DEXTROSE 5% AND SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Provides free water and sodium chloride to expand extracellular fluid volume and correct electrolyte imbalances. Dextrose is metabolized to carbon dioxide and water, providing calories and preventing ketosis. Sodium chloride dissociates into sodium and chloride ions, maintaining osmotic pressure and acid-base balance.
| Metabolism | Dextrose undergoes glycolysis and subsequent metabolism via the tricarboxylic acid cycle. Sodium and chloride are primarily excreted unchanged by the kidneys. |
| Excretion | Dextrose is fully metabolized to carbon dioxide and water; no significant renal excretion of intact dextrose. Sodium chloride is excreted renally; sodium and chloride ions are eliminated via kidneys, with excretion proportional to intake and renal function. No biliary or fecal elimination of intact components. |
| Half-life | Dextrose: not applicable (endogenous substrate); glucose half-life ~1.5–2 hours in circulation under normal conditions, prolonged in hyperglycemia. Sodium chloride: not applicable as ions are electrolytes with no elimination half-life; renal clearance depends on glomerular filtration and tubular reabsorption. |
| Protein binding | Dextrose: not bound to plasma proteins. Sodium chloride: sodium and chloride ions are not protein-bound (<1% bound). |
| Volume of Distribution | Dextrose: ~0.2 L/kg (distributes in extracellular fluid). Sodium: ~0.2–0.3 L/kg (mainly extracellular). Chloride: ~0.2–0.3 L/kg. Clinical meaning: Vd approximates extracellular fluid volume; expansion of Vd indicates fluid overload. |
| Bioavailability | Intravenous: 100% for both dextrose and sodium chloride. Not administered by other routes. |
| Onset of Action | Intravenous: immediate onset for plasma volume expansion (sodium chloride) and caloric supply (dextrose). Glucose levels rise within minutes of infusion. |
| Duration of Action | Intravenous: Dextrose: metabolic effects last minutes to hours depending on infusion rate and endogenous insulin. Sodium chloride: volume expansion effects last 1–2 hours post-infusion; electrolyte effects persist until renal excretion. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da |
Intravenous infusion; dose determined by fluid and electrolyte requirements. Typical adult: 500-1000 mL at 50-100 mL/hour, adjusted based on clinical status.
| Dosage form | INJECTABLE |
| Renal impairment | No specific renal dose adjustment; use caution in renal impairment due to sodium load. Monitor fluid status. GFR <30 mL/min: consider reduced rate or use of alternative fluids. |
| Liver impairment | No specific hepatic adjustment required. Use standard dosing; monitor for fluid overload in severe hepatic impairment (Child-Pugh C). |
| Pediatric use | Weight-based: 5-10 mL/kg/dose as maintenance fluid, administered at 100-150 mL/kg/day for infants and 60-80 mL/kg/day for older children, adjusted per clinical need. |
| Geriatric use | Start at lower end of infusion rate (50 mL/hour) and titrate based on renal function and cardiac status. Monitor for hyperglycemia and fluid overload due to reduced renal function and comorbidities. |
| 1st trimester | Dextrose 5% and sodium chloride 0.9% are components of normal physiology. Use when clinically indicated; no known teratogenic risk at standard infusion rates. |
| 2nd trimester | Safe for maternal hydration and electrolyte replacement. Monitor for fluid overload in conditions like preeclampsia. |
| 3rd trimester | Generally safe. Avoid excessive sodium load in patients with gestational hypertension or edema. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Both dextrose and sodium chloride cross the placenta via passive diffusion and active transport; transfer is proportional to maternal serum levels and is physiologically regulated. |
| Breastfeeding | Dextrose and sodium chloride are normal constituents of breast milk. Intravenous infusion does not pose risk to the infant, as the amount transferred is negligible. |
| Lactation Rating | Safe |
| Teratogenic Risk | Dextrose 5% and sodium chloride 0.9% are not teratogenic. No known fetal risks at recommended doses. First trimester: No evidence of harm. Second trimester: No risk. Third trimester: No risk. |
| Fetal Monitoring | Monitor serum glucose, electrolytes (sodium, chloride), and fluid balance. Assess for signs of hyperglycemia, hypernatremia, or fluid overload. Fetal monitoring as clinically indicated for maternal conditions. |
| Fertility Effects | No known effects on fertility at therapeutic doses. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia with marked glycosuria (dextrose component)HypernatremiaFluid overload states (e.g., congestive heart failure, pulmonary edema)
| Precautions | Risk of fluid overload, especially in patients with heart failure, renal impairment, or edema, Hyperglycemia in diabetic patients or those with glucose intolerance, Hypersensitivity reactions (rare), Electrolyte disturbances (e.g., hypernatremia, hyponatremia, hyperchloremia) with improper use, Not for use in patients with increased intracranial pressure or severe renal impairment without careful monitoring |
| Food/Dietary | No specific food interactions, but patients should avoid high-sodium foods to prevent hypernatremia. |
| Clinical Pearls | This solution is isotonic (308 mOsm/L) and provides 170 kcal/L from dextrose. It is contraindicated in patients with hyperglycemia, hypernatremia, or fluid overload. Use with caution in renal impairment, heart failure, or elderly patients. Monitor serum glucose, sodium, and volume status. Do not administer if solution is discolored or contains particulates. |
| Patient Advice | Inform your healthcare provider if you have diabetes, high blood pressure, or heart failure. · Tell your doctor if you experience headache, swelling, shortness of breath, or dry mouth. · This medication provides sugar and salt; avoid additional sodium in your diet unless directed. · Report any pain, redness, or swelling at the IV site. |
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