Lipid emulsion

- Lipid emulsion 20%, 100ml vials* and 500ml bags* (IV)

  *Intralipid® and Smoflipid® formulations

Executive Summary

(March 29, 2023)

Intravenous lipid emulsion (IVLE) is a nutritional supplement approved by the US-FDA for parenteral nutrition (22, 23), that have promising results for the treatment of lipophilic agents toxicity, mostly for local anesthetic systemic toxicity (LAST): 

Adult dose for Local Anesthetic Systemic Toxicity (LAST)(9, 11, 17, 18, 19)

Intralipid® 20%, 1,5 ml/kg IV bolus over 1 minute (approximately 100ml in adults), followed by an infusion of 0.25ml/kg/min IV over the next 30-60 minutes. 

Adult dose

Adult dose for Local Anesthetic Systemic Toxicity (LAST)(9, 11, 17, 18, 19)

Adult dose for non-local anesthetics acute toxicity 

Usage of IVLE for other lipophilic agents overdose such as calcium channel blockers, tricyclic antidepressants, beta-adrenergic antagonists, etc, has not been yet validated as a  standard treatment measure. 


US FDA-Labeled (22, 23)

Off-label (6, 10, 12, 19)

About LAST

Local Anesthetics Systemic Toxicity (LAST)

Guidelines on lipid emulsion for LAST

A precise dosing regimen is not yet well established (5, 6, 13, 17, 18, 19).

Mechanism of action for acute toxicity

The mechanisms of action of IVLE in toxicology are not well understood. There are three proposed mechanisms (19):



In depth safety*concerns about Intralipid® and Smoflipid® are discussed in labeling information (22, 23). 

*Known safety data have been studied in IVLE as a nutritional supplement, not for acute toxicity management (6, 8). 

Black Box Warning** (22):

**Black box warning is not included in Smoflipid labeling (23).

Contraindications (22, 23)



Pregnancy and Lactation

Pregnancy risk classification



® 2023 EMDrugs. All rights reserved.


This website provides general information and discussion about medications, health, and related subjects. The words and other con­tent pro­vided in this website, and in any linked mate­ri­als, are not intended and should not be con­strued as med­ical advice. If the reader or any other per­son has a med­ical con­cern, he or she should con­sult with an appropriately-licensed physi­cian or other legally accredited health care worker in the country that resides or is visiting. 


Please do not delay your medical concerns and potential health emergencies by searching information in this website, instead look out for medical opinion in the services that exist with that specific purpose and work under the respective local health-care regulations. 


The views expressed on this blog and web­site have no rela­tion to those of any academic, hospital, practice or other insti­tu­tion with which the authors are  affiliated. 


For other instances, the authors of this website do not have any conflict of interest with any institution or pharmaceutical company in particular, and do not receive any compensation about any licenced drug mentioned in the website. In the same matter, the website is not intended to recommend any specific patented medication.

EMDrugs Team