DEXTROSE 5% AND SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose (glucose) is a monosaccharide that serves as a substrate for cellular metabolism, providing energy and restoring blood glucose levels. Sodium chloride (0.45%) provides electrolytes and helps maintain osmolality; the hypotonic solution replaces fluid and electrolytes.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle in cells; sodium and chloride are excreted renally and via sweat; no significant hepatic metabolism. |
| Excretion | Dextrose is completely metabolized to carbon dioxide and water, with negligible renal excretion of intact glucose under normal conditions. Sodium and chloride are freely filtered by the glomerulus and undergo variable tubular reabsorption; excess is excreted renally. No biliary or fecal elimination. |
| Half-life | The terminal half-life of infused dextrose is not applicable as glucose is rapidly metabolized; however, exogenous glucose infusion is cleared with a half-life of approximately 15-30 minutes due to insulin-mediated uptake. Sodium and chloride have no defined elimination half-life as they are homeostatically regulated. |
| Protein binding | Dextrose: not bound to plasma proteins. Sodium: negligible protein binding. Chloride: not significantly protein bound. |
| Volume of Distribution | Dextrose distributes into total body water, approximately 0.55-0.6 L/kg in adults. Sodium and chloride distribute primarily into extracellular fluid, with volumes of distribution of approximately 0.2 L/kg for sodium and 0.25 L/kg for chloride. These reflect rapid equilibration in respective compartments. |
| Bioavailability | Intravenous: 100% for dextrose, sodium, and chloride. Not applicable for other routes as this formulation is for IV use only. |
| Onset of Action | Intravenous administration: immediate restoration of intravascular volume (within minutes) and correction of hypernatremia/hyponatremia over hours depending on rate. Dextrose provides rapid caloric supply with onset of metabolic effects within minutes. |
| Duration of Action | Duration of volume expansion is transient (30-60 minutes) as crystalloid distributes to interstitial space. Caloric effect persists for the duration of infusion; metabolic effects depend on glucose utilization. Electrolyte correction duration varies with infusion rate and patient factors. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da |
Intravenous infusion; dose depends on fluid and electrolyte needs. Typical adult rate: 100-200 mL/hour (2-4 mL/kg/hour) for maintenance. Maximum infusion rate: 25 mL/kg/hour. Not to exceed 50 mL/kg/24 hours.
| Dosage form | INJECTABLE |
| Renal impairment | GFR <10 mL/min: Avoid or use with caution due to risk of fluid overload and hypernatremia. GFR 10-50 mL/min: Monitor serum sodium and fluid status; adjust rate as needed. No specific dose reduction, but infusion rate may need to be decreased. |
| Liver impairment | No specific adjustment required for Child-Pugh class A or B. For Child-Pugh class C: Use with caution due to potential fluid retention; monitor serum sodium and adjust rate accordingly. |
| Pediatric use | Intravenous infusion; dose based on weight and clinical condition. Typical maintenance: 2-4 mL/kg/hour for children. For neonates, rate may be adjusted to 80-100 mL/kg/day. Do not exceed 25 mL/kg/hour. |
| Geriatric use | Elderly patients: Start at lower end of dosing range (e.g., 100 mL/hour) and titrate based on fluid status, renal function, and cardiac reserve. Monitor for signs of fluid overload and electrolyte imbalance. |
| 1st trimester | Dextrose and sodium chloride are essential nutrients; no known teratogenic risk at standard doses. Use only if clearly needed. |
| 2nd trimester | Safe for maternal hydration and electrolyte replacement. Monitor for fluid overload in conditions like preeclampsia. |
| 3rd trimester | Safe for use; avoid excessive fluids in patients with compromised cardiac or renal function. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Crosses placenta freely; dextrose and electrolytes are physiologically regulated. |
| Breastfeeding | Both components are normal constituents of breast milk. Intravenous administration does not pose a risk to the nursing infant. Use as clinically indicated. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Deferral: Normal maternal glucose homeostasis is essential for fetal development; administration of 5% dextrose is not expected to increase teratogenic risk when properly monitored. Hyperglycemia or fluid/electrolyte imbalances may pose fetal risks. No first trimester data suggest direct teratogenicity. |
| Fetal Monitoring | Monitor maternal blood glucose, serum electrolytes (Na+, Cl-, particularly in patients with impaired glucose tolerance, preeclampsia, or renal disease). Fetal heart rate monitoring if fluid load or hyperglycemia risk. Assess for signs of fluid overload (edema, dyspnea, weight gain). |
| Fertility Effects | No known adverse effects on fertility attributed to dextrose or sodium chloride at standard therapeutic doses. Hyperglycemia associated with gestational diabetes may impact fertility indirectly; proper glycemic control is recommended. |
■ FDA Black Box Warning
Not for use in patients with intracranial or intraspinal hemorrhage, or in patients with known hypersensitivity to corn-derived products. Do not administer to patients with anuria. Use with caution in patients with congestive heart failure, renal failure, or hyperglycemia.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia (severe, uncompensated)HypernatremiaFluid overload states (e.g., pulmonary edema, congestive heart failure)
| Precautions | Risk of hyperglycemia and hyperosmolarity, especially in diabetic or stressed patients, Monitor serum glucose and electrolytes, Use with caution in renal impairment, heart failure, and increased intracranial pressure, Hypotonic solution; may cause hemolysis if administered rapidly, Do not use if solution is discolored or contains particulates |
| Food/Dietary | No specific food interactions. However, patients should avoid excessive salt or sugar intake unless directed by a healthcare provider. |
| Clinical Pearls | Dextrose 5% and sodium chloride 0.45% is a hypotonic solution. Use cautiously in patients at risk for increased intracranial pressure (e.g., traumatic brain injury) as rapid administration may cause cerebral edema. Avoid in patients with hyperglycemia, as dextrose can worsen glycemic control. Monitor serum sodium closely in patients with impaired renal function or syndrome of inappropriate antidiuretic hormone (SIADH) to prevent hyponatremia. |
| Patient Advice | Tell your healthcare provider if you have diabetes, heart failure, kidney disease, or are on a low-salt diet. · Report symptoms like headache, nausea, confusion, or swelling during the infusion. · Do not consume additional salt or sugar without medical advice while receiving this solution. |
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