DEXTROSE 2.5% AND SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides caloric support and helps correct hypoglycemia. Sodium chloride is an electrolyte that maintains osmotic balance and fluid volume.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle. Sodium chloride is not metabolized; it is excreted renally. |
| Excretion | Dextrose is metabolized to CO2 and water via glycolysis and the Krebs cycle; negligible renal excretion (<5%). Sodium chloride is excreted renally with sodium and chloride ions freely filtered and variably reabsorbed (99% reabsorption under normal conditions, but excretion increases with excess intake). |
| Half-life | Not applicable for dextrose as it is rapidly metabolized; plasma glucose half-life is approximately 1.7-2.0 hours after IV infusion but highly variable depending on metabolic demand and insulin activity. For sodium chloride, ions are continuously regulated by renal handling; no traditional half-life. |
| Protein binding | Dextrose: negligible (<1%); not protein-bound. Sodium and chloride ions: negligible (<1%); are free ions in plasma. |
| Volume of Distribution | Dextrose: approximately 0.25-0.4 L/kg, reflecting distribution primarily into extracellular fluid and cells. Sodium chloride: sodium distributes mainly in extracellular fluid (Vd ~0.2 L/kg for sodium), chloride follows sodium distribution. |
| Bioavailability | Intravenous: 100% (complete bioavailability). No other relevant routes; oral dextrose is absorbed but formulation is for IV use only. |
| Onset of Action | Intravenous: Immediate (within seconds) for volume expansion and dextrose delivery as the solution is directly infused into the bloodstream. |
| Duration of Action | Intravenous: Short; dextrose effect on plasma glucose lasts 1-2 hours after infusion stops, while volume expansion from sodium chloride persists for 2-4 hours depending on renal function and distribution. |
| Molecular Weight | 180.156 (dextrose); 58.44 (sodium chloride) |
Intravenous infusion; dosage depends on fluid and electrolyte requirements. Typical maintenance: 75-150 mL/kg/day for adults, administered as continuous infusion.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >= 50 mL/min: no adjustment; GFR 30-49 mL/min: reduce total volume by 20-30% or use with caution; GFR <30 mL/min: avoid use due to risk of fluid overload and hypernatremia unless carefully monitored. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B: monitor for fluid overload and electrolyte disturbances; Child-Pugh C: use with caution, reduce infusion rate and volume, may need diuretic therapy. |
| Pediatric use | Intravenous infusion: neonates: 60-120 mL/kg/day; infants: 100-120 mL/kg/day; children: 75-100 mL/kg/day; adjust based on clinical status and serum electrolytes. |
| Geriatric use | Elderly patients may require reduced total volume and slower infusion rate due to decreased renal function and increased risk of fluid overload; monitor serum sodium, potassium, and fluid balance closely. |
| 1st trimester | Dextrose and sodium chloride are essential nutrients; use is generally considered safe during pregnancy when administered for fluid and electrolyte maintenance. No known teratogenic effects. |
| 2nd trimester | Safe for use in second trimester for hydration and electrolyte replacement. Monitor for fluid overload and electrolyte disturbances. |
| 3rd trimester | Safe for use; however, caution in patients with preeclampsia or impaired renal function due to risk of fluid overload. May affect fetal glucose and sodium levels if maternal levels are abnormal. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Both dextrose and sodium chloride freely cross the placenta by passive diffusion, achieving equilibrium with maternal concentrations. Fetal levels mirror maternal levels. |
| Breastfeeding | Dextrose and sodium chloride are normal components of breast milk. Intravenous administration is compatible with breastfeeding as the amounts transferred are negligible. No special precautions needed. |
| Lactation Rating | L1 - Safe |
| Teratogenic Risk | Dextrose and sodium chloride are physiologic substances. No teratogenic risk has been identified at standard infusion rates. First trimester: No known risk. Second trimester: No known risk. Third trimester: Use caution to avoid fluid/electrolyte imbalance, which may affect fetal homeostasis. |
| Fetal Monitoring | Monitor maternal serum electrolytes, blood glucose, fluid balance, and vital signs. Fetal monitoring should include heart rate and growth if prolonged administration occurs. Watch for maternal edema or hyperglycemia. |
| Fertility Effects | No known adverse effects on fertility. Dextrose and sodium chloride are essential for cellular function and do not impair reproductive capacity at therapeutic doses. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia (for dextrose component)Hypernatremia (for sodium chloride component)Fluid overloadSevere renal impairment with oliguria
| Precautions | Risk of hyperglycemia in patients with diabetes mellitus, Risk of fluid overload in patients with heart failure or renal impairment, Electrolyte imbalances with prolonged use, Do not administer if solution contains particulate matter or is discolored |
| Food/Dietary | No food interactions. May affect glucose control in diabetics; maintain consistent carbohydrate intake. |
| Clinical Pearls | Used for maintenance fluid therapy; monitor for fluid overload in patients with CHF or renal impairment. Check serum glucose in diabetics as dextrose may cause hyperglycemia. Avoid in resuscitation due to hypotonicity. |
| Patient Advice | Report any swelling of hands, feet, or shortness of breath immediately. · If diabetic, monitor blood glucose closely. · This solution provides hydration and electrolytes; do not adjust infusion rate yourself. |
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