DEXTROSE 60% IN PLASTIC CONTAINER

Clinical safety rating: caution

Comprehensive clinical and safety monograph for DEXTROSE 60% IN PLASTIC CONTAINER (DEXTROSE 60% IN PLASTIC CONTAINER).

How it works

Dextrose 60% is a hypertonic solution that increases blood glucose levels, providing a source of calories and fluid. It acts as an osmotic diuretic at high concentrations, drawing water from intracellular to extracellular spaces.

What the body does with it

Metabolism	Dextrose is metabolized via glycolysis and the citric acid cycle to produce ATP, carbon dioxide, and water. Insulin facilitates cellular uptake.
Excretion	Renal: essentially 100% as CO2 and water; negligible unchanged glucose under normal conditions; in hyperglycemia, small amounts (<5%) excreted unchanged in urine when renal threshold exceeded.
Half-life	Approximately 1.5-2.5 hours for exogenous glucose; clinically relevant in monitoring glucose infusion rates in critically ill patients.
Protein binding	Negligible (<5%); glucose is not significantly bound to plasma proteins.
Volume of Distribution	Approximately 0.15-0.25 L/kg, approximating extracellular fluid volume; clinically, it indicates distribution primarily in extracellular space.
Bioavailability	Intravenous: 100%. Not administered orally for systemic effect; oral glucose is absorbed with near 100% bioavailability but subject to first-pass hepatic metabolism.
Onset of Action	Intravenous: immediate (seconds to minutes) as parenteral infusion.
Duration of Action	Duration depends on infusion rate and metabolic demand; continuous IV infusion maintains effect; after cessation, serum glucose returns to baseline within 30-60 minutes due to rapid cellular uptake and metabolism.

Classification & Brands

Dosing & administration

250 mL of 60% dextrose (150 g) intravenously over 2 hours for hypoglycemia; for parenteral nutrition, dosage individualized based on caloric requirements and glucose tolerance.

Dosage form	INJECTABLE
Renal impairment	In GFR < 30 mL/min, reduce infusion rate to avoid volume overload and monitor serum glucose; in ESRD, use with caution and consider lower concentration (e.g., 50% dextrose) to minimize fluid load.
Liver impairment	In Child-Pugh class C, reduce dose by 30-50% due to impaired gluconeogenesis and risk of hyperglycemia; monitor blood glucose closely.
Pediatric use	Neonates: 0.5-1 g/kg/dose (0.8-1.7 mL/kg of 60% dextrose) IV for hypoglycemia; for maintenance, 4-8 mg/kg/min as continuous infusion (adjust concentration to 5-12.5% dextrose). Children: 2 mL/kg of 25% dextrose (0.5 g/kg) IV for hypoglycemia; for parenteral nutrition, start at 5-10 mg/kg/min and titrate.
Geriatric use	Elderly patients: Reduce infusion rate by 20-30% due to decreased glucose tolerance and increased risk of fluid overload; monitor serum glucose and electrolytes frequently.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for DEXTROSE 60% IN PLASTIC CONTAINER (DEXTROSE 60% IN PLASTIC CONTAINER).

Breastfeeding	Dextrose is a normal constituent of breast milk. No M/P ratio reported; infusion of 60% dextrose does not pose a risk. Monitor infant for signs of hyperglycemia if maternal infusion is prolonged.
Teratogenic Risk	Dextrose 60% is not teratogenic. Hyperglycemia during pregnancy may increase the risk of fetal macrosomia, neonatal hypoglycemia, and congenital anomalies (first trimester). Controlled glucose levels reduce risk.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

None.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Diabetic coma with hyperglycemia","Intracranial hemorrhage (unless used specifically for treatment)","Severe dehydration","Known hypersensitivity to dextrose or corn products"]

Clinical Precautions

Precautions

["Risk of hyperglycemia and hyperosmolar syndrome, especially in patients with diabetes mellitus or renal impairment","Intravenous administration of hypertonic solutions can cause phlebitis and extravasation injury","Use with caution in patients with intracranial hemorrhage or brain edema due to risk of increasing intracranial pressure"]

Clinical Tips & Counseling

Drug interactions

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DEXTROSE 60% IN PLASTIC CONTAINER

Clinical safety rating: caution

Comprehensive clinical and safety monograph for DEXTROSE 60% IN PLASTIC CONTAINER (DEXTROSE 60% IN PLASTIC CONTAINER).

