DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 0.15% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of calories and carbohydrate for metabolism; sodium and chloride are major electrolytes that maintain osmotic pressure and acid-base balance; potassium is essential for nerve impulse transmission, muscle contraction, and cardiac function.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to produce carbon dioxide, water, and energy. Sodium and chloride are not metabolized and are excreted primarily by the kidneys. Potassium is actively transported into cells and excreted mainly by the kidneys. |
| Excretion | Renal: D-glucose is completely reabsorbed under normal conditions; excess is excreted unchanged. Potassium is primarily excreted by the kidneys (90%), with minor fecal (10%) loss. Sodium is predominantly excreted renally (95%), with small amounts via sweat and feces (5%). Chloride follows sodium excretion. |
| Half-life | Glucose: 1.5-2.5 hours for exogenous glucose clearance. Potassium: terminal half-life 7-12 hours in normal renal function. Sodium: no defined half-life; body content regulated by renal excretion. |
| Protein binding | Glucose: negligible (<10%). Potassium: not protein bound. Sodium: not protein bound. Chloride: not protein bound. |
| Volume of Distribution | Glucose: ~0.2 L/kg (extracellular fluid). Potassium: ~0.5 L/kg (total body water). Sodium: ~0.25 L/kg (extracellular fluid). Chloride: ~0.25 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100% for all components. Oral: not applicable for this formulation. |
| Onset of Action | Intravenous: immediate for glucose (within seconds to minutes) and electrolyte effects; clinical effect on hydration and electrolyte balance within minutes to hours depending on deficit. |
| Duration of Action | Glucose: 2-3 hours after infusion stop. Potassium: 4-6 hours for plasma K+ elevation; full effect on total body K+ requires longer. Sodium: duration depends on infusion rate and renal function; rapid distribution, then sustained by renal handling. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium chloride: 58.44 Da; Potassium chloride: 74.55 Da |
Intravenous infusion. Dose depends on patient's fluid, electrolyte, and caloric needs. Typical adult: 1000-2000 mL/day at 1-4 mL/min. Rate should not exceed 10 mL/min. Potassium content is 20 mEq/L; maximum potassium infusion rate is 10-20 mEq/h, not to exceed 240 mEq/day.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in anuria and severe renal impairment (GFR < 30 mL/min) due to risk of potassium accumulation. For GFR 30-50 mL/min, reduce infusion rate and monitor potassium levels closely. No dose adjustment needed for GFR > 50 mL/min. |
| Liver impairment | Child-Pugh Class A: No dose adjustment. Child-Pugh Class B or C: Use with caution; monitor potassium and glucose levels. No specific dose reduction established, but fluid overload risk increased in cirrhotic patients; consider lower infusion rates. |
| Pediatric use | Weight-based: 5-10 mL/kg/h for maintenance, titrated to clinical response. For neonates and infants, potassium infusion rate should not exceed 0.5 mEq/kg/h. Maximum daily potassium: 2-3 mEq/kg/day. Monitor serum electrolytes and glucose. |
| Geriatric use | Elderly patients often have reduced renal function and higher risk of fluid overload and hyperkalemia. Start at lower infusion rates (0.5-1 mL/min) and monitor renal function, electrolytes, and volume status closely. Avoid in those with significant renal impairment. |
| 1st trimester | Intravenous administration is generally considered safe when clinically indicated. Electrolyte imbalances should be corrected carefully; avoid hyperkalemia or hypernatremia. |
| 2nd trimester | Same as T1. Use only if clearly needed, with monitoring of serum electrolytes. |
| 3rd trimester | Same as T1. Prolonged use may cause neonatal hypoglycemia; monitor maternal glucose. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Dextrose, sodium, and potassium freely cross the placenta. |
| Breastfeeding | Components (dextrose, sodium, potassium) are normal blood constituents. No known risk, but consider potential for maternal fluid/electrolyte disturbances. |
| Lactation Rating | L1: Safe |
| Teratogenic Risk | Dextrose 5%, sodium chloride 0.33%, and potassium chloride 0.15% is a balanced electrolyte and caloric solution. Dextrose is a physiological nutrient; sodium and potassium are essential electrolytes. There are no known teratogenic effects associated with this combination. Fetal risks are primarily related to maternal electrolyte imbalances or fluid overload, which can occur with improper administration. No specific first, second, or third trimester risks have been reported. |
| Fetal Monitoring | Monitor maternal serum electrolytes, blood glucose, fluid balance, and renal function. For fetal monitoring, assess fetal heart rate and amniotic fluid volume if prolonged infusion or large volumes are administered, especially in cases of preeclampsia or diabetes. |
| Fertility Effects | No known adverse effects on fertility. The solution is used for fluid and electrolyte replacement and does not contain hormones or agents affecting reproductive function. |
■ FDA Black Box Warning
Solutions containing potassium should be used with caution in patients with renal impairment, and administration must be monitored to avoid hyperkalemia.
| Common Effects | fluid replacement |
| Serious Effects |
AnuriaHyperkalemiaHypernatremiaPatients with known hypersensitivity to any componentSevere metabolic acidosisIntracranial or intraspinal hemorrhageIn patients with increased intracranial pressure
| Precautions | Risk of hyperglycemia, especially in patients with diabetes mellitus or glucose intolerance. Risk of hyperkalemia in patients with renal impairment or those receiving potassium-sparing diuretics. Monitor serum electrolytes, blood glucose, and fluid balance during administration. Use with caution in patients with heart failure, renal failure, or conditions predisposing to fluid overload. |
| Food/Dietary | Patients should avoid excessive intake of high-potassium foods (e.g., bananas, oranges, spinach) unless prescribed, as this solution already provides 20 mEq/L potassium chloride. No specific food restrictions for dextrose or sodium chloride. |
| Clinical Pearls | Do not administer if solution contains visible particulates or if container is damaged. Monitor for signs of fluid overload, especially in patients with heart failure or renal impairment. Potassium administration must be guided by serum potassium levels to avoid hyperkalemia. Use with caution in patients receiving potassium-sparing diuretics or ACE inhibitors. |
| Patient Advice | This solution provides fluids, sugar, and electrolytes to correct dehydration and electrolyte imbalances. · Report any shortness of breath, swelling of ankles/feet, or irregular heartbeat immediately. · Do not adjust the flow rate; the infusion rate is set by your healthcare provider. · Tell your doctor if you have kidney problems, heart disease, or high potassium levels. · Avoid consuming potassium-rich foods in excess unless directed by your doctor. |
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