DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for DEXTROSE 5% IN PLASTIC CONTAINER (DEXTROSE 5% IN PLASTIC CONTAINER).
Dextrose is a monosaccharide that provides a source of calories and fluid for parenteral nutrition. It increases blood glucose levels and is metabolized to carbon dioxide and water, providing energy. It also serves as a source of water for hydration.
| Metabolism | Dextrose is metabolized via glycolysis and subsequently enters the citric acid cycle (Krebs cycle) to produce ATP. It is also stored as glycogen in the liver and muscles. |
| Excretion | Renal: negligible as unchanged drug; metabolized to water and carbon dioxide, excreted via lungs (>90%) and urine (glucose normally <0.1%) |
| Half-life | Intravenous: 1.5-2.5 hours for glucose clearance; prolonged in renal impairment or diabetes mellitus |
| Protein binding | Negligible (<5%); not bound to plasma proteins |
| Volume of Distribution | Approximately 0.15-0.25 L/kg; approximates extracellular fluid volume; expands in hyperglycemia or fluid overload |
| Bioavailability | Intravenous: 100%; oral: not applicable (dextrose administered parenterally) |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for caloric effect; peak glucose elevation at 5-15 minutes |
| Duration of Action | Intravenous: 1-2 hours for glucose concentration; effects on hydration and caloric support persist during infusion |
| Molecular Weight | 180.16 |
Intravenous infusion: 500-1000 mL as needed based on fluid and caloric requirements. Typical rate: 100-200 mL/hour for maintenance. Maximum infusion rate: 0.5-0.8 g/kg/hour.
| Dosage form | INJECTABLE |
| Renal impairment | No specific GFR-based dose adjustment; monitor serum glucose and electrolytes, especially in severe renal impairment (GFR <15 mL/min) due to risk of fluid overload and hyperglycemia. |
| Liver impairment | No specific Child-Pugh based adjustment; caution in severe hepatic impairment due to impaired gluconeogenesis, risk of hypoglycemia. |
| Pediatric use | Neonates: 6-12 mg/kg/min as continuous IV infusion. Infants/children: 2-6 mg/kg/min for maintenance. Adjust rate based on glucose needs. |
| Geriatric use | Use with caution due to decreased renal function and higher risk of hyperglycemia and volume overload. Start at lower rates (50-100 mL/hour) and titrate based on response. |
| 1st trimester | Safe; used as vehicle for medications and for hydration; no known teratogenicity. |
| 2nd trimester | Safe; used as vehicle for medications and for hydration. |
| 3rd trimester | Safe; used as vehicle for medications and for hydration; monitor for maternal hyperglycemia if large volumes. |
Clinical note
Comprehensive clinical and safety monograph for DEXTROSE 5% IN PLASTIC CONTAINER (DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Dextrose readily crosses the placenta via facilitated diffusion; present in both maternal and fetal circulations at similar concentrations. |
| Breastfeeding | Dextrose is a normal constituent of breast milk; intravenous administration does not pose risk to infant. Use with caution in mothers with diabetes as it may affect maternal glucose levels. |
| Lactation Rating | Safe |
| Teratogenic Risk | Dextrose is an essential nutrient; no teratogenic risk at therapeutic doses. IV administration in pregnancy is safe; risk of maternal hyperglycemia may increase fetal macrosomia and neonatal hypoglycemia. No trimester-specific fetal malformation risk. |
| Fetal Monitoring | Monitor maternal blood glucose levels during infusion to avoid hyperglycemia. Fetal monitoring indicated if maternal glucose is poorly controlled; assess for signs of macrosomia via ultrasound if prolonged use. |
| Fertility Effects | No known effects on fertility or reproductive function at therapeutic doses. May support fertility in undernourished patients. |
■ FDA Black Box Warning
None. Dextrose 5% in plastic container does not have an FDA black box warning.
| Serious Effects |
Diabetic ketoacidosis with hyperglycemia (if used as sole fluid without insulin)Hyperglycemia and hyperosmolar syndrome (if high concentrations)
| Precautions | Risk of hyperglycemia in patients with diabetes mellitus or glucose intolerance, Monitor serum glucose levels closely in patients with impaired glucose tolerance, Avoid in patients with intracranial or intraspinal hemorrhage, Use with caution in patients with renal impairment due to risk of fluid overload, Do not administer if solution is cloudy or contains particles |
| Food/Dietary | No significant food interactions; monitor dietary carbohydrate intake if hyperglycemia occurs. |
| Clinical Pearls | Dextrose 5% in water is isotonic but becomes hypotonic after dextrose metabolism; monitor for hyperglycemia in stressed patients; avoid in patients with intracranial hemorrhage solutions; use with caution in renal impairment due to risk of fluid overload. |
| Patient Advice | Your IV bag contains sugar water to provide calories and hydration. · Tell your nurse if you feel increased thirst, frequent urination, or headache. · This solution may raise blood sugar, especially if you have diabetes. |
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