DEXTROSE 38.5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DEXTROSE 38.5% IN PLASTIC CONTAINER (DEXTROSE 38.5% IN PLASTIC CONTAINER).
Dextrose is a simple sugar that provides caloric support and serves as a source of energy. It increases blood glucose levels, which is essential for cellular metabolism, particularly in the brain and erythrocytes.
| Metabolism | Dextrose is metabolized via glycolysis, the citric acid cycle, and oxidative phosphorylation to produce ATP. It is primarily metabolized in the liver and peripheral tissues; insulin facilitates its cellular uptake. |
| Excretion | 100% renal (excreted as carbon dioxide and water after metabolism; negligible unchanged glucose in urine under normoglycemia; renal threshold ~180 mg/dL) |
| Half-life | ~30 minutes (endogenous glucose turnover; clinical context: continuous infusion required for maintenance as glucose is rapidly metabolized) |
| Protein binding | 0% (glucose does not bind to plasma proteins) |
| Volume of Distribution | ~0.15-0.20 L/kg (approximates extracellular fluid volume; clinically indicates distribution primarily in extracellular space) |
| Bioavailability | 100% (intravenous); not applicable for oral as D-glucose undergoes extensive first-pass metabolism but is not used orally in this formulation |
| Onset of Action | Immediate (within seconds to minutes) following intravenous injection; rapid increase in blood glucose concentration |
| Duration of Action | Dependent on metabolic clearance: after a single dose, blood glucose returns to baseline within minutes to ~1 hour; continuous infusion maintains steady state |
Intravenous administration. Dose depends on clinical condition; typically 50-100 mL of 38.5% dextrose (19.25-38.5 g glucose) for hypoglycemia. Maximum infusion rate: 0.5 g/kg/h.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment for renal impairment. Use with caution in severe renal impairment due to risk of fluid overload and hyperglycemia. Monitor serum glucose and electrolytes. |
| Liver impairment | No specific dose adjustment for hepatic impairment. Use with caution in severe hepatic impairment due to risk of hypoglycemia or hyperglycemia. Monitor glucose levels. |
| Pediatric use | Intravenous. For hypoglycemia: 0.5-1 g/kg (1.3-2.6 mL/kg of 38.5% dextrose). Administer at 0.5-1 mL/kg/min. Maximum concentration for peripheral infusion: 12.5% (dilute if necessary). |
| Geriatric use | No specific dose adjustment. Use with caution due to age-related changes in glucose metabolism and renal function. Monitor fluid status and serum glucose closely; slower infusion rates may be required. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DEXTROSE 38.5% IN PLASTIC CONTAINER (DEXTROSE 38.5% IN PLASTIC CONTAINER).
| Breastfeeding | Compatible with breastfeeding. Dextrose is normal constituent of milk; exogenous administration does not alter milk composition significantly. M/P ratio not relevant as it is endogenous. |
| Teratogenic Risk | No documented teratogenic risk. Dextrose is a physiologic glucose source; hyperglycemia may cause fetal macrosomia, neonatal hypoglycemia, or congenital anomalies if maternal diabetes uncontrolled. Third trimester: risk of neonatal hypoglycemia with maternal hyperglycemia. |
■ FDA Black Box Warning
Intravenous administration of hypertonic dextrose solutions may cause hyperglycemia, glycosuria, and osmotic diuresis. Do not administer unless solution is clear and container is undamaged.
| Serious Effects |
["Hyperglycemia or diabetes mellitus not controlled","Intracranial or intraspinal hemorrhage","Patients with known allergy to corn or corn products","Severe dehydration with hyperosmolality"]
| Precautions | ["Monitor serum glucose levels closely to avoid hyperglycemia or hypoglycemia","Use with caution in patients with diabetes mellitus or glucose intolerance","May cause fluid overload, especially in patients with renal or cardiac impairment","Extravasation of hypertonic solutions may cause tissue necrosis"] |
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| Fetal Monitoring |
| Monitor maternal blood glucose, electrolytes (especially sodium, potassium), and fluid balance. Fetal monitoring for signs of hyperglycemia (macrosomia) or hypoglycemia after delivery. For hyperosmolar solutions, monitor for fluid overload. |
| Fertility Effects | No direct effects on fertility. Dextrose is a carbohydrate source; no adverse reproductive impact at physiologic concentrations. |