DEXTROSE 10% AND SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides caloric supplementation and serves as a source of glucose for cellular metabolism. Sodium chloride provides electrolytes for maintenance of fluid and electrolyte balance.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle; sodium chloride is not metabolized. |
| Excretion | Dextrose and sodium chloride are endogenous substances. Dextrose is metabolized to CO2 and water; excess is excreted renally as glucose. Sodium and chloride are primarily excreted renally, with minimal biliary/fecal elimination. Nearly 100% of infused sodium and chloride are eliminated renally under normal conditions. |
| Half-life | Dextrose has a plasma half-life of approximately 1-2 hours; sodium and chloride have half-lives that depend on renal function and hydration status, typically 6-12 hours for sodium. In clinical context, half-life is not typically used for fluid and electrolyte replacement. |
| Protein binding | Dextrose: negligible (<1%). Sodium: negligible. Chloride: negligible. |
| Volume of Distribution | Dextrose: approximately 0.2 L/kg (extracellular fluid). Sodium: 0.2 L/kg (extracellular fluid). Chloride: 0.2 L/kg (extracellular fluid). These reflect distribution primarily in extracellular space. |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: immediate (seconds to minutes) for volume expansion and electrolyte correction. |
| Duration of Action | Intravenous: 1-2 hours for dextrose distribution and metabolism; electrolyte effects persist until renal excretion. Continuous infusion required for sustained effect. |
Intravenous infusion; typical adult dose is 1000-2000 mL per day, rate dependent on clinical condition and fluid status; maximum infusion rate usually 5 mL/kg/hour.
| Dosage form | INJECTABLE |
| Renal impairment | eGFR <30 mL/min: Use with caution; monitor fluid and electrolyte balance; adjust volume and rate based on renal function and urine output. |
| Liver impairment | No specific adjustment required; use caution in severe hepatic impairment due to potential volume overload. |
| Pediatric use | Weight-based: Initial dose 5-10 mL/kg, may repeat as needed; maintenance: 80-120 mL/kg/day for infants and 60-80 mL/kg/day for older children; adjust rate based on clinical response and glucose/electrolyte monitoring. |
| Geriatric use | Start at lower end of adult dose; monitor for fluid overload, hyperglycemia, and electrolyte disturbances due to decreased renal function and cardiovascular reserve. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Breastfeeding | Both dextrose and sodium chloride are endogenous substances and are present in breast milk at concentrations similar to maternal plasma. M/P ratio: Not applicable; considered compatible with breastfeeding. |
| Teratogenic Risk | First trimester: No evidence of teratogenicity from dextrose or sodium chloride at recommended doses. Second and third trimesters: Use is generally safe; however, administration of large volumes may cause electrolyte imbalances and fluid overload, potentially affecting fetal hydration status. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia (severe) or diabetic coma with hyperglycemia","Hypersensitivity to any component","Clinically significant hypernatremia or fluid overload","Patients with increased intracranial pressure"]
| Precautions | ["Risk of hyperglycemia, especially in patients with diabetes mellitus or impaired glucose tolerance","Risk of fluid overload, particularly in patients with cardiac or renal impairment","Electrolyte imbalances with prolonged use or rapid infusion","May cause phlebitis or extravasation at infusion site","Use with caution in patients with intracranial or intraspinal hemorrhage"] |
| Food/Dietary | No specific food interactions. However, due to dextrose content, patients with diabetes should monitor blood glucose closely. Avoid concurrent use with alcohol due to risk of hypoglycemia or hyperglycemia. |
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| Fetal Monitoring | Monitor maternal serum glucose and electrolytes if large volumes are administered. Assess for signs of fluid overload (e.g., edema, hypertension) in both mother and fetus. Fetal heart rate monitoring may be indicated if maternal glucose levels are significantly altered. |
| Fertility Effects | No known adverse effects on fertility from dextrose or sodium chloride at therapeutic doses. |
| Clinical Pearls | Contains 10% dextrose (100 g/L) and 0.2% sodium chloride (34 mEq/L Na+ and Cl-). Osmolality approximately 505 mOsm/L, pH ~4.0. Provides 340 kcal/L. Use with caution in patients with fluid overload, heart failure, or renal impairment. Monitor serum glucose, electrolytes, and fluid balance. Not for use as a sole source of nutrition; consider thiamine supplementation in chronic alcoholics to prevent Wernicke's encephalopathy. Do not administer with blood products through same IV line. |
| Patient Advice | This solution provides sugar (dextrose) and salt (sodium chloride) to help maintain your body's fluid and energy balance. · Report any signs of allergic reaction, such as rash, itching, or difficulty breathing, during infusion. · Inform your healthcare provider if you have diabetes, high blood pressure, heart failure, or kidney disease. · This solution is given through a vein; you may feel warmth or discomfort at the injection site. · Follow your doctor's instructions regarding fluid intake and monitoring of blood sugar levels. |