Enteral feeding formulation proteins

Mixing liquid medications with certain enteral feeding formulations has been associated with several types of physical incompatibilities including granulation, gel formation, separation, and precipitation. Not only can these physical incompatibilities inhibit drug absorption, gel formation potentially may clog small-bore enteral feeding tubes. Physical incompatibility with medications is more common in formulations that contain intact protein than in those with hydrolyzed protein. Also, medication and enteral formula incompatibilities are more common with the use of acidic pharmaceutical syrups. The most prudent recommendation is to avoid the routine admixture whenever possible, especially for nonaqueous preparations and syrups. In the... 

A study in healthy subjects found phenytoin levels were reduced by enteral feeds, but that it was easier to attain therapeutic levels of phenytoin in those also receiving a meat-based formulation (Compleat Modified) rather than a protein hydrolysate formulation (Osmofite). ... 

---