DEXTROSE 5%, SODIUM CHLORIDE 0.2% AND POTASSIUM CHLORIDE 0.15% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of calories and energy, preventing protein catabolism and ketosis. Sodium chloride maintains osmotic pressure and fluid balance. Potassium chloride replenishes potassium and maintains intracellular ion gradients.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle. Sodium chloride and potassium chloride are not metabolized; they are excreted primarily by the kidneys. |
| Excretion | Renal: Dextrose is completely metabolized to CO2 and water; only trace amounts excreted unchanged (<2%). Sodium and chloride are primarily excreted renally, with >90% of filtered load reabsorbed; excess is excreted in urine. Potassium is predominantly excreted renally (90%), with minor fecal (10%) loss. Biliary excretion is negligible. |
| Half-life | Dextrose: Not applicable (endogenous substrate, rapidly cleared via metabolism). Potassium: Terminal elimination half-life ~12-24 hours in healthy individuals, prolonged in renal impairment. Sodium and chloride: No defined half-life; renal excretion is regulated by homeostatic mechanisms. |
| Protein binding | Dextrose: Negligible (<1%). Sodium: Negligible. Chloride: Negligible. Potassium: Negligible. No specific binding proteins. |
| Volume of Distribution | Dextrose: 0.2-0.3 L/kg (mainly extracellular fluid). Sodium: 0.6-0.7 L/kg (total body water). Chloride: 0.4-0.5 L/kg (extracellular fluid). Potassium: 3-5 L/kg (primarily intracellular; Vd large due to active transport into cells). |
| Bioavailability | Intravenous: 100%. Oral: Not applicable (solution is for IV use only). |
| Onset of Action | Intravenous: Immediate (within seconds to minutes) for electrolyte and fluid effects; glucose metabolism begins promptly upon infusion. Subcutaneous/Other routes: Not applicable. |
| Duration of Action | Intravenous: Fluid expansion persists for 1-2 hours (distribution phase); electrolyte effects last 4-6 hours depending on renal function; glucose levels return to baseline within 30-60 minutes after infusion stop. Continuous infusion required for sustained effect. |
Intravenous infusion; rate and volume determined by patient's fluid, electrolyte, and caloric needs. Typical adult maintenance: 100-125 mL/hour (2-3 L/day) of D5 0.2% NaCl with 0.15% KCl (20 mEq KCl/L) administered via continuous IV infusion.
| Dosage form | INJECTABLE |
| Renal impairment | For GFR <30 mL/min: use with caution; reduce potassium content as needed based on serum potassium levels; avoid if anuria or severe renal impairment. No specific dose adjustment for the dextrose/saline component, but consider total volume and electrolyte content. |
| Liver impairment | Child-Pugh Class A: no adjustment. Class B or C: monitor serum potassium and glucose; consider reducing potassium if hyperkalemia risk; no specific dose change required but infusion rate may need adjustment based on fluid tolerance. |
| Pediatric use | Weight-based: 0.2% NaCl with 0.15% KCl in 5% dextrose. Rate: 100-150 mL/kg/day for maintenance; adjust based on age, weight, and clinical condition. Potassium: 1-2 mEq/kg/day, not to exceed 3 mEq/kg/day. Administer via IV infusion. |
| Geriatric use | Elderly patients: use with caution due to potential renal impairment and reduced cardiac reserve. Monitor serum potassium and renal function closely. Infusion rates should be conservative, generally lower than younger adults, with careful attention to fluid balance to avoid overload. |
| 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, sodium, and potassium are normal constituents of breast milk. IV administration at standard doses does not significantly alter milk composition. M/P ratio not applicable; use during lactation is considered safe. |
| Teratogenic Risk | Dextrose, sodium chloride, and potassium chloride are essential nutrients and electrolytes; no teratogenic risk is expected at physiological doses. Inadvertent excessive administration leading to electrolyte imbalances may pose indirect fetal risks (e.g., hyperkalemia causing fetal arrhythmias). Use during pregnancy only if clearly needed and with monitoring. |
■ FDA Black Box Warning
Not for use in patients with intracranial or intraspinal hemorrhage, or in patients with anuria. Potassium-containing solutions should not be used in patients with severe renal impairment or hyperkalemia.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Severe renal impairment (anuria or oliguria)","Addison's disease","Severe burns or trauma","Solutions containing dextrose may be contraindicated in patients with known allergy to corn"]
| Precautions | ["Monitor serum electrolytes, including potassium and sodium, and blood glucose levels","Risk of hyperkalemia, especially in patients with renal impairment or those receiving potassium-sparing diuretics","Avoid fluid overload in patients with heart failure or renal impairment","Use with caution in patients with diabetes mellitus or glucose intolerance"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, glucose) and fluid balance; fetal heart rate monitoring if maternal electrolyte disturbances occur. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. |