DEXTROSE 10% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for DEXTROSE 10% IN PLASTIC CONTAINER (DEXTROSE 10% IN PLASTIC CONTAINER).
Intravenous dextrose provides a source of calories and water for hydration. Dextrose is metabolized to carbon dioxide and water, yielding energy (approximately 3.4 kcal/g). It also stimulates insulin secretion and promotes glycogen synthesis.
| Metabolism | Dextrose is metabolized via glycolysis, the citric acid cycle, and oxidative phosphorylation to produce ATP, carbon dioxide, and water. Insulin facilitates cellular uptake and metabolism. Excess glucose is stored as glycogen in liver and muscle, or converted to fat via lipogenesis. |
| Excretion | Glucose is primarily metabolized via glycolysis and oxidative phosphorylation to CO2 and water; less than 5% is excreted unchanged in urine under normal conditions. In hyperglycemia with glycosuria, up to 50% may be lost renally. |
| Half-life | The metabolic half-life of glucose is 1.5–2.5 hours; however, the plasma half-life of infused dextrose is approximately 1.5–2 hours, with clinical context indicating that doses >0.5 g/kg/hour can exceed oxidative capacity, leading to hyperglycemia. |
| Protein binding | Glucose is not significantly bound to plasma proteins (<10%); it is freely diffusible. |
| Volume of Distribution | Approximately 0.2 L/kg (total body water), reflecting distribution into extracellular and intracellular spaces; clinical meaning: Vd approximates total body water (0.6 L/kg in lean body mass), but glucose is rapidly taken up by cells. |
| Bioavailability | Oral bioavailability is 100% for absorbed glucose; intravenous administration yields 100% bioavailability. |
| Onset of Action | Intravenous administration of 10% dextrose: hyperglycemic effect within 1–2 minutes; full metabolic effects (e.g., insulin release) occur within 15–30 minutes. |
| Duration of Action | A 500 mL infusion of D10W at 100 mL/h provides glucose for about 30–45 minutes for caloric needs; metabolic effects persist for 1–2 hours after infusion cessation. |
| Molecular Weight | 180.16 |
Intravenous infusion, 500-1000 mL (50-100 g dextrose) as a single dose, rate determined by clinical condition; typical maintenance 100-125 mL/h.
| Dosage form | INJECTABLE |
| Renal impairment | No specific GFR-based dosing adjustment; contraindicated in anuria or oliguria due to volume overload risk; use with caution in renal impairment. |
| Liver impairment | No evidence for Child-Pugh-based adjustment; use with caution in severe hepatic impairment due to risk of fluid overload. |
| Pediatric use | Intravenous infusion, 5-10 mg/kg/min dextrose (equivalent to 3-6 mL/kg/h of D10W) for maintenance; adjust based on glucose monitoring. |
| Geriatric use | Caution due to risk of volume overload, heart failure, and electrolyte disturbances; start at lower rates and monitor closely. |
| 1st trimester | Generally considered safe when used for maternal hydration or hypoglycemia; glucose is a normal metabolic substrate. |
| 2nd trimester | Safe for maternal indications; monitor for maternal hyperglycemia. |
| 3rd trimester | Safe; use with caution in gestational diabetes to avoid fetal hyperinsulinemia. |
Clinical note
Comprehensive clinical and safety monograph for DEXTROSE 10% IN PLASTIC CONTAINER (DEXTROSE 10% IN PLASTIC CONTAINER).
| Placental transfer | Crosses placenta via facilitated diffusion; fetal levels mirror maternal levels. |
| Breastfeeding | Excreted into breast milk as endogenous glucose; no adverse effects expected. Use compatible with breastfeeding. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | No evidence of teratogenic effects in animal studies; not associated with congenital anomalies in humans regardless of trimester. Intravenous glucose crosses the placenta; maternal hyperglycemia may cause fetal hyperinsulinism and neonatal hypoglycemia. Use only if clearly needed. |
| Fetal Monitoring | Monitor maternal blood glucose, fluid status, and electrolyte balance. Fetal monitoring indicated if maternal glucose levels exceed 120 mg/dL or if signs of fetal distress. |
| Fertility Effects | No known adverse effects on fertility. |
■ FDA Black Box Warning
None
| Serious Effects |
Diabetic ketoacidosis (DKA) without concomitant insulin therapyHyperglycemia > 200 mg/dL (use with caution)Intracranial or intraspinal hemorrhage (if administered via IV)Hypersensitivity to dextrose or corn products
| Precautions | Hyperglycemia and hyperosmolar syndrome in patients with glucose intolerance, Risk of fluid overload, especially in patients with heart failure, renal impairment, or edema, Electrolyte disturbances (e.g., hypokalemia, hypophosphatemia) due to insulin-mediated cellular shifts, Thrombophlebitis if infused into small veins, Do not administer if solution is discolored or contains particulate matter |
| Food/Dietary | No direct food interactions. However, dietary intake of carbohydrates may need adjustment to prevent hyperglycemia. Monitor blood glucose levels if eating. |
| Clinical Pearls | Dextrose 10% in water (D10W) is a hypertonic solution (510 mOsm/L) that provides 340 kcal/L. Administer via central line to avoid phlebitis. Monitor serum glucose closely, especially in diabetics and critically ill patients. Use with caution in patients with intracranial hemorrhage as hyperglycemia may worsen outcomes. D10W is often used for neonatal hypoglycemia or as a maintenance fluid when higher dextrose concentrations are needed. Rapid infusion can cause hyperglycemia and osmotic diuresis. |
| Patient Advice | This solution provides sugar and fluids to prevent or treat low blood sugar. · Tell your doctor if you have diabetes, kidney disease, or heart failure. · Report any signs of infection at the IV site such as redness, swelling, or pain. · You may experience increased urination due to the sugar content. · Do not stop the infusion abruptly without medical advice. |
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