DEXTROSE 5% IN SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating: safe
No 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. |
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 | 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 | Both dextrose and sodium chloride are normal constituents of breast milk. Administration of this solution does not pose a risk to the nursing infant. The M/P ratio is not applicable as these substances are endogenous and not actively concentrated in milk. |
| 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. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperglycemia with marked glycosuria or hyperosmolar coma.","Hypersensitivity to corn or corn products.","Severe electrolyte imbalances (e.g., hypernatremia) unless corrected.","Patients with anuria not related to hypovolemia."]
| 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."] |
Loading safety data…
| 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. |