DEXTROSE 5% AND SODIUM CHLORIDE 0.9%
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose 5% provides a source of calories and fluid for hydration, preventing ketosis by providing a minimal carbohydrate source. Sodium chloride 0.9% supplies electrolytes and maintains osmotic pressure in extracellular fluid.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle to carbon dioxide and water; insulin-dependent. Sodium chloride is not metabolized; excreted renally. |
| Excretion | Glucose is completely metabolized to CO2 and water; renal excretion of unchanged glucose is negligible (<1%) in normoglycemic patients. Sodium and chloride are primarily excreted renally (90-95% of infused load) with small fecal and sweat losses. In dextrose 5% and sodium chloride 0.9%, both components are eliminated renally; the dextrose is metabolized, not excreted unchanged. |
| Half-life | Glucose has a plasma half-life of approximately 1.5-2.5 hours in normal individuals, reflecting rapid cellular uptake and metabolism. Sodium and chloride have no definable half-life as they are actively regulated; however, the half-life of infused sodium is approximately 2-4 hours depending on renal function. |
| Protein binding | Dextrose: negligible (<1%) binding to plasma proteins. Sodium: not protein-bound. Chloride: not protein-bound. |
| Volume of Distribution | Dextrose: Vd approximately 0.15-0.25 L/kg (primarily extracellular fluid). Sodium and chloride: Vd approximately 0.25 L/kg (distributes into extracellular space). Total body water distribution occurs only if free water is present. |
| Bioavailability | Intravenous: 100% bioavailability. Not administered orally for these purposes; if ingested, dextrose undergoes first-pass metabolism (oral bioavailability ~50-60% due to hepatic extraction) and sodium chloride is fully absorbed. |
| Onset of Action | Intravenous: Plasma volume expansion occurs within minutes (1-2 minutes) due to osmotic effects; correction of hyponatremia begins within 1-2 hours. Caloric effect from dextrose occurs immediately upon metabolism, but significant glucose elevation is seen within 5-10 minutes. |
| Duration of Action | Duration of plasma volume expansion is 2-4 hours post-infusion. Electrolyte effects persist for 4-6 hours depending on renal function. The caloric effect of dextrose lasts 1-2 hours as glucose is rapidly cleared. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da |
Intravenous infusion; typical adult dose is 500-1000 mL as a single dose, administered at a rate determined by clinical condition (e.g., 100-200 mL/h for maintenance).
| Dosage form | INJECTABLE |
| Renal impairment | Not applicable; contains sodium chloride and dextrose; monitor serum sodium and glucose in renal impairment. For GFR <30 mL/min, use with caution due to risk of hypernatremia and fluid overload. |
| Liver impairment | No specific dose adjustment; monitor blood glucose in hepatic impairment due to risk of hyperglycemia. |
| Pediatric use | Intravenous infusion; dose based on fluid and electrolyte needs, typically 5-10 mL/kg per hour, adjusted for clinical response; maximum rate 20 mL/kg/h in neonates. |
| Geriatric use | Use with caution; lower infusion rates recommended due to reduced renal function and higher risk of fluid overload and electrolyte disturbances; monitor serum sodium and glucose closely. |
| 1st trimester | Dextrose 5% and sodium chloride 0.9% are constituents of normal body fluids; used for fluid and electrolyte maintenance. No known teratogenic risk; generally considered safe when clinically indicated. |
| 2nd trimester | Continued safety; use for fluid resuscitation or maintenance as needed. Monitor for electrolyte imbalances and fluid overload. |
| 3rd trimester | Generally safe; caution in preeclampsia or cardiac conditions due to sodium load. Avoid excessive fluid administration. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose and sodium chloride freely cross the placenta via passive diffusion; equilibrium between maternal and fetal compartments is rapidly achieved. |
| Breastfeeding | Intravenous administration of dextrose and sodium chloride results in minimal excretion into breast milk; components are normal constituents of human milk. Compatible with breastfeeding; no adverse effects expected. |
| Lactation Rating | Safe |
| Teratogenic Risk | Dextrose and sodium chloride are physiologic substances. No teratogenic risk at standard doses. Excessive sodium may cause maternal hypernatremia with fetal effects indirectly. No trimester-specific risks. |
| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, and fluid balance. In high-risk pregnancies (e.g., preeclampsia, diabetes), monitor fetal heart rate and uterine activity if large volumes infused. |
| Fertility Effects | No known adverse effects on fertility at standard doses. |
■ FDA Black Box Warning
No FDA black box warnings.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia with dextrose-containing solutionsHypersensitivity to any component
| Precautions | Hyperglycemia in patients with diabetes or stress-induced hyperglycemia, Fluid overload in patients with heart failure, renal impairment, or edematous states, Hyponatremia (especially in children, elderly, and post-operative patients), Hypernatremia with excessive administration, Osmotic demyelination syndrome with rapid correction of hyponatremia, Phlebitis or extravasation at infusion site |
| Food/Dietary | No direct food interactions. However, monitor total sodium and glucose intake if patient is on a restricted diet for diabetes or hypertension. |
| Clinical Pearls | Must confirm IV access patency before infusion; hypertonic 0.9% NaCl may cause phlebitis. Use with caution in heart failure, renal impairment, or hypernatremia. Monitor serum glucose and sodium levels during prolonged administration. Not suitable for dilution of incompatible medications. |
| Patient Advice | Inform your doctor if you have heart disease, kidney problems, or high blood pressure. · Report any signs of allergic reaction (rash, itching, swelling) or infusion site pain/redness. · This solution provides sugar and salt; your fluid and electrolyte levels will be monitored. · Do not stop or adjust the infusion rate without medical advice. |
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