DEXTROSE 70% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DEXTROSE 70% IN PLASTIC CONTAINER (DEXTROSE 70% IN PLASTIC CONTAINER).
Dextrose is a monosaccharide that provides a source of calories and fluid for intravenous administration. It increases blood glucose concentration and is metabolized to carbon dioxide and water, yielding energy.
| Metabolism | Dextrose is metabolized via glycolysis and the tricarboxylic acid cycle to produce ATP, carbon dioxide, and water. Insulin facilitates cellular uptake and utilization. |
| Excretion | 100% renal; metabolized to CO2 and water; none excreted unchanged under normal conditions |
| Half-life | 30-60 minutes; clinically relevant in hyperglycemic states or renal impairment where glucose clearance is prolonged |
| Protein binding | Negligible (<1%); does not significantly bind to plasma proteins |
| Volume of Distribution | 0.2-0.3 L/kg; distributes primarily in extracellular fluid; total body water volume approximates 0.6 L/kg |
| Bioavailability | Intravenous: 100%; oral: not applicable (not available as oral formulation for systemic effects) |
| Onset of Action | Intravenous: within 1-2 minutes; peak effect on plasma glucose concentration occurs within 30 minutes |
| Duration of Action | Approximately 1-2 hours after bolus administration; continuous infusion effects persist as long as infusion continues |
Adults: Intravenous infusion, dose dependent on clinical need; typically 500 mL of 70% dextrose (350 g) administered as part of parenteral nutrition at a rate not exceeding 0.5 g/kg/h.
| Dosage form | INJECTABLE |
| Renal impairment | No specific GFR-based adjustments; use with caution in renal impairment due to risk of fluid overload and hyperglycemia. Monitor glucose and electrolytes. |
| Liver impairment | No specific Child-Pugh adjustments; caution in severe hepatic impairment due to impaired gluconeogenesis and risk of hyperglycemia. |
| Pediatric use | Neonates and children: Intravenous infusion, dose based on weight and clinical need; typical rate 0.1-0.5 g/kg/h, not to exceed 0.5 g/kg/h. Maximum concentration for peripheral infusion is 12.5%; central line required for 70% dextrose. |
| Geriatric use | Elderly: Use lower initial doses and monitor glucose closely due to increased risk of hyperglycemia and fluid overload. Adjust rate based on tolerance. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DEXTROSE 70% IN PLASTIC CONTAINER (DEXTROSE 70% IN PLASTIC CONTAINER).
| Breastfeeding | Exogenous dextrose is not secreted into breast milk; M/P ratio not applicable. Considered safe during breastfeeding as it is endogenous to human milk. |
| Teratogenic Risk | No teratogenic risk identified in any trimester; dextrose is a normal physiological constituent. High concentrations may cause maternal hyperglycemia, which could lead to fetal hyperinsulinemia and subsequent hypoglycemia at birth if prolonged. |
| Fetal Monitoring |
■ FDA Black Box Warning
None.
| Serious Effects |
["Hyperglycemia with ketosis (e.g., diabetic ketoacidosis)","Severe dehydration with hypernatremia","Known hypersensitivity to corn-derived products","Intracranial or intraspinal hemorrhage (for dextrose solutions with high osmolality)"]
| Precautions | ["Hyperglycemia and hyperosmolar syndrome in patients with impaired glucose tolerance or diabetes mellitus","Electrolyte disturbances, particularly hypokalemia and hypophosphatemia","Volume overload in patients with cardiac or renal impairment","Thrombophlebitis at injection site","Rebound hypoglycemia upon abrupt discontinuation"] |
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| Monitor maternal blood glucose levels, electrolyte balance, and fluid status. In prolonged infusion, monitor for signs of fluid overload or electrolyte disturbances in both mother and fetus via fetal heart rate monitoring and maternal symptoms. |
| Fertility Effects | No adverse effects on fertility reported. Dextrose is a simple sugar used for caloric replacement and does not interfere with reproductive function. |