DRUG	SUPPLIED	DOSE	COMMENTS
SODIUM BENZOATE AND SODIUM PHENYLACETATE (Paeds) (Ammonul) Mechanism of action: Provides alternate pathway for ammonia removal. Ref: 61, 110, 151 Last update: 2023-10-23	10% injection: 100 mg Na benzoate per mL and 100 mg Na phenylacetate per mL. Available only through Health Canada’s Special Access Program. An emergency supply is kept at BCCH and individual patient use will be tracked by the pharmacy.	I.V.: Weight <20 kg: Loading dose: 250 mg/kg/dose IV over 90-120 min. followed by maintenance: 250-500 mg/kg/24 hr by continuous IV infusion. Weight > 20 kg: Loading dose: 5.5 g/m2/dose IV over 90-120 min. followed by maintenance: 5.5 g/m2/24 hr by continuous IV infusion. Max 12 g/24 h. Dose refers to grams of one of the components only.	mixed with L-arginine in D10W. pre-treatment with IV ondansetron prior to IV loading dose is recommended; followed by PRN doses. Supplemental potassium may be required; monitor. KCl is usually added to the continuous IV infusion mixture at 20 mmol/L. If on hemodialysis/hemodiafiltration, maintenance IV infusion should be increased to 350 mg/kg/day (or proportional increase for BSA/m2 dose calculation). Standard Prescription: Ammonul __g IV load (__g/kg or g/m2), then __g by continuous IV infusion (__g/kg/24 hr or g/m2/24 hr)