DEXTROSE 2.5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DEXTROSE 2.5% IN PLASTIC CONTAINER (DEXTROSE 2.5% IN PLASTIC CONTAINER).
Dextrose is a monosaccharide that provides a source of glucose, which is metabolized to produce adenosine triphosphate (ATP) via glycolysis and the Krebs cycle. It serves as a carbohydrate caloric agent to prevent or treat hypoglycemia and provide parenteral nutrition.
| Metabolism | Dextrose is metabolized via glycolysis and subsequent oxidative pathways. Excess glucose can be stored as glycogen in the liver and skeletal muscle, or converted to fat via lipogenesis. Metabolism occurs in all tissues, primarily under insulin regulation. |
| Excretion | Excreted primarily via renal filtration; <1% is excreted unchanged in urine. The majority is metabolized to CO2 and water via glycolysis and the Krebs cycle, with CO2 eliminated via the lungs. |
| Half-life | The terminal elimination half-life of glucose is approximately 1.5–2.5 hours in healthy individuals. In renal impairment, half-life may be prolonged due to reduced gluconeogenesis and altered clearance. |
| Protein binding | Glucose does not significantly bind to plasma proteins; protein binding is negligible (<5%). |
| Volume of Distribution | Volume of distribution (Vd) for glucose is approximately 0.2–0.3 L/kg, approximating total body water. This indicates distribution into extracellular and intracellular fluid compartments. |
| Bioavailability | Intravenous: 100% bioavailability. Oral: not applicable for dextrose as a drug; oral glucose is absorbed via GLUT transporters, but bioavailability is nearly 100% from the GI tract, though first-pass metabolism yields variable amounts reaching systemic circulation. |
| Onset of Action | Intravenous administration: immediate onset of action (within 1–2 minutes) due to direct delivery into systemic circulation. Oral administration: onset of glucose absorption is within 5–10 minutes. |
| Duration of Action | Intravenous dextrose: duration of action is approximately 1–2 hours, as glucose is rapidly taken up by cells and metabolized. The effect on blood glucose levels is transient unless continuously infused. |
Intravenous infusion. Typical adult dose: 500-1000 mL as a continuous infusion at a rate of 100-200 mL/hour. Dose based on fluid and glucose requirements, typically providing 50-100 g glucose per day.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment required for renal impairment as dextrose is metabolized to carbon dioxide and water. Monitor for fluid overload in patients with renal failure. |
| Liver impairment | No specific dose adjustment required for hepatic impairment. However, in severe hepatic insufficiency, monitor for hypoglycemia or hyperglycemia due to altered glucose metabolism. |
| Pediatric use | Intravenous infusion. Dose: 5-10 mg/kg/min of dextrose, adjusted to maintain normoglycemia. Typical solution: D2.5% (2.5% dextrose) for neonates and infants, D5% for older children. Rate: 100-150 mL/kg/day for maintenance. |
| Geriatric use | Use with caution due to age-related changes in glucose metabolism and renal function. Monitor fluid balance and serum glucose closely. Reduce infusion rate if signs of fluid overload or hyperglycemia occur. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DEXTROSE 2.5% IN PLASTIC CONTAINER (DEXTROSE 2.5% IN PLASTIC CONTAINER).
| Breastfeeding | Dextrose is a normal constituent of breast milk. Intravenous infusion of 2.5% dextrose does not significantly alter maternal blood glucose or milk composition. M/P ratio not applicable as it is endogenous. Generally considered compatible with breastfeeding. |
| Teratogenic Risk | Dextrose 2.5% is a crystalloid solution used for fluid and caloric replacement. At therapeutic doses, it is not associated with teratogenicity. However, severe maternal hyperglycemia (dose-related) in the first trimester may increase risk of neural tube defects; in second/third trimester, may cause fetal hyperinsulinism and macrosomia. Overall, risk is low with standard administration. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hyperglycemia with severe dehydration","Diabetic coma (unless ketotic or hyperosmolar nonketotic coma)","Intracranial hemorrhage (use isotonic solutions preferred)","Known hypersensitivity to dextrose or corn products"]
| Precautions | ["Risk of hyperglycemia and hyperglycemia-related complications in patients with diabetes mellitus or glucose intolerance","May cause hypokalemia due to intracellular shift of potassium","Use with caution in patients with intracranial hemorrhage or stroke (may exacerbate cerebral edema)","Avoid in patients with known allergy to corn (dextrose derived from corn)","Monitor for fluid overload in patients with renal impairment or heart failure"] |
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| Fetal Monitoring | Monitor maternal blood glucose levels, especially in diabetic or gestational diabetic patients. Fetal monitoring for signs of hyperglycemia-related complications (e.g., macrosomia, polyhydramnios) if prolonged high-dose infusion. Assess fluid balance and electrolytes to avoid dilutional hyponatremia. |
| Fertility Effects | No known adverse effects on fertility. Dextrose 2.5% is a simple sugar solution and does not impact reproductive function when used appropriately. |