DEXTROSE 5% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides a source of calories and fluid for intravenous administration. It increases blood glucose levels and may cause diuresis via osmotic effects. Sodium chloride provides electrolyte replacement to maintain or restore intravascular volume and extracellular fluid balance.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle in all tissues; insulin-dependent cellular uptake occurs in most cells. Sodium chloride is not metabolized but is excreted renally. |
| Excretion | Renal elimination of free water and electrolytes. Glucose is metabolized to CO2 and water; excess glucose not metabolized is excreted renally as glucose (glucosuria) when renal threshold exceeded. Sodium and chloride are excreted renally, with >90% of filtered sodium reabsorbed; chloride follows sodium. No biliary or fecal elimination of intact drug. |
| Half-life | Glucose: ~1.5–2 hours for metabolic clearance in euglycemic individuals; prolonged in renal impairment (adds renal excretion of glucose if threshold exceeded). Dextrose solution constituents (water, sodium, chloride) have no true half-life; water turnover half-life ~3–4 hours in adults. |
| Protein binding | Glucose: negligible binding (<1%). Sodium and chloride: not protein bound. |
| Volume of Distribution | Glucose: Vd ~0.15–0.25 L/kg (total body water). Sodium: Vd ~0.25 L/kg (extracellular fluid). Chloride: Vd ~0.25–0.35 L/kg. Water distributes throughout total body water (~0.6 L/kg). |
| Bioavailability | Intravenous: 100% bioavailable. Not applicable to oral or other routes. |
| Onset of Action | Intravenous: Rapid, within minutes for plasma volume expansion and glucose elevation. Clinical effect on glucose levels seen within 5–10 minutes. |
| Duration of Action | Plasma volume expansion persists for 1–2 hours depending on infusion rate and patient status; glucose elevation lasts 1–2 hours after infusion stops, influenced by endogenous insulin response. Sodium and chloride effects persist for distribution and elimination half-life of 2–4 hours. |
| Molecular Weight | 180.16 Da (for dextrose; sodium chloride is not a molecule but dissociates) |
Intravenous infusion; typical adult dose is 100-200 mL/hour of D5 0.9% NaCl, adjusted based on fluid and electrolyte status, glucose monitoring, and clinical indication.
| Dosage form | INJECTABLE |
| Renal impairment | In acute kidney injury or chronic kidney disease, use with caution; monitor for volume overload and hypernatremia. GFR < 30 mL/min: restrict volume to 500-1000 mL/day with careful sodium assessment. GFR 30-50 mL/min: use standard dosing with monitoring. GFR > 50 mL/min: no adjustment required. |
| Liver impairment | No specific Child-Pugh based dose adjustments; monitor for fluid retention and electrolyte disturbances in decompensated cirrhosis (Child-Pugh B or C). Use with caution in ascites. |
| Pediatric use | Weight-based infusion: neonates 0-28 days: 5-10 mL/hour; infants 1-12 months: 10-20 mL/hour; children 1-12 years: 20-50 mL/hour; adolescents 13-17 years: 50-100 mL/hour. Adjust based on glucose and electrolyte monitoring. |
| Geriatric use | Elderly patients: start at lower infusion rates (50-100 mL/hour) and titrate; monitor for fluid overload, hyperglycemia, and hypernatremia due to reduced renal function and comorbid conditions. Adjust based on cardiac status and renal function. |
| 1st trimester | Dextrose 5% in sodium chloride 0.9% is generally considered safe during the first trimester when used as a source of hydration and calories. No known teratogenic effects have been reported at therapeutic doses. However, use only when clearly needed and monitor maternal blood glucose levels. |
| 2nd trimester | Safe for use in the second trimester for maintenance fluid and electrolyte replacement. Monitor for fluid overload and electrolyte imbalances, especially in patients with preeclampsia or gestational diabetes. |
| 3rd trimester | Safe in the third trimester but caution in patients with gestational diabetes or impaired glucose tolerance as dextrose may cause hyperglycemia. Also, monitor for fluid overload in patients with pregnancy-induced hypertension. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose crosses the placenta freely via facilitated diffusion; sodium and chloride also cross but are tightly regulated. At therapeutic infusion rates, transfer is limited and does not typically cause fetal harm. |
| Breastfeeding | Dextrose 5% in sodium chloride 0.9% is compatible with breastfeeding when used intravenously at standard doses. Components are endogenous and do not accumulate in breast milk. However, intravenous administration may affect maternal hydration and electrolyte status, which can influence milk composition. No specific restrictions are recommended. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Dextrose 5% in Sodium Chloride 0.9% is a crystalloid solution not associated with teratogenicity. No fetal risk has been identified in any trimester when used appropriately for fluid and electrolyte replacement. Maternal hyperglycemia or electrolyte disturbances may indirectly affect the fetus if improperly administered, but the solution itself is not teratogenic. |
| Fetal Monitoring | Monitor maternal vital signs, input/output, serum electrolytes, glucose, and signs of fluid overload (e.g., edema, dyspnea). In pregnancy, monitor for signs of preeclampsia or gestational diabetes if large volumes are administered. Fetal heart rate monitoring may be indicated if maternal condition warrants. |
| Fertility Effects | No known adverse effects on fertility. The solution is used for hydration and electrolyte balance, which are supportive for reproductive health. No specific fertility impact has been reported. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
Hyperglycemia (unless part of diabetic management protocol)Hypersensitivity to corn or corn products (dextrose source)Severe fluid overload or hypervolemiaSevere hyponatremia or hypernatremiaSevere renal impairment with oliguria or anuria
| Precautions | Risk of fluid overload in patients with congestive heart failure, renal insufficiency, or hepatic cirrhosis., Monitor serum glucose, electrolytes, and fluid balance; dextrose can cause hyperglycemia, especially in diabetic patients., Do not administer simultaneously with blood through same tubing due to risk of RBC aggregation/hemolysis., Intraosseous administration may cause compartment syndrome., Use with caution in patients with preexisting electrolyte abnormalities or those receiving corticosteroids. |
| Food/Dietary | Avoid high-sodium foods as this solution already contains sodium chloride. Diabetic patients should monitor carbohydrate intake, as dextrose provides 5 g/100 mL. No direct food interactions, but overall sodium and glucose intake should be considered. |
| Clinical Pearls | Contains 5 g dextrose and 0.9 g sodium chloride per 100 mL; provides 170 kcal/L and 154 mEq/L each of Na+ and Cl-. Monitor serum glucose in diabetic patients; avoid in hyperglycemia. Use with caution in heart failure, renal impairment, and hypertension due to sodium load. Incompatible with certain drugs (e.g., amphotericin B, erythromycin). |
| Patient Advice | This solution provides sugar and salt to replace fluids and energy. · Tell your doctor if you have diabetes, high blood pressure, or heart or kidney problems. · You may experience swelling due to the salt content; report shortness of breath or leg swelling. · Do not consume additional salty foods unless advised by your doctor. · Your blood sugar and electrolytes will be monitored during treatment. |
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