Osmolar

PN products osmolarity

Label osmolarity of premixed parenteral nutrition bags, measured vs labelled values, and how additives change them.

Premixed PN osmolarity table

Osmolarity of multi-chamber and premixed parenteral nutrition bags, with the exact source. Values apply to the activated (mixed) bag as labelled.

Dataset
v1.1.7
Checked
Records
30 sourced, 1 gap

Two-chamber: amino acids + dextrose

Two-chamber: amino acids + dextrose: osmolarity/osmolality, composition and source (7 products)
ProductManufacturerValueUnitBasisCompositionpHSource
CLINIMIX 4.25/5 sulfite-free (Amino Acid in Dextrose) Injection4.25/5US Baxter 675 mOsm/L Calculated Acetate 37 mEq/L, Cl 17 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing both chambers.
CLINIMIX 4.25/10 sulfite-free (Amino Acid in Dextrose) Injection4.25/10US Baxter 930 mOsm/L Calculated Acetate 37 mEq/L, Cl 17 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing both chambers.
CLINIMIX 5/15 sulfite-free (Amino Acid in Dextrose) Injection5/15US Baxter 1,255 mOsm/L Calculated Acetate 42 mEq/L, Cl 20 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing both chambers.
CLINIMIX 5/20 sulfite-free (Amino Acid in Dextrose) Injection5/20US Baxter 1,505 mOsm/L Calculated Acetate 42 mEq/L, Cl 20 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing both chambers.
CLINIMIX 6/5 sulfite-free (Amino Acid in Dextrose) Injection6/5US Baxter 850 mOsm/L Calculated Acetate 53 mEq/L, Cl 24 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing both chambers.
CLINIMIX 8/10 sulfite-free (Amino Acid in Dextrose) Injection8/10US Baxter 1,308 mOsm/L Calculated Acetate 71 mEq/L, Cl 32 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing both chambers.
CLINIMIX 8/14 sulfite-free (Amino Acid in Dextrose) Injection8/14US Baxter 1,520 mOsm/L Calculated Acetate 71 mEq/L, Cl 32 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing both chambers.

Two-chamber: amino acids + dextrose + electrolytes

Two-chamber: amino acids + dextrose + electrolytes: osmolarity/osmolality, composition and source (8 products)
ProductManufacturerValueUnitBasisCompositionpHSource
CLINIMIX E 2.75/5 sulfite-free (Amino Acid with Electrolytes in Dextrose with Calcium) Injection2.75/5US Baxter 665 mOsm/L Calculated Na 35 mEq/L, K 30 mEq/L, Mg 5 mEq/L, Ca 4.5 mEq/L, Acetate 51 mEq/L, Cl 39 mEq/L, HPO₄ 30 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing. Calcium 4.5 mEq/L = 2.2 mmol/L; phosphate 30 mEq/L = 15 mmol/L.
CLINIMIX E 4.25/5 sulfite-free (Amino Acid with Electrolytes in Dextrose with Calcium) Injection4.25/5US Baxter 815 mOsm/L Calculated Na 35 mEq/L, K 30 mEq/L, Mg 5 mEq/L, Ca 4.5 mEq/L, Acetate 70 mEq/L, Cl 39 mEq/L, HPO₄ 30 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing. Calcium 4.5 mEq/L = 2.2 mmol/L; phosphate 30 mEq/L = 15 mmol/L.
CLINIMIX E 4.25/10 sulfite-free (Amino Acid with Electrolytes in Dextrose with Calcium) Injection4.25/10US Baxter 1,070 mOsm/L Calculated Na 35 mEq/L, K 30 mEq/L, Mg 5 mEq/L, Ca 4.5 mEq/L, Acetate 70 mEq/L, Cl 39 mEq/L, HPO₄ 30 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing. Calcium 4.5 mEq/L = 2.2 mmol/L; phosphate 30 mEq/L = 15 mmol/L.
CLINIMIX E 5/15 sulfite-free (Amino Acid with Electrolytes in Dextrose with Calcium) Injection5/15US Baxter 1,395 mOsm/L Calculated Na 35 mEq/L, K 30 mEq/L, Mg 5 mEq/L, Ca 4.5 mEq/L, Acetate 80 mEq/L, Cl 39 mEq/L, HPO₄ 30 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing. Calcium 4.5 mEq/L = 2.2 mmol/L; phosphate 30 mEq/L = 15 mmol/L.
CLINIMIX E 5/20 sulfite-free (Amino Acid with Electrolytes in Dextrose with Calcium) Injection5/20US Baxter 1,650 mOsm/L Calculated Na 35 mEq/L, K 30 mEq/L, Mg 5 mEq/L, Ca 4.5 mEq/L, Acetate 80 mEq/L, Cl 39 mEq/L, HPO₄ 30 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing. Calcium 4.5 mEq/L = 2.2 mmol/L; phosphate 30 mEq/L = 15 mmol/L. The SPL table column header for this strength reads 'CLINIMIX 5/20'.
CLINIMIX E 8/10 sulfite-free (Amino Acid with Electrolytes in Dextrose with Calcium) Injection8/10US Baxter 1,450 mOsm/L Calculated Na 35 mEq/L, K 30 mEq/L, Mg 5 mEq/L, Ca 4.5 mEq/L, Acetate 83 mEq/L, Cl 76 mEq/L, HPO₄ 30 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing. Calcium 4.5 mEq/L = 2.2 mmol/L; phosphate 30 mEq/L = 15 mmol/L.
CLINIMIX E 8/14 sulfite-free (Amino Acid with Electrolytes in Dextrose with Calcium) Injection8/14US Baxter 1,650 mOsm/L Calculated Na 35 mEq/L, K 30 mEq/L, Mg 5 mEq/L, Ca 4.5 mEq/L, Acetate 83 mEq/L, Cl 76 mEq/L, HPO₄ 30 mEq/L 6.0 dailymed.nlm.nih.gov
Note

