DEXTROSE 5% IN SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides calories and serves as a source of glucose for metabolism, which is essential for cellular energy production. Sodium chloride provides electrolytes to maintain fluid and electrolyte balance. The combination is used for fluid resuscitation and as a vehicle for drug administration.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, producing ATP. Sodium and chloride ions are excreted by the kidneys. |
| Excretion | 100% renal, as glucose and sodium are completely metabolized or reabsorbed; no biliary or fecal elimination |
| Half-life | Not applicable; dextrose is rapidly metabolized, half-life of glucose is ~1.5-2 hours in normal individuals; sodium is distributed and excreted renally with half-life varying with renal function |
| Protein binding | Dextrose: negligible; sodium: negligible |
| Volume of Distribution | Dextrose: ~0.2 L/kg (total body water); sodium: ~0.2-0.3 L/kg (extracellular fluid volume) |
| Bioavailability | Intravenous: 100% |
| Onset of Action | Intravenous: immediate, within minutes for caloric effect and volume expansion |
| Duration of Action | Intravenous: 1-2 hours for caloric effect, longer for volume effect depending on renal function; continuous infusion required for sustained effect |
Intravenous infusion: 1000-2000 mL as maintenance fluid, typically at 1-2 mL/kg/h, adjusting for fluid and electrolyte needs.
| Dosage form | INJECTABLE |
| Renal impairment | GFR >50 mL/min: no adjustment; GFR 10-50 mL/min: monitor fluid and electrolytes, reduce rate if hyperkalemia or fluid overload; GFR <10 mL/min: avoid or use with caution, consider alternative. |
| Liver impairment | No specific adjustment for Child-Pugh class; monitor serum sodium and glucose due to risk of hypo/hyperglycemia and fluid retention in cirrhosis. |
| Pediatric use | Weight-based: 100-150 mL/kg/day for maintenance, infused intravenously; adjust for dehydration and ongoing losses. |
| Geriatric use | Start at lower end of adult dose; monitor for fluid overload, hyperglycemia, and electrolyte imbalances; reduce rate in renal impairment. |
| 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. Administration of these IV fluids does not pose a risk to the nursing infant. No M/P ratio is available as they are endogenous substances. |
| Teratogenic Risk | Dextrose and sodium chloride are standard components of IV fluids; no teratogenic risk is associated with therapeutic use. Dextrose is an endogenous nutrient; sodium chloride is an electrolyte. No fetal harm is expected across all trimesters when used as indicated for fluid and electrolyte maintenance. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia with or without ketoacidosis","Severe fluid overload states (e.g., pulmonary edema)","Known hypersensitivity to dextrose or sodium chloride","Cerebral edema in patients with acute ischemic stroke (hypertonic solutions)"]
| Precautions | ["Monitor serum glucose, electrolytes, and fluid balance","Risk of hyperglycemia, especially in diabetic patients","Risk of fluid overload, especially in patients with renal or cardiac impairment","Avoid in patients with known allergies to corn or corn products (since dextrose is derived from corn)","Use with caution in patients with hyponatremia or hypernatremia"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, chloride, glucose) and fluid balance (intake/output). Assess for signs of hyperglycemia, hypernatremia, or fluid overload. Fetal monitoring is not specifically required unless maternal condition warrants. |
| Fertility Effects | No effect on fertility is expected. Dextrose and sodium chloride are physiologic components and do not interfere with reproductive function at therapeutic doses. |