DEXTROSE 3.3% AND SODIUM CHLORIDE 0.3% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that serves as a source of calories and water for intravenous administration. It is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle, providing energy. Sodium chloride provides sodium and chloride ions to maintain electrolyte balance and osmotic pressure.
| Metabolism | Dextrose is metabolized via glycolysis to pyruvate, then enters the citric acid cycle to produce ATP. Sodium and chloride are excreted primarily by the kidneys. |
| Excretion | Renal: Dextrose is completely metabolized; sodium and chloride are eliminated renally. Excretion of water follows urine output. No biliary or fecal elimination. |
| Half-life | Dextrose: functional half-life ~2 hours (rapid cellular uptake). Sodium: ~6-12 hours (renal regulation). Chloride: parallels sodium. Clinical context: elimination is rapid with normal renal function. |
| Protein binding | Dextrose: negligible. Sodium/Chloride: minimal (sodium <5%, chloride <5% bound to proteins). |
| Volume of Distribution | Dextrose: 0.15-0.25 L/kg (extracellular fluid). Sodium: 0.15-0.3 L/kg (total body water). Chloride: 0.2-0.3 L/kg (extracellular fluid). |
| Bioavailability | Not applicable; administered intravenously only (100% bioavailability via IV). |
| Onset of Action | Intravenous: plasma volume expansion and correction of electrolyte imbalances occur immediately upon infusion completion; glucose effect within minutes. |
| Duration of Action | Intravenous: effects last 1-2 hours for glucose elevation; fluid and electrolyte effects persist as long as infusion continues and renal function is normal. |
Intravenous infusion; rate and volume determined by fluid and electrolyte needs, typically 100-200 mL/hour for maintenance, not to exceed 50 mL/kg/day to avoid fluid overload.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment; GFR 10-50 mL/min: monitor serum sodium and chloride, reduce rate; GFR <10 mL/min: avoid use due to risk of hypernatremia and volume overload. |
| Liver impairment | No specific dosing adjustment for Child-Pugh class A, B, or C; monitor fluid and electrolyte balance carefully in cirrhosis due to ascites risk. |
| Pediatric use | Intravenous infusion based on maintenance fluid requirements: 4 mL/kg/hour for first 10 kg, 2 mL/kg/hour for next 10 kg, 1 mL/kg/hour for each kg above 20 kg; adjust for clinical status. |
| Geriatric use | Use lower initial rates (e.g., 50-100 mL/hour) with frequent monitoring of electrolytes and fluid status; avoid excessive rates due to increased risk of pulmonary edema and electrolyte disturbances. |
| 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 | Dextrose and sodium chloride are endogenous substances. Administration results in minimal changes to composition of breast milk. M/P ratio not available; however, both are considered compatible with breastfeeding. |
| Teratogenic Risk | Dextrose and sodium chloride are standard components of intravenous fluids and are not associated with teratogenic risk. Both are normal constituents of body fluids and are administered at physiologic concentrations. No evidence of teratogenicity in animal studies or human case reports. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia with marked glucosuria (>50 g/24 hours)","Hypersensitivity to dextrose or sodium chloride","Intracranial or intraspinal hemorrhage","Anuria or severe renal impairment (unless on dialysis)","Severe metabolic alkalosis","Edematous conditions (e.g., heart failure, cirrhosis) with sodium retention"]
| Precautions | ["Do not use in patients with intracranial or intraspinal hemorrhage, or in those with known allergy to corn or corn products.","Monitor serum glucose, electrolytes, and fluid balance, especially in patients with impaired renal function, heart failure, or diabetes.","Risk of hyperglycemia, hyperosmolar syndrome, and fluid overload.","Use with caution in patients with severe dehydration, thiamine deficiency, or hepatic disease."] |
| Food/Dietary |
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| Fetal Monitoring | Monitor maternal fluid and electrolyte balance, urine output, serum glucose and sodium levels. In high-risk pregnancies (e.g., preeclampsia, diabetes), monitor for fluid overload, hyperglycemia, or hypernatremia. Fetal monitoring per standard obstetric indications. |
| Fertility Effects | No known effects on fertility reported. Dextrose and sodium chloride are basic metabolic substrates and electrolytes; no impact on reproductive function. |
| No direct food interactions. However, consider total caloric intake with dextrose content. Patients on carbohydrate-restricted diets should be informed about the dextrose content. |
| Clinical Pearls | This solution provides 3.3% dextrose (caloric source) and 0.3% sodium chloride (electrolyte replacement). It is isotonic (approximately 340 mOsm/L) and used for maintenance fluid therapy or hypovolemia when concurrent dextrose is needed. Monitor serum glucose in diabetic patients or those with glucose intolerance. Avoid in hyperglycemia, hypernatremia, or fluid overload. Use with caution in renal impairment. |
| Patient Advice | This intravenous fluid provides sugar (dextrose) and salt (sodium chloride) to help maintain your body's hydration and energy levels. · The infusion will be administered by a healthcare professional; do not adjust the drip rate yourself. · Report any symptoms like headache, swelling, shortness of breath, or changes in heart rate to your nurse or doctor. · If you have diabetes, your blood sugar will be monitored closely during treatment. · Tell your healthcare provider if you have a history of heart, kidney, or liver problems, or if you are on a low-salt diet. |