After mixing. Calcium 4.5 mEq/L = 2.2 mmol/L; phosphate 30 mEq/L = 15 mmol/L.
CLINIMIX N14G30E (with electrolytes) solution for infusionUK Baxter 1,415 mOsm/L Labeled — — www.medicines.org.uk

Three-chamber PN

Three-chamber PN: osmolarity/osmolality, composition and source (10 products)
ProductManufacturerValueUnitBasisCompositionpHSource
KABIVEN (amino acids, electrolytes, dextrose and lipid injectable emulsion)3-chamber, mixedUS Fresenius Kabi 1,060 mOsm/L Labeled Na 31 mmol/L, K 23 mmol/L, Mg 3.9 mmol/L, Ca 1.9 mmol/L, P 9.7 mmol/L, Acetate 38 mmol/L, Cl 45 mmol/L, SO₄ 3.9 mmol/L 5.6 dailymed.nlm.nih.gov
Note

All three chambers mixed.
PERIKABIVEN (amino acids, electrolytes, dextrose and lipid injectable emulsion), peripheralUS Fresenius Kabi 750 mOsm/L Labeled — — dailymed.nlm.nih.gov
TRIOMEL 12 g/l nitrogen 950 kcal/l with electrolytes, emulsion for infusionUK Baxter ≈ 1,270 mOsm/L Labeled — — www.medicines.org.uk
Note

Triomel is the UK trade name of the Olimel range.
TRIOMEL 5 g/l nitrogen 990 kcal/l with electrolytes, emulsion for infusionUK Baxter 1,120 mOsm/L Labeled — — www.medicines.org.uk
Note

Triomel is the UK trade name of the Olimel range.
TRIOMEL 7 g/l nitrogen 1140 kcal/l with electrolytes, emulsion for infusionUK Baxter 1,360 mOsm/L Labeled — — www.medicines.org.uk
Note

Triomel is the UK trade name of the Olimel range.
TRIOMEL 7 g/l nitrogen 1140 kcal/l, emulsion for infusion (without electrolytes)UK Baxter 1,220 mOsm/L Labeled — — www.medicines.org.uk
Note

Triomel is the UK trade name of the Olimel range.
TRIOMEL 9 g/l nitrogen 1070 kcal/l with electrolytes, emulsion for infusionUK Baxter 1,310 mOsm/L Labeled — — www.medicines.org.uk
Note

Triomel is the UK trade name of the Olimel range.
TRIOMEL 9 g/l nitrogen 1070 kcal/l, emulsion for infusion (without electrolytes)UK Baxter 1,170 mOsm/L Labeled — — www.medicines.org.uk
Note

Triomel is the UK trade name of the Olimel range.
TRIOMEL PERIPHERAL 4 g/l nitrogen 700 kcal/l with electrolytes, emulsion for infusionUK Baxter 760 mOsm/L Labeled — — www.medicines.org.uk
Note

UK name of Peri-Olimel N4E.Triomel is the UK trade name of the Olimel range.
SmofKabiven (three-chamber bag) Fresenius Kabi Gap: no published value — — — — None found
Note

No primary source found in DailyMed or emc. Fresenius Kabi country SmPCs were not reachable when checked (2026-10-18).

