DEXTROSE 10% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive 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. |
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 | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DEXTROSE 10% IN PLASTIC CONTAINER (DEXTROSE 10% IN PLASTIC CONTAINER).
| Breastfeeding | Endogenous glucose is a normal component of breast milk. Intravenous dextrose infusion increases maternal blood glucose, leading to increased milk glucose concentrations. No adverse effects expected. M/P ratio not applicable. |
| 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. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hyperglycemia (severe)","Intracranial or intraspinal hemorrhage","Delirium tremens with dehydration","Hypersensitivity to dextrose or any component of the formulation","In patients with anuria, renal failure, or severe fluid overload"]
| 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"] |
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| 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. |