TOLEREX® Novartis Nutrition Elemental Diet

Indications And Clinical Uses:

A nutritionally complete elemental diet formulated for the nutritional management of patients with impaired digestion and absorption. May include those with inflammatory bowel disease, intestinal atresia, pancreatitis, fistula, partial obstruction, short-gut syndrome. Malnutrition and cachexia. Bowel preparation prior to diagnostic and surgical procedures. Transition diet between parenteral and normal oral feeding. Food sensitivities.:


Not for parenteral administration. For use only under medical supervision.

Children: Use in children may require adjusting the daily consumption to meet the Recommended Daily Allowance for the age group involved.

Dosage And Administration:

1 800 mL or 7 520 kJ (6 servings or 1 800 kcal) provides at least 100% of the Canadian RNI (adult males, 25 to 49) for essential vitamins and minerals. May be administered by nasogastric, nasointestinal, esophagostomy, gastrostomy or jejunostomy feeding tube. Follow a physician’s or dietitian’s directions.

Oral: For oral use, the product may be flavored and chilled over ice. Flavoring agents may be used if their contribution to the elemental and nutritional qualities of the diet are kept in mind. It should be sipped slowly, perferably through a straw, when served as a beverage.


Gastric Administration:

Day Strength Approx. Rate mL/hr Kilojoules (kJ)/24 hrs Nitrogen (g)/24 hrs

1 1/2 50 2 510 2.4

2 Full 50 5 020 4.8

3 Full 100 10 041 9.6

4 Full 125 12 552 12.0

Intestinal Administration:

1 1/2 50 2 510 2.4

2 1/2 100 5 020 4.8

3 3/4 100 7 531 7.2

4 Full 100 10 041 9.6

5 Full 125 12 552 12.0

Tolerex is a perishable liquid food when in solution. A full day’s supply may be prepared at one time and stored in the refrigerator for up to 48 hours, shake the liquid before serving. Do not leave at room temperature for more than 8 hours.

Availability And Storage:

Each 80 g packet contains: D maltodextrin, magnesium gluconate, L-glutamine, calcium glycerophosphate, L-arginine acetate, modified cornstarch, L-aspartic acid, glycine, L-lysine acetate, L-leucine, safflower oil, potassium chloride, L-proline, L-phenylalanine, L-valine, L-alanine, L-methionine, L-threonine, L-isoleucine, sodium phosphate dibasic, L-serine, potassium sorbate, potassium citrate, L-histidine monohydrochloride monohydrate, sodium citrate, L-tryptophan, L-tyrosine, choline bitartrate, polyoxyethylene sorbitan monooleate, ascorbic acid, ferrous sulfate, alpha tocopheryl acetate, zinc sulfate, niacinamide, copper gluconate, calcium pantothenate, manganese sulfate, ascorbyl palmitate (to preserve freshness), vitamin A palmitate, alpha tocopherol (to preserve freshness), pyridoxine HCl, riboflavin, thiamine HCl, chromic acetate, folic acid, BHA/BHT (to preserve freshness), biotin, potassium iodide, sodium molybdate, sodium selenite, phytonadione (vitamin K 1), cholecalciferol (vitamin D 3), cyanocobalamin (vitamin B 12).

Table II – Tolerex

Analysis 100 mL

Energy 418 (100) kJ (kcal)

Protein 2.1 g

Carbohydrate 23 g

Fat 0.15 g

Linoleic Acid 0.12 g

Sodium 47 mg

Potassium 120 mg

Vitamin A 280 IU

Vitamin C 3.3 mg

Thiamine 0.083 mg

Riboflavin 0.094 mg

Niacin 1.1 mg

Calcium 56 mg

Iron 1.0 mg

Vitamin D 22 IU

Vitamin E 1.7 IU

Vitamin B6 0.11 mg

Folic Acid 0.022 mg

Vitamin B12 0.0003 mg

Phosphorus 56 mg

Iodine 0.009 mg

Magnesium 22 mg

Zinc 0.83 mg

Copper 0.11 mg

Biotin 0.017 mg

Pantothenic Acid 0.56 mg

Vitamin K 0.0037 mg

Choline 4.1 mg

Chloride 95 mg

Manganese 0.11 mg

Selenium 0.004 mg

Chromium 0.007 mg

Molybdenum 0.004 mg

The standard dilution of 4.2 kJ (1 kcal)/mL has a pH of approximately 5.5 and an average osmolality of 550 mOsm/kg/water. Pouches of 80 g, cartons of 6, cases of 10 cartons. Store unopened powder below 30°C.

TOLEREX® Novartis Nutrition Elemental Diet

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