DEXTROSE 5% AND SODIUM CHLORIDE 0.225%
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of calories and acts as a substrate for cellular metabolism, replenishing glucose stores. Sodium chloride provides electrolytes for maintenance of osmotic pressure and fluid balance.
| Metabolism | Dextrose is metabolized via glycolysis and the tricarboxylic acid cycle. Sodium chloride is not metabolized but excreted primarily by the kidneys. |
| Excretion | Dextrose is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle; essentially eliminated as CO₂ (exhaled) and water (renal, insensible loss). Sodium and chloride are primarily excreted renally (95%) with minor fecal (<2%) and sweat losses. |
| Half-life | Not applicable as a terminal half-life; dextrose is rapidly cleared from circulation with a metabolic clearance rate of ~15-20 mg/kg/min under normal conditions. The half-life of infused glucose is approximately 15-30 minutes due to rapid cellular uptake and metabolism. |
| Protein binding | Negligible (<1%); dextrose does not bind to plasma proteins. Sodium and chloride are not protein bound. |
| Volume of Distribution | Dextrose distributes into total body water (~0.55 L/kg). Sodium distributes primarily in extracellular fluid (~0.2 L/kg). Volume of distribution for dextrose and electrolytes is not clinically meaningful as a single value. |
| Bioavailability | Intravenous: 100%. Oral dextrose: variable but high; not applicable for this formulation, which is IV only. Sodium chloride is completely bioavailable via IV. |
| Onset of Action | Intravenous: within seconds to minutes for correction of hypoglycemia; fluid and electrolyte effects begin immediately upon infusion. |
| Duration of Action | Duration depends on infusion rate and patient metabolic state; for a single bolus, glucose-raising effect lasts 30-60 minutes. Continuous infusion maintains effects as long as administered. |
| Molecular Weight | 180.16 |
Intravenous; adult dose is 500-1000 mL at a rate of 100-200 mL/hour; frequency depends on fluid and electrolyte needs; maximum rate up to 400 mL/hour in hypovolemic states.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR <30 mL/min/1.73 m²: reduce infusion rate to 50-100 mL/hour; monitor serum sodium and glucose; avoid in anuria. |
| Liver impairment | No specific Child-Pugh based adjustments; use with caution in severe hepatic impairment due to risk of fluid overload and hyperglycemia. |
| Pediatric use | Intravenous; weight-based dose: 5-10 mL/kg; infusion rate: 2-6 mL/kg/hour; adjust based on age, weight, and clinical status; maximum 100 mL/kg/day in term neonates. |
| Geriatric use | Elderly: use lowest effective dose; infusion rate: 50-100 mL/hour; monitor for fluid overload, hyperglycemia, and electrolyte imbalance due to decreased renal and cardiac function. |
| 1st trimester | Generally considered safe; dextrose and sodium chloride are physiologic components. Use only when clearly needed. |
| 2nd trimester | Generally considered safe; monitor for fluid and electrolyte balance. |
| 3rd trimester | Generally considered safe; avoid excessive fluid volumes to prevent maternal fluid overload. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Both dextrose and sodium chloride freely cross the placenta. Dextrose is actively transported; sodium and chloride ions diffuse across. |
| Breastfeeding | Compatible with breastfeeding. Dextrose and sodium chloride are normal constituents of breast milk and are not expected to cause adverse effects in the infant. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Dextrose 5% and sodium chloride 0.225% is considered compatible in pregnancy when used as a vehicle or for correction of fluid and electrolyte disturbances. No teratogenic effects are expected at standard infusion rates. However, excessive administration may cause maternal hyperglycemia, which can lead to fetal hyperinsulinism and neonatal hypoglycemia. No known structural teratogenicity. |
| Fetal Monitoring | Monitor maternal serum glucose, electrolytes, and fluid balance. Assess for signs of fluid overload (e.g., edema, pulmonary congestion). In pregnancy, monitor fetal heart rate and uterine activity if administering large volumes or if maternal hyperglycemia occurs. |
| Fertility Effects | No known adverse effects on fertility. Dextrose and sodium chloride are normal physiological constituents and do not impair reproductive function when used appropriately. |
■ FDA Black Box Warning
Not applicable; no FDA black box warning for this combination product.
| Common Effects | fluid replacement |
| Serious Effects |
HyperglycemiaHypernatremiaFluid overloadSevere renal impairment with oliguria
| Precautions | Monitor serum glucose and electrolytes, especially in patients with diabetes mellitus or renal impairment, Avoid use in patients with known hypersensitivity to corn or corn products, Risk of fluid overload in patients with heart failure or renal insufficiency, Use with caution in patients with hyperglycemia, hyponatremia, or hypernatremia, Do not administer simultaneously with blood products |
| Food/Dietary | No significant food interactions; however, dietary sodium intake should be considered in patients with hypertension or edema. |
| Clinical Pearls | Use cautiously in pediatric and elderly patients to avoid fluid overload and electrolyte imbalance. Monitor serum sodium, glucose, and osmolarity in patients with renal impairment or hyperglycemia. Do not administer if solution is discolored or contains particulates. |
| Patient Advice | Report signs of fluid overload (swelling, rapid weight gain, shortness of breath). · Advise patients with diabetes that this solution contains dextrose and may affect blood glucose levels. · Inform patients that intravenous administration requires careful monitoring by healthcare professionals. |
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