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# ALPHA LIPOIC ACID (ALA) IM

## Clinical Purpose

Alpha Lipoic Acid (ALA) IM injection provides antioxidant, metabolic, and mitochondrial support in clients who do not require, or are not suitable for, IV infusion. ALA assists in detoxification, energy production, nerve protection, and reduction of oxidative stress associated with fatigue, metabolic syndrome, or neuropathy.

## ALPHA LIPOIC ACID - 15MG/ML - STANDARD IM DOSE

- 0.5ML-1ML IM
- THIAMINE (B1) 100MG/ML
- RIBOFLAVIN-5-PHOSPHATE (B2) 2MG/ML
- CYANOCOBALAMIN (B12) 1MG/ML

💉 **Total Volume:** 0.5-1mL (max per IM injection site: 1 mL)

📍 **Route:** Deep IM injection

📦 **Site:** Ventrogluteal or dorsogluteal (preferred), alternate: vastus lateralis

## Preparation Procedure

⚕

### 1. Verify Order & Consent

- Confirm authorised medical order and indication.
- Review allergies and contraindications.
- Obtain informed consent and record baseline vitals (BP, HR, RR).

### 2. Preparation

- Use aseptic technique.
- Draw up ALA and co-factors into one syringe (Luer-lock).
- If using multiple ampoules, ensure compatibility and label syringe with compound and dose.

### 3. Administration

- Clean injection site with 70% alcohol swab.
- Insert needle at 90° angle (21–23 gauge, 1–1.5 inch).
- Inject slowly over 10–15 seconds to reduce discomfort.
- Withdraw needle smoothly and apply gentle pressure (do not massage).

### 4. Post-Injection Observation

- Monitor patient for 15–20 minutes for adverse reactions.
- Document site, dose, batch number, and patient response.

## Contraindications / Precautions

⚠

- Known hypersensitivity to ALA or any excipient
- Severe renal or hepatic impairment
- Pregnancy or breastfeeding (safety not established)
- Uncontrolled diabetes (risk of hypoglycaemia)
- Avoid concurrent metal chelation or iron therapy on the same day

## Potential Adverse Effects

🩺

| Effect                                | Management                             |
|---------------------------------------|----------------------------------------|
| Mild burning or stinging at injection site | Slow injection; apply cool compress     |
| Metallic taste                        | Common, transient                      |
| Light-headedness or nausea            | Have patient seated; offer water/snack |
| Hypoglycaemia (rare)                  | Ensure patient has eaten pre-treatment |

## Frequency

⏱

- **Therapeutic phase:** 1–2 times per week for 4–6 weeks
- **Maintenance:** Every 2–4 weeks depending on clinical goals and patient response

## Mechanism of Action

🧠

ALA acts as a universal antioxidant, regenerating glutathione, Vitamin C, and Vitamin E, while supporting ATP production and insulin sensitivity. It helps restore nerve conduction velocity and protect against oxidative damage to mitochondria and tissues.

## Clinical Notes

🧰

- ALA is slightly acidic — inject deep IM only to avoid irritation.
- Rotate injection sites between visits to prevent local tissue irritation.
- Use only preservative-free, sterile compounded ALA suitable for IM use.

## Compliance Statement

🧾

This clinical procedure is provided for educational and practitioner reference only. Use must be under the direction of an authorised prescriber and within AHPRA-approved scope of practice. Complies with TGA advertising restrictions and AHPRA professional communication guidelines.

No Data on Alpha Lipoic Acid (ALA) in AIDH

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