DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER (DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER).
Peritoneal dialysis solution; dextrose provides osmotic gradient for ultrafiltration and solute removal; low magnesium and low calcium concentrations maintain electrolyte balance.
| Metabolism | Dextrose is metabolized via glycolysis and oxidative phosphorylation; electrolytes are excreted renally or via dialysis. |
| Excretion | Renal: 100% (unchanged dextrose and electrolytes; magnesium and calcium are partially reabsorbed, but net excretion is via urine). Biliary/fecal: negligible. |
| Half-life | Dextrose: 1.5–2 hours (intracellular metabolism); Magnesium: 27–40 hours; Calcium: 2.5–3 hours (exchangeable pool); Low concentrations do not alter endogenous kinetics. |
| Protein binding | Dextrose: none; Magnesium: ~30% (to albumin); Calcium: ~45% (to albumin and globulins). |
| Volume of Distribution | Dextrose: 0.2–0.3 L/kg (extracellular fluid); Magnesium: 0.5–0.6 L/kg; Calcium: 0.2–0.3 L/kg; reflects distribution into interstitial and intracellular spaces. |
| Bioavailability | Intraperitoneal: 100% (complete absorption of dextrose and electrolytes across peritoneal membrane). |
| Onset of Action | Intraperitoneal: rapid (within minutes) for glucose absorption and electrolyte distribution; dextrose serum levels rise within 15–30 minutes. |
| Duration of Action | Dwell time in peritoneal dialysis: 4–6 hours for typical exchanges; glucose absorption continues for duration of dwell; electrolyte effects persist until drainage. |
Intraperitoneal: 2.5% dextrose solution with low magnesium (0.25 mEq/L) and low calcium (2.5 mEq/L); typical exchange volume 2-2.5 L per exchange, 4-5 exchanges per day for continuous ambulatory peritoneal dialysis.
| Dosage form | SOLUTION |
| Renal impairment | Not applicable; drug is used for peritoneal dialysis in end-stage renal disease. No dose adjustment needed as it is a dialysis solution. |
| Liver impairment | No specific adjustments for Child-Pugh classes; use with caution in severe hepatic impairment due to potential lactate accumulation, but no dose modification guidelines. |
| Pediatric use | Intraperitoneal: 30-40 mL/kg per exchange, frequency determined by dialysis prescription (typically 4-5 exchanges per day). Adjust dextrose concentration based on fluid removal needs. |
| Geriatric use | Same dosing as adults; monitor for fluid overload, electrolyte imbalances, and peritonitis. Lower initial exchange volumes (1.5-2 L) may be considered in frail elderly. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER (DELFLEX W/ DEXTROSE 2.5% LOW MAGNESIUM LOW CALCIUM IN PLASTIC CONTAINER).
| Breastfeeding | Minimal systemic absorption; dextrose and electrolytes are normal blood constituents. M/P ratio not applicable. Considered compatible with breastfeeding. |
| Teratogenic Risk | No fetal harm reported in animal studies; considered low risk. Intraperitoneal glucose and electrolytes at physiologic doses are not teratogenic. No human data available for first trimester; however, systemic absorption of dextrose and electrolytes from peritoneal dialysis is minimal. No known risk of congenital malformations. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hypersensitivity to any component","Severe hypercalcemia or hypermagnesemia","Anuria without dialysis","Significant abdominal pathology (e.g., recent surgery, adhesions)"]
| Precautions | ["Monitor serum electrolytes, glucose, and fluid balance closely","Risk of hyperglycemia, especially in diabetic patients","Peritonitis risk with catheter use","Not for intravenous use","Use with caution in patients with severe hypocalcemia or hypomagnesemia"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, and renal function. Fetal monitoring indicated for maternal metabolic disturbances. Assess fetal growth if long-term use. |
| Fertility Effects | No known effect on fertility. Dextrose and electrolytes at physiologic concentrations do not impair reproductive function. |