DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 20MEQ IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose is a monosaccharide that provides calories and serves as a source of glucose for cellular metabolism. Sodium chloride and potassium chloride are electrolytes that restore and maintain fluid and electrolyte balance. Potassium is essential for nerve conduction, muscle contraction, and acid-base balance. Sodium is the main cation of extracellular fluid and regulates fluid balance, while chloride is the main anion.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to produce energy. Sodium and potassium are not metabolized but are excreted renally. Chloride is also reabsorbed and excreted by the kidneys. |
| Excretion | Electrolytes (sodium, chloride, potassium) are primarily excreted renally; glucose is metabolized to CO2 and water, with minimal renal excretion of unchanged glucose (<1% in normoglycemia). Biliary/fecal elimination is negligible for individual components. |
| Half-life | Glucose: ~30 minutes (metabolic clearance). Potassium: distribution half-life 1 hour, elimination half-life ~12 hours (renal-dependent). Sodium/chloride: rapidly equilibrated, with elimination half-life determined by renal function. |
| Protein binding | Glucose: minimal (<10% bound to albumin). Potassium: not protein bound. Sodium/chloride: not protein bound. |
| Volume of Distribution | Glucose: Vd 0.2–0.3 L/kg (restricted to extracellular fluid). Potassium: Vd 0.5–0.7 L/kg (distributes in total body water, with higher intracellular uptake). Sodium/chloride: Vd 0.2–0.3 L/kg (extracellular fluid). |
| Bioavailability | Intravenous: 100% (only route of administration). |
| Onset of Action | Intravenous: Immediate (seconds to minutes) for volume expansion and electrolyte correction. |
| Duration of Action | Intravenous: Volume effect lasts ~1-2 hours; metabolic effects (glucose utilization) persist until glucose is cleared; electrolyte effects persist ~2-6 hours depending on renal function. |
| Molecular Weight | 180.16 (dextrose); 58.44 (NaCl); 74.55 (KCl) |
Intravenous infusion; adult dose determined by fluid, electrolyte, and caloric needs. Typical administration rate: 1-2 liters per day at 100-200 mL/hour, not to exceed 0.5 g/kg/hour dextrose and 0.5 mEq/kg/hour potassium. Maximum potassium infusion rate: 10 mEq/hour (or 0.5 mEq/kg/hour).
| Dosage form | INJECTABLE |
| Renal impairment | For GFR 30-50 mL/min: reduce potassium content or infusion rate; monitor potassium levels closely. For GFR <30 mL/min: contraindicated unless potassium levels and ECG are monitored; consider potassium-free alternatives. Anuria: contraindicated. |
| Liver impairment | Child-Pugh Class A and B: no specific adjustment needed; monitor potassium and glucose levels. Child-Pugh Class C: use with caution; monitor for hyperkalemia and fluid overload; reduce potassium infusion rate if necessary. |
| Pediatric use | Weight-based dose: 100-150 mL/kg/day for maintenance; potassium dose: 2-4 mEq/kg/day, not to exceed 0.5 mEq/kg/hour. Maximum dextrose infusion rate: 0.5 g/kg/hour. Adjust for fluid and electrolyte deficits. |
| Geriatric use | Lower starting doses due to decreased renal function; monitor renal function, potassium, and glucose levels closely. Avoid excessive fluid administration; typical rate: 50-100 mL/hour initially, adjust based on clinical response and serum electrolytes. |
| 1st trimester | Generally considered safe; used for fluid and electrolyte maintenance. No known teratogenic effects. |
| 2nd trimester | Safe for use; monitor electrolyte levels and fluid balance. |
| 3rd trimester | Safe for use; caution with fluid overload in preeclampsia or compromised cardiac function. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | All components (dextrose, sodium, chloride, potassium) cross the placenta; used for fetal hydration and electrolyte balance. |
| Breastfeeding | Excreted into breast milk in small amounts; considered compatible with breastfeeding. Monitor infant for electrolyte imbalance if large volumes administered. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | Teratogenic risk is low due to the physiological nature of components. Dextrose and electrolytes are essential nutrients; potassium at 20 mEq is within standard supplementation range. No increased risk of major malformations reported in any trimester. However, careful monitoring is required in cases of maternal hyperglycemia or electrolyte imbalances, which may indirectly affect fetal development. |
| Fetal Monitoring | Monitor maternal serum electrolytes (especially potassium and sodium), blood glucose, and fluid status. Fetal monitoring advised if maternal hyperglycemia, electrolyte imbalances, or fluid overload occur. Assess for signs of phlebitis at infusion site. In high-risk pregnancies, fetal heart rate monitoring may be indicated. |
| Fertility Effects | No known direct effects on fertility. Dextrose and electrolytes do not impair reproductive function. However, underlying conditions requiring this infusion (e.g., dehydration, electrolyte disturbances) may indirectly affect fertility if untreated. |
■ FDA Black Box Warning
NOT FOR USE IN NEONATES OR INFANTS LESS THAN 1 MONTH OF AGE CONTAINING BENZYL ALCOHOL AS PRESERVATIVE (not applicable to this product as it is preservative-free). Also, solutions containing potassium chloride must be administered with caution due to risk of hyperkalemia and cardiac arrest from rapid infusion.
| Common Effects | fluid replacement |
| Serious Effects |
HyperkalemiaHypernatremiaFluid overload states (e.g., pulmonary edema, congestive heart failure)Hyperglycemia with significant glycosuriaSevere renal impairment with oliguria or anuriaHypersensitivity to any component
| Precautions | Risk of hyperglycemia, especially in patients with diabetes mellitus, Risk of hyperkalemia with rapid infusion or in patients with renal impairment, Fluid overload in patients with heart failure or renal impairment, Electrolyte imbalances including hypernatremia or hyponatremia, Extravasation may cause tissue damage, Use with caution in patients with severe renal impairment, metabolic alkalosis, or respiratory alkalosis |
| Food/Dietary | No direct food interactions with intravenous administration. However, patients should maintain a balanced diet as per their underlying condition; potassium-rich foods may need to be considered if oral intake is resumed. |
| Clinical Pearls | This combination is used for maintenance hydration and correction of electrolyte deficits. Do not administer unless solution is clear and container undamaged. Monitor serum potassium levels and renal function; risk of hyperkalemia if renal impairment or rapid infusion. Infuse via central line if concentration >10% dextrose. Use with caution in patients with heart failure or edema due to sodium load. |
| Patient Advice | This solution is given intravenously to provide fluids, sugar, and potassium. · Tell your healthcare provider if you have kidney disease, high potassium levels, or heart problems. · Report any swelling, shortness of breath, or irregular heartbeat while receiving this infusion. · Inform your doctor if you are pregnant, breastfeeding, or taking any potassium-sparing diuretics or ACE inhibitors. |
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