DEXTROSE 5% IN SODIUM CHLORIDE 0.33% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of calories and hydration, preventing ketosis and promoting glycogen deposition. Sodium chloride maintains extracellular fluid volume and electrolyte balance.
| Metabolism | Dextrose is rapidly metabolized via glycolysis and the Krebs cycle; sodium chloride is not metabolized but excreted renally. |
| Excretion | Renal; dextrose is metabolized to CO2 and water; sodium and chloride are excreted renally with >90% reabsorption under normal conditions. |
| Half-life | Dextrose: <15 minutes due to rapid cellular uptake and metabolism; sodium and chloride: no defined half-life as electrolytes are homeostatically regulated. |
| Protein binding | Dextrose: negligible; sodium and chloride: not protein bound. |
| Volume of Distribution | Dextrose: approximately 0.2 L/kg (total body water); sodium and chloride: distribute into extracellular fluid (approx 0.2 L/kg). |
| Bioavailability | 100% for intravenous route; not applicable for oral/other routes. |
| Onset of Action | Immediate upon intravenous administration; correction of hypoglycemia occurs within minutes. |
| Duration of Action | Duration depends on infusion rate and patient status; continuous infusion required for sustained effect; electrolyte effects persist as long as infusion continues. |
Adult: Intravenous infusion at a rate determined by clinical condition, typically 100-200 mL/hour for maintenance; maximum infusion rate 25 g/hour (500 mL/hour). Dose individualized based on fluid, electrolyte, and glucose needs.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment for dextrose; monitor fluid and electrolyte balance. In severe renal impairment (eGFR <30 mL/min/1.73 m²), restrict volume as needed to avoid fluid overload and hyperkalemia when combined with sodium chloride. |
| Liver impairment | No specific adjustment for Child-Pugh class; monitor glucose and fluid status. Caution in severe hepatic failure due to risk of hyperglycemia and fluid retention. |
| Pediatric use | Weight-based dosing: Intravenous infusion at 4-8 mg/kg/min for glucose provision; typical maintenance fluid rates: 100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day for each additional kg. Individualize based on age, weight, and clinical status. |
| Geriatric use | Monitor for fluid overload, hyperglycemia, and electrolyte disturbances. Use lower initial infusion rates (e.g., 50-100 mL/hour) and adjust based on renal function and cardiovascular status. Avoid excessive sodium load in patients with hypertension or heart failure. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Breastfeeding | Dextrose and sodium chloride are normal constituents of breast milk. Intravenous infusion does not alter milk composition significantly. M/P ratio not applicable. Considered compatible with breastfeeding. |
| Teratogenic Risk | Dextrose and sodium chloride are physiological components; no evidence of teratogenicity at standard doses. Maternal glucose control important in first trimester to avoid hyperglycemia-related congenital anomalies. Intravenous administration may be necessary in third trimester for fluid maintenance. No direct fetal toxicity. |
■ FDA Black Box Warning
Not for use in patients with intracranial or intraspinal hemorrhage, or in those with known hypersensitivity to corn or corn products (dextrose source).
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia","Hypernatremia","Intracranial or intraspinal hemorrhage","Known hypersensitivity to corn or corn products","Severe hypokalemia (can worsen with dextrose infusion)"]
| Precautions | ["Risk of hyperglycemia, especially in diabetic patients","Risk of fluid overload, especially in patients with renal impairment or heart failure","Electrolyte imbalances (e.g., hypernatremia, hyperchloremia) with excessive administration","Use with caution in patients with hepatic disease, as dextrose may exacerbate encephalopathy"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, and fluid status before and during infusion. Fetal monitoring as clinically indicated (e.g., for maternal hyperglycemia or fluid overload). Assess for signs of hyponatremia or hypernatremia in both mother and fetus. |
| Fertility Effects | No adverse effects on fertility reported at therapeutic doses. Dextrose and sodium chloride are components of the body; no known reproductive toxicity. |