DEXTROSE 10% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of carbohydrates to increase blood glucose concentrations, while sodium chloride acts as a source of electrolytes to maintain osmotic pressure and fluid balance.
| Metabolism | Dextrose is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle; sodium chloride is not metabolized. |
| Excretion | Dextrose is metabolized to carbon dioxide and water; excretion of unchanged glucose in urine is minimal (<0.5%) in euglycemic patients. Sodium and chloride are primarily excreted renally (90-95%) with minor fecal loss (<5%). |
| Half-life | For exogenous glucose, the terminal elimination half-life is approximately 2-4 hours in healthy individuals, but may be prolonged in renal impairment or diabetes due to altered insulin dynamics. Sodium and chloride have no defined half-life as electrolytes; their renal clearance maintains homeostasis. |
| Protein binding | Glucose: negligible (<5%). Sodium and chloride: not protein-bound (free ions). |
| Volume of Distribution | Glucose: 0.2-0.3 L/kg (approximate extracellular volume). Sodium and chloride: distribute predominantly in extracellular fluid (0.2 L/kg), with rapid equilibration. Total body distribution volume for dextrose 10% and sodium chloride 0.45% approximates 0.25 L/kg. |
| Bioavailability | Intravenous: 100% (complete bioavailability by definition). Not applicable for other routes due to formulation (IV only). |
| Onset of Action | Intravenous: Immediate onset of plasma volume expansion and glucose elevation within minutes; clinical effect on dehydration correction occurs over minutes to hours depending on infusion rate. |
| Duration of Action | Duration of plasma volume expansion persists for 1-2 hours post-infusion; glucose levels return to baseline within 2-4 hours after infusion stops. Electrolyte effects persist as long as infusion continues, with rapid renal equilibration upon cessation. |
Intravenous infusion. Dose is individualized based on fluid, electrolyte, and caloric needs. Typical adult maintenance: 100-200 mL/hour of D10 0.45% NaCl, providing 10-20 g/hour dextrose and 77-154 mEq/L sodium. Maximum infusion rate: 0.5-0.8 g/kg/hour dextrose.
| Dosage form | INJECTABLE |
| Renal impairment | Use with caution in renal impairment. For GFR <30 mL/min: reduce sodium and fluid load, monitor serum sodium and glucose. Avoid in anuria. Specific dose reduction not defined; adjust based on fluid/electrolyte status. |
| Liver impairment | Child-Pugh A: no adjustment. Child-Pugh B/C: monitor serum glucose and electrolytes; dextrose may worsen hyperglycemia and fluid retention. Reduce infusion rate if hepatic encephalopathy present. |
| Pediatric use | Intravenous infusion. Dose based on weight: neonates and children: 5-15 mL/kg/hour of D10 0.45% NaCl, titrate to fluid and glucose needs. Maximum dextrose infusion rate: 0.5 g/kg/hour in neonates, up to 0.8 g/kg/hour in older children. Monitor serum glucose closely. |
| Geriatric use | Elderly patients: lower initial infusion rates (100-150 mL/hour) due to reduced renal function and risk of fluid overload. Monitor serum sodium, glucose, and renal function. Avoid in patients with heart failure or hypertension. |
| 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 normal blood constituents and excreted into breast milk in negligible amounts. M/P ratio not established; considered compatible with breastfeeding. No adverse effects expected in breastfed infants. |
| Teratogenic Risk | Dextrose and sodium chloride are physiological substances. No teratogenic effects reported at therapeutic doses. In first trimester, use is considered safe; second and third trimesters, use is safe but caution for fluid and electrolyte balance. No known fetal risks. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia","Hypernatremia","Hypersensitivity to any component","Intracranial or intraspinal hemorrhage (for some formulations)","Patients with known allergies to corn (dextrose source)"]
| Precautions | ["Monitor serum glucose and electrolytes regularly","Risk of hyperglycemia, especially in patients with diabetes mellitus","Risk of hypernatremia or hyperchloremia if excessive sodium load","Use with caution in patients with heart failure, renal impairment, or edema","Intravenous administration must be monitored for signs of fluid overload"] |
| Food/Dietary | No dietary restrictions required. However, monitor caloric intake in diabetic patients as dextrose provides 3.4 kcal/g. |
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| Fetal Monitoring | Monitor maternal blood glucose, serum electrolytes, fluid balance, and urine output. In prolonged use, monitor fetal growth and amniotic fluid volume. Assess for signs of fluid overload or hyperglycemia. |
| Fertility Effects | No known effects on fertility at therapeutic doses. Used as a vehicle for other medications that may affect fertility; however, dextrose/sodium chloride alone does not impair reproductive function. |
| Clinical Pearls | Do not administer simultaneously with blood products due to risk of hemolysis. Monitor serum sodium and glucose levels during prolonged use. Use with caution in patients with heart failure, renal impairment, or hyperglycemia. Incompatible with amphotericin B, diazepam, and phenytoin. |
| Patient Advice | Inform your healthcare provider if you have diabetes, heart failure, or kidney disease. · Report any chest pain, difficulty breathing, or swelling in your legs or feet. · Do not stop the infusion abruptly without consulting your doctor. · This solution provides calories and fluid; it is not a substitute for food. |