Can Jevity (peptide-based nutritional formula) 1.5 be substituted for Isosource (balanced nutritional formula) 1.5?

Can Jevity 1.5 Be Substituted for Isosource 1.5?

Yes, Jevity 1.5 can be substituted for Isosource 1.5 in most clinical situations, as both are standard whole-protein, high-calorie-density formulas (1.5 kcal/mL) that are nutritionally equivalent and interchangeable for general enteral nutrition needs. 1

Formula Classification and Equivalence

Both Jevity 1.5 and Isosource 1.5 are classified as standard enteral formulas with high caloric density:

• Standard formulas contain intact proteins, predominantly long-chain triglycerides, and polysaccharides as the primary carbohydrate source 1
• These formulas are nutritionally complete, typically lactose-free and gluten-free, and generally contain fiber 1
• Standard formulas with 1.5 L volume typically meet complete energy, protein, and micronutrient requirements 1
• High-calorie-density formulas (≥1.5 kcal/mL) are specifically recommended for patients requiring fluid restriction or higher caloric intake in smaller volumes 2

Clinical Evidence Supporting Interchangeability

The medical literature demonstrates these formulas perform similarly:

• No clinical advantage has been demonstrated for peptide-based formulas over whole-protein formulas in critically ill patients, supporting the use of standard formulas as first-line therapy 2
• In Crohn's disease, there are no significant differences between free amino acid, peptide-based, and whole-protein formulas for tube feeding efficacy 2
• Standard formulas are appropriate for most patients, with formula selection based on patient-specific needs rather than brand preference 1, 3

Practical Considerations

Flow Rate Compatibility

• Jevity 1 Cal and Isosource formulas demonstrate similar gravity flow rates through standard feeding tubes (14F, 18F, 20F sizes), ensuring comparable delivery characteristics 4

FODMAP Content Difference (Important Caveat)

• Isosource 1.5 has significantly lower FODMAP content (47-71% lower) compared to other formulas, which was associated with a five-fold reduction in diarrhea risk in hospitalized patients 5
• If a patient is currently tolerating Isosource 1.5 well and has a history of diarrhea with enteral nutrition, consider maintaining Isosource 1.5 rather than switching to Jevity 1.5 5
• Conversely, if switching from Jevity 1.5 to Isosource 1.5, expect potentially improved gastrointestinal tolerance 5

When Standard Formulas Are NOT Appropriate

Avoid substitution and reassess formula choice if the patient has:

• Documented malabsorption requiring peptide-based formulas with medium-chain triglycerides 1
• Severe pancreatic insufficiency where standard formulas are poorly tolerated 2
• Specific disease states requiring specialized formulas (renal failure, hepatic encephalopathy with specific amino acid requirements) 1

Bottom Line Algorithm

1. For general enteral nutrition needs: substitute freely between Jevity 1.5 and Isosource 1.5 1
2. If patient has diarrhea with current formula: prefer Isosource 1.5 due to lower FODMAP content 5
3. If patient requires fluid restriction: both 1.5 kcal/mL formulas are appropriate 2
4. If malabsorption is present: neither formula is appropriate; use peptide-based formula instead 1