Pediatric PN

Pediatric PN: osmolarity/osmolality, composition and source (6 products)
ProductManufacturerValueUnitBasisCompositionpHSource
Numeta G13%E Preterm emulsion for infusion - activated 2-chamber (no lipid)activated 2CBUK Baxter ≈ 1,400 mOsm/L Labeled — — www.medicines.org.uk
Note

Values printed in the order 2CB, 2CB (per 100 mL column), 3CB, 3CB.
Numeta G13%E Preterm emulsion for infusion - activated 3-chamber (with lipid)activated 3CBUK Baxter ≈ 1,150 mOsm/L Labeled — — www.medicines.org.uk
Numeta G16%E emulsion for infusion - activated 2-chamber (no lipid)activated 2CBUK Baxter ≈ 1,585 mOsm/L Labeled — — www.medicines.org.uk
Note

Values printed in the order 2CB, 2CB (per 100 mL column), 3CB, 3CB.
Numeta G16%E emulsion for infusion - activated 3-chamber (with lipid)activated 3CBUK Baxter ≈ 1,230 mOsm/L Labeled — — www.medicines.org.uk
Numeta G19%E emulsion for infusion - activated 2-chamber (no lipid)activated 2CBUK Baxter ≈ 1,835 mOsm/L Labeled — — www.medicines.org.uk
Note

Values printed in the order 2CB, 2CB (per 100 mL column), 3CB, 3CB.
Numeta G19%E emulsion for infusion - activated 3-chamber (with lipid)activated 3CBUK Baxter ≈ 1,460 mOsm/L Labeled — — www.medicines.org.uk

Every sourced row was checked against the cited label or paper on 2026-10-18. Values are shown in the unit their source used; nothing is converted. Gap rows mean no published number was found, not zero. Reference data for education, not prescribing, compounding or rehydration guidance.

Premixed parenteral nutrition (PN) bags and ready-made IV admixtures print an osmolarity on the label. This page collects those label values, shows where measured values differ from them, and works through how adding lipid or electrolytes changes the number. For your own PN recipe, use the TPN osmolarity calculator. For plain IV fluids, see IV fluid osmolarity.

No route, rate or compounding instructions. Every figure here is a label statement, a published measurement or arithmetic. Which vein, which catheter, and what may be added to a bag are decisions for the prescriber and pharmacist, following product labeling and institutional protocol.

Reading a label osmolarity

  • Units. Osmolarity is mOsm per litre of solution. Osmolality is mOsm per kg of water. Lipid emulsions show the gap clearly: Intralipid 20% is labelled at about 350 mOsm/kg and 260 mOsm/L. Oil droplets take up volume but are not water [12]. See osmolality vs osmolarity.
  • Basis. Some labels say “(calc)”, meaning computed from the ingredients. Others print a number without saying how it was obtained. Osmolar Data records the latter as “labelled, basis not stated”.
  • After mixing. Multi-chamber bags give the value for the mixed contents. Two-chamber and three-chamber activation give different values (Numeta, below).

Premixed PN products (label values after mixing)

All values come from Osmolar Data v1.1.3. Each traces to the label section and verbatim extract recorded in the dataset.

Product (manufacturer, market)Osmolarity (mOsm/L)BasisSource
CLINIMIX 4.25/5 · 4.25/10 · 5/15 · 5/20 · 6/5 · 8/10 · 8/14 (Baxter, US)675 · 930 · 1,255 · 1,505 · 850 · 1,308 · 1,520Calculated[1] Table 7
CLINIMIX E 2.75/5 · 4.25/5 · 4.25/10 · 5/15 · 5/20 · 8/10 · 8/14 (Baxter, US)665 · 815 · 1,070 · 1,395 · 1,650 · 1,450 · 1,650Calculated[2] Table 7
KABIVEN (Fresenius Kabi, US)1,060Labelled, basis not stated[3] Table 2
PERIKABIVEN (Fresenius Kabi, US)750Labelled, basis not stated[4] §11
CLINIMIX N14G30E (Baxter, UK)1,415Labelled, basis not stated[5]
TRIOMEL 5 g/l N 990 kcal/l with electrolytes (Baxter, UK)1,120Labelled, basis not stated[6]
TRIOMEL 7 g/l N 1140 kcal/l, with / without electrolytes1,360 / 1,220Labelled, basis not stated[6]
TRIOMEL 9 g/l N 1070 kcal/l, with / without electrolytes1,310 / 1,170Labelled, basis not stated[6]
TRIOMEL 12 g/l N 950 kcal/l with electrolytesapprox. 1,270Labelled, basis not stated[6]
TRIOMEL PERIPHERAL 4 g/l N 700 kcal/l with electrolytes760Labelled, basis not stated[6]
Numeta G13%E Preterm: 2-chamber / 3-chamber activation (Baxter, UK)approx. 1,400 / 1,150Labelled, basis not stated[7]
Numeta G16%E: 2-chamber / 3-chamberapprox. 1,585 / 1,230Labelled, basis not stated[7]
Numeta G19%E: 2-chamber / 3-chamberapprox. 1,835 / 1,460Labelled, basis not stated[7]

Triomel is the UK trade name of the Olimel range. Numeta products are paediatric; this page makes no age-specific threshold claim. SmofKabiven is not listed: Osmolar Data found no primary label value in DailyMed or the UK emc.

