DEXTROSE 5%, SODIUM CHLORIDE 0.33% AND POTASSIUM CHLORIDE 5MEQ IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Dextrose provides a source of glucose for cellular metabolism, replenishing energy stores. Sodium chloride and potassium chloride restore electrolyte balance and maintain osmotic pressure in extracellular fluid.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, producing ATP. Potassium is primarily excreted renally; sodium is also excreted mainly by kidneys. |
| Excretion | Renal: 100% (both glucose and ions are excreted renally; potassium is actively secreted and reabsorbed, net excretion depends on renal function and serum levels; sodium and chloride follow passive reabsorption; glucose is reabsorbed in proximal tubule up to renal threshold, excess is excreted in urine). |
| Half-life | Not applicable as a drug; dextrose undergoes cellular uptake and metabolism with a half-life of minutes to hours depending on insulin and metabolic state; potassium has a plasma half-life of 1-1.5 hours in healthy individuals, prolonged in renal impairment; sodium and chloride have no defined half-life as they are regulated by renal excretion. |
| Protein binding | 0% (dextrose, sodium, chloride, and potassium are not protein-bound; potassium is free in plasma; sodium and chloride are free ions). |
| Volume of Distribution | Dextrose: 0.2-0.3 L/kg (initial distribution to extracellular fluid); sodium and chloride: 0.15-0.2 L/kg (extracellular space); potassium: varies (0.4-0.7 L/kg, primarily intracellular). Clinical meaning: reflects distribution primarily to extracellular fluid for sodium/chloride and glucose, and intracellular for potassium. |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for volume expansion and electrolyte effects. |
| Duration of Action | Intravenous: effects last as long as infusion continues; distribution and metabolism of dextrose occur rapidly; potassium redistribution takes 24-48 hours for total body balance; sodium and chloride effects resolve after infusion stops, typically within hours. |
Intravenous infusion; dose determined by patient fluid, electrolyte, and caloric needs. Typical adult dose: 1000 mL to 2000 mL per 24 hours, at a rate of 50-100 mL/hour.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) except with close monitoring of potassium levels; reduce infusion rate or volume as needed to avoid fluid overload and hyperkalemia. |
| Liver impairment | No specific Child-Pugh based dose adjustment; however, caution in severe hepatic impairment due to risk of fluid retention and electrolyte imbalances. |
| Pediatric use | Weight-based: 5-10 mL/kg/day up to 30 mL/kg/day, adjusted for fluid and electrolyte requirements. Infusion rate not to exceed 0.5-1 g/kg/hour of dextrose. |
| Geriatric use | Start at lower end of dosing range; careful monitoring of fluid status, renal function, and serum potassium to avoid fluid overload and electrolyte disturbances. |
| 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 | Excretion into breast milk minimal; components are normal constituents of milk. M/P ratio not established. Use compatible with breastfeeding when medically indicated. Monitor infant for electrolyte disturbances if large volumes administered. |
| Teratogenic Risk | No known teratogenic risk. Dextrose, sodium chloride, and potassium chloride are physiological substances. In first trimester, no evidence of fetal harm. Second and third trimesters: infusion rate and volume must be monitored to avoid maternal fluid overload, electrolyte imbalances, and hyperglycemia, which could affect fetal well-being. No specific teratogenic effects reported. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hyperkalemia","Hypernatremia","Severe renal impairment with oliguria","Fluid overload states (e.g., pulmonary edema)","Hypersensitivity to any component"]
| Precautions | ["Use with caution in patients with renal impairment, heart failure, or conditions predisposing to fluid overload","Monitor serum potassium and glucose levels","Avoid in patients with hyperkalemia, hypernatremia, or fluid overload states","May cause phlebitis or infection at infusion site"] |
| Food/Dietary | Avoid potassium-rich foods (e.g., bananas, oranges, potatoes) unless advised by a healthcare provider; no other significant food interactions. |
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| Fetal Monitoring | Monitor serum electrolytes (sodium, potassium, glucose), fluid balance (intake/output, urine output, signs of edema), and clinical signs of hyperglycemia or fluid overload. In pregnancy, monitor maternal heart rate, blood pressure, and uterine activity if using for labor management. Fetal heart rate monitoring if indicated by condition. |
| Fertility Effects | No known effects on fertility. Dextrose, sodium chloride, and potassium chloride do not impair reproductive function. Use as a maintenance solution does not alter fertility. |
| Clinical Pearls | Use with caution in patients with heart failure, renal impairment, or hyperkalemia; monitor serum potassium and glucose levels; not for use as a resuscitation fluid due to low sodium content; adjust rate based on fluid and electrolyte status. |
| Patient Advice | Report any signs of fluid overload, such as shortness of breath or swelling. · Understand that this solution provides calories and electrolytes; do not consume additional potassium-rich foods without consulting your doctor. · Monitor for symptoms of high or low blood sugar if you have diabetes. · Keep all appointments for blood tests to check your electrolyte levels. |