DEXTROSE 5% AND SODIUM CHLORIDE 0.11% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose 5% provides a source of carbohydrates for metabolism, increasing blood glucose levels and serving as a caloric supplement. Sodium chloride 0.11% supplies electrolytes to maintain osmolality and fluid balance. The combination restores intravascular volume and corrects hyponatremia or hypochloremia.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to produce carbon dioxide, water, and energy. Sodium and chloride are excreted unchanged primarily by the kidneys. |
| Excretion | Dextrose and sodium chloride are endogenous substances. Dextrose is metabolized via glycolysis and the citric acid cycle, ultimately producing CO2 (exhaled via lungs) and water. Renal excretion of intact glucose is negligible in euglycemia but occurs when blood glucose exceeds renal threshold (~10 mmol/L). Sodium and chloride are freely filtered at the glomerulus and extensively reabsorbed (≥99% for sodium) in the renal tubules; excretion is regulated by hormonal and hemodynamic factors. No biliary/fecal elimination of intact drug. |
| Half-life | Not applicable as a composite entity. Dextrose: rapid clearance from plasma (half-life ~15-30 minutes) due to cellular uptake and metabolism. Sodium: no defined half-life; plasma sodium concentration is tightly regulated by renal function and ADH/aldosterone. Clinical context: infusion effects are immediate and sustained during administration; after discontinuation, plasma levels of glucose and electrolytes return to baseline within hours depending on metabolic and renal function. |
| Protein binding | Not applicable (endogenous substances). Dextrose: not protein bound. Sodium and chloride: not bound to plasma proteins. |
| Volume of Distribution | Dextrose: Vd approximates total body water (~0.6 L/kg). Sodium: Vd corresponds to extracellular fluid volume (~0.2 L/kg). Chloride: similar to sodium (~0.2 L/kg). Clinical meaning: changes reflect distribution in body fluid compartments. |
| Bioavailability | Intravenous: 100% (only route of administration). Not applicable for oral or other routes as this formulation is for IV use. |
| Onset of Action | Intravenous: immediate (within seconds) for hemodynamic and electrolyte effects. Dextrose: rapid increase in blood glucose occurs within 1-2 minutes. Sodium chloride: correction of hyponatremia and volume expansion begins immediately but full effect may require hours depending on infusion rate. |
| Duration of Action | Duration is dependent on infusion rate and patient's metabolic/renal status. For a single bolus or rapid infusion: glucose effect lasts 1-2 hours; sodium and chloride effects last 2-4 hours as excess is excreted renally. Continuous infusion maintains effect throughout administration. Clinical note: sustained use may lead to fluid overload or electrolyte disturbances. |
Intravenous infusion; dose determined by clinical condition and fluid/electrolyte requirements; typical maintenance: 100-200 mL/hour for adults (provides 5-10 g glucose and 0.11-0.22 g sodium chloride per hour); adjust rate based on patient status.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of hypernatremia and fluid overload; in moderate impairment (GFR 30-60 mL/min), use with caution and monitor serum sodium and volume status; no specific dose adjustment provided. |
| Liver impairment | No specific dose adjustment required for hepatic impairment; monitor glucose and electrolyte levels closely in severe hepatic disease due to risk of hyperglycemia or hypoglycemia. |
| Pediatric use | Intravenous infusion; neonates and children: 0.5-1 g glucose/kg/hour (equivalent to 10-20 mL/kg/hour of this solution); adjust based on age, weight, and clinical need; typical maintenance: 100-150 mL/kg/day for infants, 80-120 mL/kg/day for older children; do not exceed 0.8 g glucose/kg/hour. |
| Geriatric use | Use with caution due to increased risk of fluid overload, hypernatremia, and hyperglycemia; start at low end of dosing range (e.g., 50-100 mL/hour) and titrate based on volume status, renal function, and serum electrolytes; monitor cardiac and renal function. |
| 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 normal constituents of breast milk. Intravenous infusion results in minimal transfer to milk. M/P ratio is not applicable as these are endogenous substances. Use during lactation is considered safe when administered as clinically indicated. |
| Teratogenic Risk | Dextrose 5% and sodium chloride 0.11% is an isotonic crystalloid solution. At physiological concentrations, dextrose and sodium chloride are not associated with teratogenic effects in any trimester. However, hyperglycemia from excessive dextrose administration may increase the risk of fetal macrosomia, neonatal hypoglycemia, and congenital anomalies in the first trimester. Fluid and electrolyte imbalances (e.g., hyponatremia, hypernatremia) can affect fetal development and amniotic fluid volume. |
■ FDA Black Box Warning
Not for use in patients with known hyperglycemia, hypernatremia, or increased risk of osmotic diuresis. Do not administer if solution is discolored or contains particulate matter.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia (blood glucose > 300 mg/dL)","Hypernatremia (serum sodium > 145 mEq/L)","Severe renal impairment with oliguria or anuria","Hypersensitivity to dextrose or sodium chloride"]
| Precautions | ["Monitor serum glucose, electrolytes, and fluid balance during administration","Risk of hyperglycemia, especially in patients with diabetes mellitus","Risk of hypernatremia or hyperchloremia with excessive infusion","Avoid in patients with intracranial or intraspinal hemorrhage","Use with caution in renal impairment, heart failure, or edema"] |
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| Fetal Monitoring | Monitor maternal serum glucose, sodium, potassium, chloride, and osmolality, especially with prolonged infusion or in patients with impaired renal function. Monitor for signs of fluid overload (e.g., edema, weight gain) and electrolyte disturbances. Fetal monitoring includes assessment of amniotic fluid volume and fetal growth via ultrasound in cases of sustained maternal hyperglycemia or electrolyte abnormalities. |
| Fertility Effects | No adverse effects on fertility are expected from administration of dextrose and sodium chloride at standard concentrations. No human or animal studies indicate reproductive impairment. |