How it works

What the body does with it

Metabolism	Dextrose is metabolized via glycolysis and the citric acid cycle to produce ATP, carbon dioxide, and water. Insulin facilitates cellular uptake.
Excretion	Renal: essentially 100% as CO2 and water; negligible unchanged glucose under normal conditions; in hyperglycemia, small amounts (<5%) excreted unchanged in urine when renal threshold exceeded.
Half-life	Approximately 1.5-2.5 hours for exogenous glucose; clinically relevant in monitoring glucose infusion rates in critically ill patients.
Protein binding	Negligible (<5%); glucose is not significantly bound to plasma proteins.
Volume of Distribution	Approximately 0.15-0.25 L/kg, approximating extracellular fluid volume; clinically, it indicates distribution primarily in extracellular space.
Bioavailability	Intravenous: 100%. Not administered orally for systemic effect; oral glucose is absorbed with near 100% bioavailability but subject to first-pass hepatic metabolism.
Onset of Action	Intravenous: immediate (seconds to minutes) as parenteral infusion.
Duration of Action	Duration depends on infusion rate and metabolic demand; continuous IV infusion maintains effect; after cessation, serum glucose returns to baseline within 30-60 minutes due to rapid cellular uptake and metabolism.

Classification & Brands

Dosing & administration

250 mL of 60% dextrose (150 g) intravenously over 2 hours for hypoglycemia; for parenteral nutrition, dosage individualized based on caloric requirements and glucose tolerance.

Dosage form	INJECTABLE
Renal impairment	In GFR < 30 mL/min, reduce infusion rate to avoid volume overload and monitor serum glucose; in ESRD, use with caution and consider lower concentration (e.g., 50% dextrose) to minimize fluid load.
Liver impairment	In Child-Pugh class C, reduce dose by 30-50% due to impaired gluconeogenesis and risk of hyperglycemia; monitor blood glucose closely.
Pediatric use	Neonates: 0.5-1 g/kg/dose (0.8-1.7 mL/kg of 60% dextrose) IV for hypoglycemia; for maintenance, 4-8 mg/kg/min as continuous infusion (adjust concentration to 5-12.5% dextrose). Children: 2 mL/kg of 25% dextrose (0.5 g/kg) IV for hypoglycemia; for parenteral nutrition, start at 5-10 mg/kg/min and titrate.
Geriatric use	Elderly patients: Reduce infusion rate by 20-30% due to decreased glucose tolerance and increased risk of fluid overload; monitor serum glucose and electrolytes frequently.

Use during pregnancy

1st trimester	Consult provider
2nd trimester	Consult provider
3rd trimester	Consult provider

Clinical note

Comprehensive clinical and safety monograph for DEXTROSE 60% IN PLASTIC CONTAINER (DEXTROSE 60% IN PLASTIC CONTAINER).

Breastfeeding	Dextrose is a normal constituent of breast milk. No M/P ratio reported; infusion of 60% dextrose does not pose a risk. Monitor infant for signs of hyperglycemia if maternal infusion is prolonged.
Teratogenic Risk	Dextrose 60% is not teratogenic. Hyperglycemia during pregnancy may increase the risk of fetal macrosomia, neonatal hypoglycemia, and congenital anomalies (first trimester). Controlled glucose levels reduce risk.
Fetal Monitoring

Warnings & precautions

■ FDA Black Box Warning

None.

Side Effect Profile

Serious Effects

Absolute Contraindications

["Diabetic coma with hyperglycemia","Intracranial hemorrhage (unless used specifically for treatment)","Severe dehydration","Known hypersensitivity to dextrose or corn products"]