DEXTROSE 2.5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides calories and serves as a source of glucose for cellular metabolism. Sodium chloride supplies electrolytes to maintain osmotic balance and fluid distribution.
| Metabolism | Dextrose is metabolized via glycolysis to pyruvate, entering the Krebs cycle for energy production; regulated by insulin and other hormones. Sodium chloride is not metabolized; it dissociates into Na+ and Cl- ions and is excreted primarily by the kidneys. |
| Excretion | Renal: Glucose is completely reabsorbed or metabolized; negligible excretion. Sodium and chloride are primarily excreted renally, with >90% reabsorption under normal conditions; excess is excreted in urine. Water follows solute excretion. |
| Half-life | Glucose: ~1.5-2 hours (metabolic clearance); Sodium: biological half-life ~2-3 weeks (exchangeable pool); Chloride: ~12-24 hours (renal adaptation). Clinical context: Dextrose 2.5% provides ~85 kcal/L as glucose, rapidly cleared, while sodium and chloride are regulated by renal function and hormonal control. |
| Protein binding | Glucose: <5% bound (non-specifically to albumin); Sodium and chloride: negligible (<1% bound). |
| Volume of Distribution | Dextrose: ~0.2 L/kg (intracellular distribution); Sodium: ~0.2-0.3 L/kg (extracellular fluid); Chloride: ~0.2-0.3 L/kg (extracellular fluid). Values represent distribution into total body water. |
| Bioavailability | IV: 100% bioavailability for all components. Not administered via other routes. |
| Onset of Action | IV: Dextrose increases blood glucose within 5 minutes; sodium and chloride correct serum levels within 15-30 minutes due to rapid distribution. |
| Duration of Action | IV: Metabolic effects of dextrose last 1-2 hours; volume expansion and electrolyte effects last 1-2 hours depending on renal function. Continuous infusion required to maintain effect. |
Intravenous infusion, rate depends on clinical condition; typical maintenance: 100-200 mL/hour for adults.
| Dosage form | INJECTABLE |
| Renal impairment | Anuria: contraindicated; severe impairment (eGFR <30 mL/min): use with caution and monitor fluid balance. |
| Liver impairment | No dose adjustment recommended based on Child-Pugh score; monitor for fluid overload in cirrhosis. |
| Pediatric use | Weight-based: 4-8 mg/kg/min dextrose as continuous infusion; adjust rate based on serum glucose and electrolytes. |
| Geriatric use | Use with caution due to decreased renal function; reduce infusion rate and monitor for hyperglycemia and fluid overload. |
| 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 | Compatible with breastfeeding. Dextrose and electrolytes are normal milk constituents; no adverse effects expected. M/P ratio not applicable/unknown as these are endogenous substances. |
| Teratogenic Risk | No known teratogenic risk in any trimester at physiologic concentrations. Dextrose and sodium chloride are essential nutrients and electrolytes; no human or animal studies indicate teratogenicity. However, hyperglycemia from excessive dextrose may cause fetal macrosomia, neonatal hypoglycemia, or other diabetic fetopathy if maternal glucose is poorly controlled. Use caution in gestational diabetes. |
■ FDA Black Box Warning
Not for use in patients with intracranial or intraspinal hemorrhage, or in patients with known hypersensitivity to corn or corn products (dextrose derived from corn). Solutions containing sodium chloride should be used with caution in patients with congestive heart failure, severe renal insufficiency, or conditions involving sodium retention.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia with severe dehydration","Intracranial or intraspinal hemorrhage","Known hypersensitivity to corn or corn products","Severe electrolyte disturbances","Anuria or severe renal impairment with oliguria"]
| Precautions | Use with caution in patients with hyperglycemia, diabetes mellitus, renal impairment, congestive heart failure, or conditions predisposing to fluid overload. Monitor serum glucose, electrolytes, and fluid balance. Avoid extravasation; may cause tissue necrosis. |
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| Fetal Monitoring | Monitor maternal blood glucose (especially in diabetes or gestational diabetes), serum electrolytes, fluid balance, and signs of fluid overload (edema, hypertension). In prolonged therapy, monitor maternal and fetal heart rate, uterine activity if IV line is used peripartum. Assess fetal growth and amniotic fluid volume if long-term parenteral nutrition. |
| Fertility Effects | No known adverse effects on fertility. Dextrose and sodium chloride are physiologic; no reproductive toxicity reported. |