DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 0.22% 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, which is utilized for cellular energy metabolism. Sodium chloride provides sodium and chloride ions to maintain electrolyte balance and osmotic pressure. Potassium chloride provides potassium ions essential for cellular functions, including nerve conduction and muscle contraction, and helps correct or prevent hypokalemia.
| Metabolism | Dextrose is metabolized via glycolysis to pyruvate, then enters the Krebs cycle for energy production; excess glucose is stored as glycogen in the liver and muscle. Sodium chloride is not metabolized but excreted renal. Potassium chloride is absorbed and distributed; excess potassium is excreted by the kidneys. |
| Excretion | Dextrose is metabolized to carbon dioxide and water; <1% excreted unchanged in urine. Sodium chloride and potassium chloride are excreted renally; >90% of filtered sodium and potassium is reabsorbed, with excretion balancing intake via renal regulation. Biliary/fecal excretion is negligible. |
| Half-life | Dextrose: not applicable as it is rapidly metabolized; glucose half-life is approximately 1.5-2 hours in normal individuals, prolonged in diabetes. Sodium and potassium: not defined as they are regulated by renal function. |
| Protein binding | Dextrose: negligible. Sodium and potassium: not bound to proteins. |
| Volume of Distribution | Dextrose: distributes into total body water (~0.6 L/kg). Sodium: primarily extracellular fluid (~0.2 L/kg). Potassium: primarily intracellular fluid (~4-5 L/kg total body content, but Vd for administered potassium is highly variable and influenced by cellular uptake). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: immediate (within seconds) for correction of volume deficit and electrolyte imbalances. |
| Duration of Action | Intravenous: effects on volume status last 1-2 hours post-infusion; electrolyte effects persist as long as infusion continues; hyperglycemia may persist for 2-3 hours after stopping. |
Intravenous infusion: 1000-2000 mL/day (25-50 mL/kg/day) titrated to fluid and electrolyte needs; maximum infusion rate 0.5 g/kg/hour dextrose.
| Dosage form | INJECTABLE |
| Renal impairment | GFR > 50 mL/min: no adjustment; GFR 10-50 mL/min: caution, reduce potassium content or monitor serum potassium; GFR < 10 mL/min: avoid unless on dialysis, use potassium-free alternative. |
| Liver impairment | Child-Pugh A: no adjustment; Child-Pugh B/C: caution due to risk of hyperkalemia, monitor potassium and glucose; no specific dose reduction. |
| Pediatric use | Neonates and children: 100-200 mL/kg/day for maintenance, adjust for deficits and ongoing losses; maximum infusion rate 0.25 g/kg/hour dextrose for neonates; monitor glucose and electrolytes. |
| Geriatric use | Elderly: use lower end of dosing range (e.g., 1000-1500 mL/day) due to reduced renal function and risk of fluid overload; monitor potassium and glucose closely. |
| 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 chloride, and potassium chloride are normal constituents of breast milk. Exogenous administration is unlikely to alter milk composition significantly. M/P ratio not applicable; these substances are endogenously regulated. Generally considered safe during lactation when used as indicated for maternal fluid and electrolyte balance. |
| Teratogenic Risk |
■ FDA Black Box Warning
This combination product is not used for black box warning indication; however, potassium chloride injection concentrate is associated with a black box warning for fatal cardiac arrhythmias if administered inappropriately. This diluted product carries risk of hyperkalemia if infusion rate or concentration is excessive.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Hypernatremia","Severe renal impairment with oliguria or anuria","Anuria","Acute intracranial hemorrhage (if dextrose-containing solution is contraindicated due to risk of cerebral edema)","Patients with known hypersensitivity to any component"]
| Precautions | ["Risk of hyperglycemia in patients with diabetes mellitus or glucose intolerance","Risk of hyperkalemia, especially in patients with renal impairment or receiving potassium-sparing diuretics","Fluid overload in patients with heart failure or severe renal disease","Risk of phlebitis and infection at infusion site","Monitor serum electrolyte levels, blood glucose, and renal function during therapy"] |
Loading safety data…
| Dextrose, sodium chloride, and potassium chloride are essential nutrients and electrolytes; no teratogenic effects are expected at physiological concentrations. However, high doses of potassium chloride may cause maternal hyperkalemia, which could affect fetal cardiac function. No specific fetal risks have been reported with standard maintenance doses. Use during pregnancy should be guided by maternal electrolyte needs. |
| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, potassium, chloride, glucose), renal function, and fluid balance. Assess fetal heart rate in cases of maternal hyperkalemia or electrolyte imbalance. Observe for signs of fluid overload or electrolyte disturbances in the mother. |
| Fertility Effects | No known adverse effects on fertility. These are physiological components necessary for cellular function; therapeutic use corrects imbalances and does not impair reproductive function. |