Common IV admixtures (label values)

Admixture (manufacturer)Label valueBasisSource
KCl 20 / 40 mEq/L in 0.9% NaCl (Baxter)348 / 388 mOsm/LCalculated[8]
KCl 20 mEq/L in 5% dextrose (Baxter)293 mOsm/LCalculated[8]
KCl 20 mEq/L in 5% dextrose + 0.45% NaCl (Baxter)447 mOsm/LCalculated[8]
Magnesium sulfate 4% in water (WG Critical Care)325 mOsm/LCalculated[8]
Magnesium sulfate 1% in 5% dextrose (Baxter)333 mOsm/LCalculated[8]
Heparin 2 units/mL in 0.9% NaCl: Baxter / B. Braun322 / 360 mOsm/L“Actual” (measured, per Baxter container label) / calculated[8]
Dopamine 1,600 mcg/mL in 5% dextrose (Baxter)269 mOsm/LCalculated[8]
Nitroglycerin 400 mcg/mL in 5% dextrose (Baxter)465 mOsm/LCalculated[8]
Vancomycin 5 mg/mL ready-to-use (Xellia)350–475 mOsm/LLabelled, basis not stated[8]
Meropenem 1 g/50 mL Duplex (B. Braun)approx. 417 mOsm/kgLabelled, basis not stated[8]
Esmolol premixed 10/20 mg/mL (Brevibloc, Baxter US)312 mOsm/LCalculated[8]
Fluconazole 2 mg/mL in 0.9% NaCl (Baxter)315 mOsm/LCalculated[8]
Metronidazole 5 mg/mL: Baxter / B. Braun310 / 297 mOsm/LCalculated[8]

Note the units column: some labels give mOsm/L and others mOsm/kg. Do not compare them as if they were the same quantity.

The two heparin products list the same electrolytes (Na 186, Cl 154, phosphate 32, citrate 6 mEq/L). The 322 vs 360 difference reflects a measured (“actual”) value against a calculated one, not a different formulation.

Measured versus labelled values

Manrique-Rodríguez et al. (2021) measured many Spanish IV products by freezing-point depression, then converted to osmolarity as osmolality × solution density [9]. That conversion multiplies by the mass of the whole solution, solute included, rather than by its water content. We also show an illustrative conversion of our own: osmolality × kg of water per litre, where kg water/L = density × 1,000 − labelled solute g/L, ÷ 1,000 (for example, mannitol 20%: 1.066 − 0.200 = 0.866 kg/L). It assumes the labelled solute is the only non-water mass. It is arithmetic, not a measurement and not a value published by the authors.

ProductLabel value (basis)Measured osmolalityAuthors’ conversion (× density)Water-basis conversion (illustrative arithmetic, not a published value)
Mannitol 20%1,098 mOsm/L (calc) (Baxter, ICU Medical); 1,100 calculated (B. Braun) [10]1,253 ± 1.15 mOsm/kg (Osmofundina 20%, B. Braun Spain; density 1.066) [9]1,335 mOsm/L1,253 × (1.066 − 0.200) = 1,085 mOsm/L
Sodium bicarbonate 8.4%2 mOsm/mL = 2,000 mOsm/L (Fresenius Kabi, Exela; basis not stated on the label, and equal to the calculated value for Na⁺ + HCO₃⁻); Hospira prints 1.56 mOsm/mL, also with no basis stated [11]1,567 ± 1.00 mOsm/kg (Venofuyesen 8.4%, Fresenius Kabi Spain; density 1.081) [9]1,694 mOsm/L1,567 × (1.081 − 0.084) = 1,562 mOsm/L
Esmolol 10 mg/mL312 mOsm/L (Baxter US) [8]305 mOsm/kg (Baxter Spain) [9]314 mOsm/Ln/a
Fluconazole 2 mg/mL315 mOsm/L (Baxter US, in NS) [8]290 mOsm/kg (Normon, Spain) [9]299 mOsm/Ln/a
Metronidazole 5 mg/mL297–310 mOsm/L (US labels) [8]274 mOsm/kg (Flagyl bag (Sanofi-Aventis), Spain) [9]284 mOsm/Ln/a

