Omegaven is a RESTRICTED formulary item. Use is RESTRICTED to patients who are currently dependent on total parenteral nutrition with a direct bilirubin > 4 mg/dL for more than 2 consecutive weeks and the patient is not expected to receive enteral nutrition in the subsequent 30 days. Omegaven use is restricted to no more than 16 weeks without documented clinical improvement and an added source of essential fatty acids. The need for Omegaven is to be reassessed every 4 weeks for possible conversion back to SMOF.  All other use requires approval from the Chief Medical Officer.

*A formal GI consult is recommended if direct bilirubin is unchanged or continuing an upward trend after 4 weeks of Omegaven to assess for liver disease.

Rationale for Omegaven Use: Omegaven is intended to be a "rescue" formulation of parenteral lipid in patients with significant cholestasis.  Because it is not well balanced with respect to essential fatty acids, its use should be limited to a short duration, normally not exceeding 16 weeks.  Additionally, as with all parenteral lipid formulations, essential fatty acid levels should be monitored.  Use does NOT require a GI consult.

• Micromedex Drug Information
• FDA Daily Med Package Insert
• Recent Citations via Medline (PubMed)
• WebMD Pill Identifier