Peptibren is a special nutrition with high energy for patient with special nutrition needs to improve brain health and prevent malnutrition.
Peptibren contains :
- High protein amount
- Choline
- Phosphatidylserine
- Nucleotide
- Completed with vitamins and minerals
Feature Benefit
| FEATURE | BENEFIT |
| High protein | Help in cell tissue recovery |
| Choline | Protect neuron cell & prevented cognitive decline |
| Phosphatidylserine | Repair 4 cognitive functions : memory, mood, behaviour, signs of depression |
| Nucleotide | Improve learning and memory skill |
| Maltodextrin as carbohydrate source | Easily dissolved & absorbed (no hot water), mask the fishy taste of fat and the bitter taste of protein |
| Combine whey and casein | Creating faster and longer protein synthesis. |
| Non animal fat | Rich in MUFA and PUFA, MCT, and also the content of USFA (twice higher) than SFA. |
| Sucralose as sweetener | Does not affect blood sugar levels, carbohydrate metabolism or insulin production. |
| Density 1.16 | Can be given through NGT/Sonde/tube feeding. |
References :
1.Alvarez-Sabin J, Roman GC. Citicoline in vascular cognitive impairment and vascular dementia after stroke. Stroke. 2011;42(1 Suppl):S40-3
2.Kato-Kataoka A, Sakai M, Ebina R, et al. Soybean-derived phosphatidylserine improves memory function of the elderly Japanese subjects with memory complaints. J Clin Biochem Nutr. 2010;47:246-55.
3.PEPTIBREN[Product Information] Jakarta. Indonesia. PT Kalbe Farma Tbk; 2020
4.Poulia, L. Nutritional support of stroke patient. ESPEN Congress Lisbon 2015 [Internet]. 2015 [cited 17 January 2019]. Available from: http://www.espen.org/presfile/Poulia_2015.pdf
5.Volkert D, Chourdakis M, Faxen-Irving G, et al. ESPEN guidelines on nutrition in dementia. Clin Nutr. 2015;34(6):1052-73.
Preparation
Peptibren can be taken orally or administered via a nasogastric tube.
- Oral feeding: To prepare a 250 ml feeding, gradually add 4 level scoops of Peptibren (+ 69 gram) into a 200 ml warmed water and mix until dissolve. Other alternative, Peptibren can be served like snack, smoothie, pudding, etc. It’s not advisable to cook or boil in high temperature (above 600 Celsius) as it may denature protein content of Peptibren. Consume Peptibren in between meals.
- Tube feeding: Follow physician’s instructor.
- Not intended to be used for parenteral administration
Nutrition Fact
1.16 kcal/mL nutritionally complete nutritional drink, with choline, phosphatidylserine, nucleotide, high protein, omega -3, omega-6, 11 vitamins, and 9 minerals
| NUTRITION | UNIT | PER SERVING | % DV |
| Calories | kCal | 290 | |
| Calories from fat | kCal | 50 | |
| Total Fat | g | 5 | 9% |
| Saturated fatty acid | g | 2 | |
| Monosaturated fatty acid | g | 3 | |
| Polyunsaturated fatty acid | g | 1.5 | |
| Protein | g | 15 | 25% |
| Total Carbohydrates | g | 44 | 15% |
| Sugar | g | 12 | |
| Fiber | g | 3 | 11% |
| Vitamins | |||
| Vitamin A | 30% | ||
| Vitamin C | 80% | ||
| Vitamin D3 | 8% | ||
| Vitamin E | 25% | ||
| Vitamin B1 | 50% | ||
| Vitamin B2 | 35% | ||
| Niacin | 25% | ||
| Vitamin B6 | 30% | ||
| Vitamin B12 | 15% | ||
| Folic Acid | 25% | ||
| Pantothenic Acid | 15% | ||
| Minerals | |||
| Sodium | mg | 65 | 3% |
| Potasium | mg | 710 | 15% |
| Calcium | 30% | ||
| Iron | 8% | ||
| Phosphorus | 30% | ||
| Magnesium | 25% | ||
| Zinc | 45% | ||
| Iodium | 15% | ||
| Selenium | 35% | ||
| Specific Nutrients | |||
| Medium Triglyceride | g | 1.1 | |
| Omega 3 | g | 0.2 | |
| Omega 6 | g | 1 | |
| Inulin | g | 3 | |
| Choline | mg | 128 | |
Ingredients
Maltodextrin, Sucrose, Calcium Caseinate, Vegetable Oil, Whey Protein, Inulin, Nucleotide, Phospholipid (Phosphatidylserine), Artificial Vanilla Flavor, Artificial Milk Flavor, Vitamins and Minerals
Storage
Opened package should be stored tightly in a cool, dry, and clean place. Consume within 1 month of opening.
Packaging & Flavor
1 box contain 210 gram nutrition powder with Vanilla flavor.
1 box available for 3 servings.
FAQ
What is the content of Peptibren?
Peptibren is a special enteral nutrient for neurological disease, has a composition of 63% carbohydrates, 21% protein and 16 % fat and completed with Choline, Phosphatidylserine and Uridine Monophosphate to improve cognitive function of neurological disease patient
Stroke patient have to limit the sodium intake < 2 g/day, What is the sodium content of Peptibren?