What the comparison shows:

  • Mannitol 20% looks about 22% “higher than labelled” if you compare 1,335 with 1,098. Most of that comes from the conversion method. On the illustrative water basis (1,085), the measured value and the calculated label agree within about 1%, although they are different products (Spain vs US).
  • Sodium bicarbonate 8.4% behaves the opposite way. The calculated 2,000 counts Na⁺ and HCO₃⁻ as fully independent particles, but the measured osmolality is 1,567 mOsm/kg (about 1,562 mOsm/L on the water basis). Concentrated electrolytes are non-ideal (see how osmometers work). On this page the measured figure is a disclosure only. Osmolar’s estimates keep the calculated 2.0 mOsm/mEq.
  • Isotonic-range premixes (esmolol, fluconazole, metronidazole) measure close to their labels. The remaining differences (different countries, products and diluents) are small.

The Spanish and US products are different products, so these rows illustrate methods, not a check of any one label.

How additives change the value (the factors Osmolar’s calculator uses)

An estimate adds each component’s contribution per litre. The factors Osmolar uses are label-derived. The TPN osmolarity calculator page explains them in full.

AdditiveFactorNote
Dextrose (hydrous)5.046 mOsm/gICU Medical D50 label [13]
Amino acidsproduct label value (US 7.88–9.98 mOsm/g); generic 10 mOsm/gGeneric only when no product is specified
Lipid 20% / 30%1.3 / 0.6667 mOsm/g fatIntralipid labels [12]
NaCl, KCl, Na/K acetate2.0 mOsm/mEqCation + anion
Sodium phosphate / potassium phosphate1.75 mOsm/mEq Na / 1.6818 mOsm/mEq KHospira labels
Magnesium sulfate1.0 mOsm/mEqHospira, Fresenius labels
Calcium gluconate 10%1.4667 mOsm/mEq: editorial default; sources conflictSources differ; see below
Sodium bicarbonate 8.4%2.0 mOsm/mEq Na (calculated)Measured ~1,567 mOsm/kg (table above). Hospira’s label: “The addition of sodium bicarbonate to parenteral solutions containing calcium should be avoided, except where compatibility has been previously established” [11]

Calcium gluconate is not settled. The sources disagree:

  • B. Braun UK SmPC: “Theoretical osmolarity: 660 mOsm/l” at 2.25 mmol Ca per 10 mL (450 mEq/L). 660 ÷ 450 = 1.4667 mOsm/mEq [14]. The same label also gives 0.23 mmol per mL (which would give 1.4348) and, in its warnings, 2.23 mmol per 10 mL (which would give 1.4798). Osmolar uses the composition figure, 2.25 mmol per 10 mL, as an editorial default.
  • Sandoz Canada prescribing information: 680 mOsmol/L at 0.465 mEq/mL, giving 1.4624, with no stated basis [15].
  • B. Braun US pharmacy bulk package: prints “Osmolarity (Calc.): 292 mOsmol/L” at 0.465 mEq/mL, giving 0.628 [16]. This value sits close to measured osmolality (hameln UK SmPC: 270–310 mOsmol/kg [17]), so it is disclosed here as a note only. The hameln label states that its product “should not be used in the preparation of Total Parenteral Nutrition (TPN), due to the risk of exposure to aluminium”. It is cited here only for its measured osmolality.

Calcium gluconate: the sources conflict. Osmolar’s TPN osmolarity calculator uses 1.4667 mOsm per mEq of calcium as an editorial default. It is calculated from a UK label (B. Braun, Calcium Gluconate 10% w/v Injection BP) [14]: “Theoretical osmolarity: 660 mOsm/l” with 2.25 mmol of calcium per 10 mL (450 mEq/L), so 660 ÷ 450 = 1.4667. Other figures exist:

  • The same label also states the calcium content as 0.23 mmol per mL; using that rounded figure would give 1.4348. Its warnings section states 2.23 mmol per 10 mL, which would give 1.4798. Osmolar uses the 2.25 mmol figure from the composition section. [14]
  • A Canadian label (Sandoz) lists 680 mOsmol/L at 0.465 mEq/mL (1.4624) and does not say whether this is calculated or measured. [15]
  • A US label (B. Braun pharmacy bulk package) lists “Osmolarity (Calc.): 292 mOsmol/L” (0.628 per mEq) [16]. That figure is close to the measured osmolality of 10% calcium gluconate (270–310 mOsmol/kg on another UK label) [17] and would give a lower estimate, so it is shown here but not used.

Osmolar uses 1.4667 because it is a calculated value, like every other factor in that calculator. This choice has not been reviewed by a clinician or pharmacist. For 9.2 mEq of calcium per litre, 1.4667 adds 13.5 mOsm/L and 0.628 adds 5.8 mOsm/L. The difference matters most when an estimate is close to 900 mOsm/L.

