0.2 mcg/day.
7 to 12 months: 5.5 mcg/day.
1 to 3 years: 11 mcg/day.
4 to 8 years: 15 mcg/day.
9 to 13 years:
Males: 25 mcg/day.
Females: 21 mcg/day.
14 to 18 years:
Males: 35 mcg/day.
Females: 24 mcg/day.
19 to 50 years:
Males: 35 mcg/day.
Females: 25 mcg/day.
>50 years:
Males: 30 mcg/day.
Females: 20 mcg/day.
Pregnancy:
14 to 18 years: 29 mcg/day.
19 to 50 years: 30 mcg/day.
Lactation:
14 to 18 years: 44 mcg/day.
19 to 50 years: 45 mcg/day.
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.
Excretion: Urine and bile.
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