Sodium content of Peptibren is 105 mg per serving, so it is far from the maximum limit of sodium intake recommended for stroke patients.
Can Peptibren be given to patient with impaired kidney function or impaired liver function ?
Special attention needed; especially for patients with impaired kidney function, where protein intake needs to be limited. But for patients with impaired liver function, Peptibren can be given with the supervision of a nutritionist.
Can Peptiben be given to neurological patients with diabetes mellitus (DM)?
DM patients who are given Peptibren to always monitor their blood sugar levels in order to stay controlled. Sometimes it is necessary to adjust the dose or adjust the type of diabetes medication so that the fulfillment of nutrition in DM patients is met.
Can Peptibren be combined with Parenteral Nutrition ?
Peptibren can be combined with Parenteral Nutrition to fulfill daily requirement
Can Peptibren be combined with other enteral nutrients?
Peptibren can be combined with other enteral nutrients if needed, but the dissolution process should be done separately.
Can the addition of water be reduced during the dissolution process?
Yes, but the dissolution process will take a little longer, and it is recommended not to exceed 1.5 density if it is to be given via tube. The dissolving process with a smaller amount of water can use a shaker to make it easier.
What is the stability / method of storing Peptibren before it is dissolved?
The unlocked Peptibren lasts for 1 month as long as it stays in the aluminum bag. Store in a dry place with a temperature <25 degrees Celsius. It is not recommended to move Peptibren into other places because it can interfere with its stability. If it is to be stored in a jar it should be together with the aluminum bag.
What is the stability / method of storing Peptibren after dissolving?
Peptibren which has been dissolved in 5 hours must be taken. If you have not finished drinking Peptibren can be stored in the refrigerator, only afterwards it is not recommended to be heated (Microwave).
What is the preparation for NGT patients?
The same with oral preparations depends on how many calorie patient needs. It can be accepted for the tube feeding size: 16 – 18 gauge and put each scoops gradually (while stirring and mix until dissolve to avoid the granules) and make sure that the density does not exceed than 1.5 kcal/mL
Why should Peptibren not be dissolved in hot water?
When the protein is heated, the protein becomes clotted because the peptide bonds are destroyed by heat, because the middle group contains a positive charge and the carbonyl contains a negative charge whose kinetic increases when hot. After clotting, the peptidase enzyme can no longer work on the protein. The more peptide chains and the longer the structure, the greater the chance that the protein will be damaged by heat.
Can Peptibren be heated?
You should not because it can damage heat-prone components such as protein and omega-3 fatty acids can be damaged.
How many servings of Peptibren can be consumed per day ?
If as a substitute food, Peptibren can be given up to 6 times / day or adjusted to the needs and patient’s conditions. If as a complementary food can be given 2-3 times / day.
Can Peptibren be given to depression patient?
One of specific nutrition in Peptibren is Phosphatidylserine that can improve activation of dopamine. People with depression often exhibit reduced motivation, anhedonia (a decrease in pleasure from usually enjoyed things), sometimes motor decreases as well. All of these are linked with dopamine. Targeting the dopamine system is one of the ways in which we can look at potential mechanisms and treatments for depressive behaviors. So Peptibren can be given to patient with depression.
What is the source of carbohydrates used in Peptibren?
Maltodextrin. Maltodextrin has the advantage of being easily absorbed so that it will optimize the formation of energy. Peptibren also dissolves easily, so the process of dissolving Nephrisol does not need to use hot water. Maltodextrin can help give volume (solid builder) by drawing water from dried products. Peptibren has a sweeter taste than sugar but has less sugar content, and serves to mask the fishy taste of fat and the bitter taste of protein content.
Can Peptibren be given to patient in acute condition?
In acute conditions where the patient's hemodynamics is unstable, nutrition should be postponed until the hemodynamic correction is stable. After that enteral nutrition can be given gradually (start slow go slow end slow), it can be started with half of the daily calorie needs, then it can be increased slowly (every 3 days) until can meet the daily calorie needs. If the patient can eat orally, then enteral administration can be switched to the oral route or switched to a regular diet.
In patients with gastric disease where patients eat using enteral tubes can Peptibren still be given?
If, the tube is up to the duodenum, generally they can still use Peptibren which is polymeric in nature. Whereas if you use the tube to jejunum, then the nutrition given must be oligomeric and Peptibren is not appropriate.
If, after consuming Peptibren patient gets diarrhoea, can it still continue to be given?
When diarrhoea occurs, it should be stopped. Only patients with severe lactose intolerance will experience diarrhoea with Peptibren. After the diarrhoea is treated, Peptibren can be given continuously, especially in patients with severe diarrhoea or can also be tried with a small amounts, for example; 1-2 measuring spoonful only, to stimulate lactase formation so that lactose intolerance in these patients is reduced and ultimately Peptibren can be given when there is no diarrhoea.
Can Peptibren be combined with oral citicoline?
The addition of Peptibren to Citicoline therapy will not exceed the patient's maximum daily citicoline requirements.