Worked example 1: adding lipid lowers osmolarity by dilution

1,000 mL CLINIMIX 4.25/10 (930 mOsm/L) [1] and 250 mL of 20% lipid emulsion (260 mOsm/L) [12], as arithmetic. Osmolarity is per litre, so volume weighting is valid:

(930 × 1.000 + 260 × 0.250) ÷ 1.250 = (930 + 65) ÷ 1.25 = 796 mOsm/L

The lipid adds osmoles (65 mOsm), but it adds them at a lower concentration than the bag, so the mixture’s value falls. The labels show the same effect. Numeta G16%E is approx. 1,585 mOsm/L when activated as two chambers and approx. 1,230 with the lipid chamber activated [7]. Whether and how lipid is given with a product is a label and pharmacy question.

Worked example 2: adding electrolytes, with and without the added volume

Per litre of CLINIMIX 4.25/5 (675 mOsm/L) [1], arithmetic only: KCl 20 mEq, MgSO₄ 8 mEq, calcium gluconate 4.5 mEq.

  • KCl: 20 × 2.0 = 40
  • MgSO₄: 8 × 1.0 = 8
  • Ca gluconate (editorial default 1.4667): 4.5 × 1.4667 = 6.6

Total = 675 + 40 + 8 + 6.6 = 729.6 mOsm. Ignoring the additive volume, that is 730 mOsm/L.

The additives also bring volume, taken from label concentrations:

  • KCl 2 mEq/mL: 10.0 mL
  • MgSO₄ 50%, 4.06 mEq/mL: 1.97 mL
  • Ca gluconate 0.465 mEq/mL: 9.68 mL

That is 21.65 mL in total. 729.6 ÷ 1.02165 L = 714.1 → 714 mOsm/L.

With the disclosed-only 0.628, the calcium term would be 2.8 rather than 6.6, a 3.8 mOsm/L difference here. Compatibility (for example calcium with phosphate) is outside this arithmetic.

The 900 mOsm/L figure

  • ASPEN (2014) suggests that PN with an osmolarity up to 900 mOsm/L can be given peripherally, and notes that higher limits may be tolerated but the evidence to support a limit is lacking. The recommendation is graded weak [18].
  • US labels carry their own wording:
    • CLINIMIX E: “Solutions with osmolarity of 900 mOsm/L or greater must be infused through a central catheter” [2]
    • PERIKABIVEN: “peripheral catheters should not be used for solutions with osmolarity of ≥ 900 mOsm/L” [4]
  • Other sources state other numbers:
    • The UK CLINIMIX N14G30E SmPC uses 800 mOsm/l, describing it as a ‘general accepted limit’ for peripheral infusion that ‘varies considerably’ with the patient [5].
    • The German DGEM 2009 guideline gives 800 mosm/L for PN without lipids [19].
    • An ASHP 2016 presentation lists 900–1,000 [20].

These are conventions that differ by country, product and institution. Every osmolarity on this page is a label or calculated value, not a measured osmolality, and this page gives no route instruction.

Practice questions

Q1. 20 mEq of KCl is added (arithmetic) to 1 L of CLINIMIX E 2.75/5 (665 mOsm/L), ignoring the added volume. What is the estimate?

Answer

665 + 20 × 2.0 = 705 mOsm/L. Including the 10 mL of 2 mEq/mL KCl: 705 ÷ 1.010 = 698.0 → 698 mOsm/L.

Q2. 500 mL CLINIMIX 5/15 (1,255 mOsm/L) plus 250 mL of 20% lipid (260 mOsm/L). What is the mixture’s osmolarity, and how does it relate to the label wording?

Answer

(1,255 × 0.5 + 260 × 0.25) ÷ 0.75 = (627.5 + 65) ÷ 0.75 = 923.3 → 923 mOsm/L. That falls in the “900 mOsm/L or greater” category of the US label wording [1]. The route is a clinical decision, and the result is an estimate.

Q3. A litre contains 9.2 mEq of calcium as gluconate. What does each source’s factor contribute?

Answer
  • 1.4667 (editorial default, B. Braun UK theoretical): 13.5 mOsm
  • 1.4624 (Sandoz Canada, basis not stated): 13.5 mOsm
  • 0.628 (B. Braun US 292, disclosed only): 5.8 mOsm

The sources differ by about 7.7 mOsm/L here. The default is an editorial choice and has not been reviewed by a clinician.

Q4. Calcium-free arithmetic: dextrose 50 g/L plus sodium 150 mEq/L as sodium bicarbonate. Compare the calculated-basis estimate with the result from Hospira’s 1.56.

