DEXTROSE 5% IN SODIUM CHLORIDE 0.2% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides caloric support, replenishes glycogen stores, and prevents ketosis by supplying glucose for cellular energy metabolism. Sodium chloride maintains osmotic balance and replaces extracellular fluid and electrolytes.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle to produce carbon dioxide, water, and energy. Sodium and chloride ions are excreted primarily by the kidneys. |
| Excretion | Exogenous dextrose is fully metabolized to carbon dioxide and water; no significant renal or biliary excretion of intact dextrose. Sodium and chloride are primarily excreted renally (greater than 90% of filtered load reabsorbed; excess excreted in urine). |
| Half-life | Exogenous dextrose has a plasma half-life of approximately 15–20 minutes under normal metabolic conditions; in hyperglycemia or insulin resistance, half-life is prolonged. |
| Protein binding | Dextrose: negligible (<5%) protein binding. Sodium and chloride: not protein bound. |
| Volume of Distribution | Dextrose: distributes into total body water, approximately 0.55–0.6 L/kg (in adults); sodium distributes primarily in extracellular fluid (0.2 L/kg). |
| Bioavailability | Intravenous: 100% bioavailable. Not administered via oral, intramuscular, or subcutaneous routes for caloric or fluid replacement (oral dextrose has high first-pass metabolism). |
| Onset of Action | Intravenous: Onset of caloric effect is immediate upon infusion; onset of volume expansion is within minutes. |
| Duration of Action | Caloric effect persists as long as infusion continues; after cessation, blood glucose returns to baseline within 30–60 minutes. Volume expansion effect lasts 1–2 hours post-infusion depending on renal function. |
| Molecular Weight | 180.156 Da (dextrose); sodium chloride dissociates into Na+ (22.99 Da) and Cl- (35.45 Da) |
Intravenous infusion; rate and volume determined by patient fluid and electrolyte needs, typically 1-2 L/day in adults.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment required; monitor fluid and electrolyte balance in renal impairment. In severe renal failure (GFR <15 mL/min), reduce volume to avoid fluid overload. |
| Liver impairment | No specific dose adjustment required; monitor glucose and electrolytes in severe hepatic impairment due to risk of glucose intolerance. |
| Pediatric use | Intravenous infusion; dose based on weight and clinical condition. Typical maintenance: 4-8 mg/kg/min dextrose for neonates, 100-150 mL/kg/day for infants, adjusting for fluid and electrolyte needs. |
| Geriatric use | Use with caution; reduced renal function may require lower infusion rates and smaller volumes to avoid fluid overload. Monitor serum glucose and electrolytes closely. |
| 1st trimester | Generally considered safe; dextrose and sodium chloride are physiologic components of maternal and fetal circulation. Use only when clearly needed for correction of hypovolemia or hypoglycemia. |
| 2nd trimester | Safe when administered for appropriate indications; monitor maternal glucose and electrolytes to avoid hyperglycemia or volume overload. |
| 3rd trimester | Generally safe; avoid hypertonic solutions or excessive volume to prevent maternal fluid overload and fetal hyponatremia. Use with caution in preeclampsia. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose and sodium chloride readily cross the placenta by passive diffusion and are actively regulated by fetal physiology. No known adverse effects at therapeutic doses. |
| Breastfeeding | Dextrose and sodium chloride are natural constituents of breastmilk. Intravenous administration does not pose risk to infant; monitor maternal fluid status to avoid excessive plasma volume expansion. |
| Lactation Rating | L1 (Safest) |
| Teratogenic Risk | Dextrose 5% in 0.2% sodium chloride is a maintenance fluid; no teratogenic risk identified at standard doses. Maternal hyperglycemia from excessive dextrose may cause fetal hyperinsulinism and neonatal hypoglycemia, particularly in third trimester. Hypoosmolar states from improper administration could impair placental perfusion. |
| Fetal Monitoring | Monitor maternal serum glucose, electrolytes, fluid balance, and urine output. Fetal monitoring for signs of hyperglycemia-induced polyhydramnios or macrosomia in prolonged use. Avoid fluid overload in preeclampsia or renal impairment. |
| Fertility Effects | No direct effects on fertility. Uncontrolled maternal hyperglycemia from excessive dextrose may indirectly impair ovulation and pregnancy outcomes. |
■ FDA Black Box Warning
No FDA boxed warning.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia (severe, uncontrolled)HypernatremiaFluid overload states (e.g., congestive heart failure, pulmonary edema)Hypersensitivity to any component
| Precautions | Risk of hyperglycemia, especially in patients with diabetes mellitus, Monitor serum electrolytes and fluid balance to avoid hypernatremia or fluid overload, Contraindicated in patients with hypertonic dehydration, hypernatremia, or hyperglycemia with ketosis, Use with caution in patients with congestive heart failure, renal failure, or liver cirrhosis, Large volumes may cause electrolyte disturbances or osmotic diuresis |
| Food/Dietary | No specific food interactions. However, concurrent administration of high-sugar or high-sodium foods may exacerbate hyperglycemia or hypernatremia. Monitor dietary intake of carbohydrates and sodium. |
| Clinical Pearls | Monitor serum glucose and electrolytes during prolonged infusion. Administer via large peripheral or central vein to prevent phlebitis. Use with caution in patients with renal impairment, heart failure, or hyperglycemia. Do not administer if solution is discolored or contains particulates. Incompatible with blood products via same line. |
| Patient Advice | Inform your doctor if you have diabetes, heart failure, or kidney problems. · Report any signs of infusion site reactions like pain, redness, or swelling. · This solution contains sugar and salt; do not consume additional salt or sugar without medical advice. · You may need frequent blood tests to monitor your sugar and electrolyte levels. · Do not use this solution at home unless specifically instructed and trained. |
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