DIALYTE LM/ DEXTROSE 1.5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DIALYTE LM/ DEXTROSE 1.5% IN PLASTIC CONTAINER (DIALYTE LM/ DEXTROSE 1.5% IN PLASTIC CONTAINER).
Peritoneal dialysis solution with dextrose as osmotic agent; dextrose creates osmotic gradient across peritoneal membrane to remove excess fluid and uremic toxins.
| Metabolism | Dextrose is metabolized via glycolysis; absorbed from peritoneal cavity and metabolized systemically; no significant hepatic metabolism required. |
| Excretion | Peritoneal dialysis fluid: DIALYTE components (electrolytes, dextrose) are not systemically absorbed in clinically significant amounts; dextrose is partially absorbed across the peritoneum and metabolized. Renal and biliary excretion are not relevant as this is a topical intraperitoneal solution. Elimination of absorbed dextrose follows glucose metabolism (oxidation, storage). |
| Half-life | Not applicable: Dextrose absorbed from peritoneal dialysate has a half-life similar to IV glucose (approx. 1-2 hours), but as a dialysis solution, the concept of terminal elimination half-life is not defined for the non-absorbed components. Clinical context: continuous intraperitoneal administration. |
| Protein binding | Not applicable: DIALYTE components (electrolytes, dextrose) do not bind to plasma proteins; dextrose is unbound in plasma. |
| Volume of Distribution | Not applicable: DIALYTE is not administered systemically; absorbed dextrose distributes into total body water (approx. 0.6 L/kg), but this is clinically irrelevant as the solution acts topically. |
| Bioavailability | Not applicable: DIALYTE is administered intraperitoneally and acts locally; systemic bioavailability of dextrose is variable (approx. 60-80% absorbed across peritoneum over dwell time), but not a standard measure. |
| Onset of Action | Intraperitoneal: Immediate upon instillation; peritoneal dialysis begins immediately after fluid infusion into the peritoneal cavity. |
| Duration of Action | Intraperitoneal: Dwell time typically 4-6 hours for standard exchanges; clinical effect (ultrafiltration and solute clearance) persists as long as fluid remains in peritoneum. |
Intraperitoneal administration via automated peritoneal dialysis (APD) or continuous ambulatory peritoneal dialysis (CAPD); typical adult dose is 2-3 liters per exchange, 4-5 exchanges per day (CAPD) or 8-12 liters total volume per night (APD).
| Dosage form | SOLUTION |
| Renal impairment | Not applicable; drug is used for renal replacement therapy in end-stage renal disease (ESRD). No dose adjustment based on GFR; therapy is dialytic. |
| Liver impairment | No dosage adjustment required; use with caution in severe hepatic impairment due to potential for altered metabolic status. |
| Pediatric use | Intraperitoneal; initial volume 10-20 mL/kg per exchange, adjust based on clinical response and ultrafiltration. Exchange frequency similar to adult pattern per body surface area. |
| Geriatric use | Use standard dosing with careful monitoring of fluid and electrolyte balance; may require lower exchange volumes due to reduced peritoneal surface area or comorbidities. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DIALYTE LM/ DEXTROSE 1.5% IN PLASTIC CONTAINER (DIALYTE LM/ DEXTROSE 1.5% IN PLASTIC CONTAINER).
| Breastfeeding | Not absorbed systemically; therefore, no effect on breastfed infant. M/P ratio: not applicable. |
| Teratogenic Risk | Dianeal PD-1 (peritoneal dialysis solution) is not absorbed systemically in significant amounts. No fetal risk is expected from intraperitoneal use during pregnancy. However, the underlying renal disease and metabolic disturbances may affect pregnancy outcomes. No human studies are available. |
| Fetal Monitoring |
■ FDA Black Box Warning
Not for intravenous use; strict aseptic technique required to prevent peritonitis; discard if solution is discolored or contains particulate matter.
| Serious Effects |
["Hypersensitivity to any component","Preexisting severe lactic acidosis or anuria unrelated to renal failure","Pre-existing severe hypokalemia or hyperglycemia","Intraperitoneal administration of other drugs without compatibility verification"]
| Precautions | ["Peritonitis risk with improper technique","Monitor serum glucose levels and electrolyte balance","Potential for hyperglycemia, especially in diabetic patients","May mask hypokalemia; potassium supplementation may be needed","Not compatible with certain medications; verify drug compatibility","Use with caution in patients with respiratory insufficiency"] |
| Food/Dietary | No direct food interactions. However, restrict dietary intake of potassium, phosphorus, sodium, and fluids as per renal diet prescribed. Avoid high-sugar foods that may exacerbate hyperglycemia due to dextrose absorption. |
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| Monitor maternal electrolytes, acid-base balance, fluid status, and renal function. Fetal monitoring per standard obstetrical care. |
| Fertility Effects | No known effects on fertility. Dialysis may improve uremic hormonal disturbances that impair fertility. |
| Clinical Pearls | Use only in patients with acute kidney injury or chronic kidney disease requiring dialysis. Confirm solution composition (electrolytes) and dextrose concentration before administration. Monitor serum glucose in diabetic patients due to 1.5% dextrose. Contraindicated in hyperkalemia with potassium >6.0 mEq/L unless adjusted. Use with caution in hyponatremia; may worsen due to low sodium content. Not for intravenous use; strictly intraperitoneal. Observe for peritonitis signs (cloudy effluent, abdominal pain). |
| Patient Advice | This solution is used for peritoneal dialysis to remove waste and excess fluid from your blood. · Keep the solution at room temperature (not refrigerated) before use. · Inspect the bag for leaks, cloudiness, or particles; do not use if present. · Wash hands thoroughly before handling the catheter or exchange procedure. · Follow your dialysis schedule exactly as prescribed by your doctor. · Check your weight daily and report sudden gain or loss, or any swelling. · Monitor blood glucose if diabetic; dextrose may affect levels. · Report signs of infection: fever, chills, abdominal pain, or cloudy dialysate effluent. · Do not use the solution after the expiration date on the bag. · Empty the bag completely after dwell time as instructed. |