Answer
  • Calculated basis: 50 × 5.046 + 150 × 2.0 = 252.3 + 300 = 552.3 → 552 mOsm/L.
  • Hospira’s 1.56 (no basis stated on the label): 252.3 + 234 = 486.3 → 486. Osmolar keeps every term on the calculated basis, so 1.56 is not used. The measured osmolality of 8.4% bicarbonate is about 1,567 mOsm/kg [9].

Q5. Why is Intralipid 20% labelled 350 mOsm/kg but 260 mOsm/L?

Answer

Osmolality counts per kg of water. Osmolarity counts per litre of emulsion, and part of each litre is oil droplets, not water. The same particles therefore give a smaller per-litre number [12].

Educational content, not medical advice. The values are label statements or published measurements for specific products, and the arithmetic is an estimate, not a measured osmolality. Nothing here is a route, rate, compatibility or compounding instruction. Institutional thresholds vary; follow product labeling, your institution’s protocols and your pharmacist. See our disclaimer and how we check content.

References

  1. CLINIMIX (amino acids in dextrose) injection (Baxter). DailyMed, SPL set id dccff103-8695-400c-a15d-cc2fd078760a, §3 Table 7. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=dccff103-8695-400c-a15d-cc2fd078760a (accessed 2026-10-18)

  2. CLINIMIX E (amino acids with electrolytes in dextrose with calcium) injection (Baxter). DailyMed, set id 8469d6fb-d6ef-476f-8cc3-0905192de0a8, §2 and §3 Table 7 (read 2026-10-18). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8469d6fb-d6ef-476f-8cc3-0905192de0a8

  3. KABIVEN injectable emulsion (Fresenius Kabi). DailyMed, set id afeb4837-a759-4484-a76e-e04611c459e7, §3 Table 2. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=afeb4837-a759-4484-a76e-e04611c459e7 (accessed 2026-10-18)

  4. PERIKABIVEN injectable emulsion (Fresenius Kabi). DailyMed, set id c2eb5522-8572-45f4-869d-42f9fd251bb6, §2 and §11 (read 2026-10-18). https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=c2eb5522-8572-45f4-869d-42f9fd251bb6

  5. CLINIMIX N14G30E solution for infusion (Baxter UK). SmPC, emc product 1807, §2 and §4.2 (read 2026-10-18). https://www.medicines.org.uk/emc/product/1807/smpc

  6. TRIOMEL emulsions for infusion (Baxter UK). SmPCs, §2, emc products 1887, 1886, 1885, 1884, 1883, 10048 and 1888. https://www.medicines.org.uk/emc/product/1887/smpc · https://www.medicines.org.uk/emc/product/1886/smpc · https://www.medicines.org.uk/emc/product/1885/smpc · https://www.medicines.org.uk/emc/product/1884/smpc · https://www.medicines.org.uk/emc/product/1883/smpc · https://www.medicines.org.uk/emc/product/10048/smpc · https://www.medicines.org.uk/emc/product/1888/smpc (accessed 2026-10-18)

  7. Numeta G13%E Preterm, G16%E and G19%E emulsions for infusion (Baxter UK). SmPCs, §2, emc products 7400, 7398 and 7399. https://www.medicines.org.uk/emc/product/7400/smpc · https://www.medicines.org.uk/emc/product/7398/smpc · https://www.medicines.org.uk/emc/product/7399/smpc (accessed 2026-10-18)

  8. DailyMed labels as recorded in Osmolar Data v1.1.3 iv_admixtures (set ids):

    • KCl in NaCl becc7410-0a25-49f5-b0c3-240078479dc8; KCl in D5W 45de5402-5e61-4bbd-8bbc-5e3392c9920e; KCl in D5/NaCl c553fed1-3de5-4826-8eff-633b5923bf0b
    • MgSO₄ 4% 752f55bb-c4ca-4545-94b3-3deea66888d4; MgSO₄ 1% in D5W 1bbaebd0-3f4c-467d-96fd-69cfad5a3fd3
    • heparin (Baxter) 0d929726-76c3-48fc-b4e7-fd06409f9fb3; heparin (B. Braun) a3041c04-0ea8-4d36-81ce-c5091c906316
    • dopamine cb97d4a0-89ed-407c-a763-209386b6f75c; nitroglycerin 457a026c-ebce-4701-9deb-2d7652759a99
    • vancomycin (Xellia) 60bee69b-be70-412c-9e83-a24a0a8a5e7b; meropenem Duplex 3b952a55-6ef7-45c8-be21-16eefe37ec2e
    • Brevibloc 220a07b8-5c68-41a3-8705-fd91f14c50b4; fluconazole cd24a261-9c15-42b4-8040-89d2dbda174e
    • metronidazole (Baxter) 9d762edb-12ac-429d-b1f0-7af5d3b909d4; metronidazole (B. Braun) fd191c06-9d3b-4e46-9f79-90f6af614947

    Each set id opens on DailyMed (dailymed.nlm.nih.gov, drugInfo page by set id). (accessed 2026-10-18)

  9. Manrique-Rodríguez S, Heras-Hidalgo I, Pernia-López MS, et al. Standardization and chemical characterization of intravenous therapy in adult patients: a step further in medication safety. Drugs R D. 2021;21(1):39–64. doi:10.1007/s40268-020-00329-w. PMID 33346878. https://pmc.ncbi.nlm.nih.gov/articles/PMC7937591/ (Table 2; mannitol and sodium bicarbonate rows read from the table images 2026-10-18)

  10. Mannitol 20% labels on DailyMed: OSMITROL (Baxter) 0d914965-7001-45cb-ba51-d7c5964b05bc; ICU Medical ba7bf864-8a4d-4262-8fd1-00174fa2f9d1; B. Braun d12cc802-b538-4065-a264-f474ff3b3043. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0d914965-7001-45cb-ba51-d7c5964b05bc (accessed 2026-10-18)

  11. Sodium bicarbonate 8.4% labels on DailyMed: Hospira 8664c7ce-707b-4c6c-9ce4-7160b5f877f8 (calcium statement read 2026-10-18); Fresenius Kabi 0ab55004-bb63-436d-ad77-cd3796905370; Exela f8806ec3-a1c0-47a9-9660-2628dca4623e. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=8664c7ce-707b-4c6c-9ce4-7160b5f877f8

  12. Intralipid 20% (Fresenius Kabi). DailyMed, set id 61e025f1-a38e-4af2-9e18-13ea12977cf5. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=61e025f1-a38e-4af2-9e18-13ea12977cf5 ; Intralipid 30% 98460eae-5195-48d2-ab73-00d276879ef6 (accessed 2026-10-18)

  13. Dextrose 50% (ICU Medical). DailyMed, set id b5cb7a5a-bbe8-4217-a82e-da818f7771c9. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=b5cb7a5a-bbe8-4217-a82e-da818f7771c9 (accessed 2026-10-18)

  14. Calcium Gluconate 10% w/v Injection BP (B. Braun Medical Ltd). SmPC, emc product 15226 (read 2026-10-18). https://www.medicines.org.uk/emc/product/15226/smpc

  15. Calcium Gluconate Injection, USP 10% (Sandoz Canada Inc.). Prescribing Information, Health Canada Drug Product Database. Date of preparation: May 13, 2026; last revised: May 13, 2026. Submission control no. 299772. https://pdf.hres.ca/dpd_pm/00084720.PDF (accessed 2026-10-18)

  16. Calcium Gluconate Injection USP 10% Pharmacy Bulk Package (B. Braun). DailyMed, set id af362bcb-7010-4eb5-b8c4-42aa3b0cdcde. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=af362bcb-7010-4eb5-b8c4-42aa3b0cdcde (accessed 2026-10-18)

  17. Calcium Gluconate 10% solution for injection/infusion (hameln pharma). SmPC, emc product 6264 (read 2026-10-18). https://www.medicines.org.uk/emc/product/6264/smpc

  18. Boullata JI, Gilbert K, Sacks G, et al.; A.S.P.E.N. A.S.P.E.N. clinical guidelines: parenteral nutrition ordering, order review, compounding, labeling, and dispensing. JPEN J Parenter Enteral Nutr. 2014;38(3):334–377. PMID 24531708. https://pubmed.ncbi.nlm.nih.gov/24531708/ (accessed 2026-10-18)

  19. Jauch KW, Schregel W, Stanga Z, et al. Access technique and its problems in parenteral nutrition – Guidelines on Parenteral Nutrition, Chapter 9. GMS Ger Med Sci. 2009;7:Doc19. doi:10.3205/000078. https://www.egms.de/static/en/journals/gms/2009-7/000078.shtml (accessed 2026-10-18)

  20. Cober MP, Tucker AM, Derenski K. Strategies for Successful Parenteral Nutrition Order Writing. ASHP Midyear Clinical Meeting 2016. https://www.ashp.org/-/media/assets/pharmacy-practice/resource-centers/Clinical-Pharmacy-Resources/Nutrition-Support/2016-MCM/MCM16-335-Strategies-for-Successful-Parenteral-nutrition.pdf (accessed 2026-10-18)

Sources

Numbered references are listed in the article above.