DIALYTE LM/ DEXTROSE 2.5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DIALYTE LM/ DEXTROSE 2.5% IN PLASTIC CONTAINER (DIALYTE LM/ DEXTROSE 2.5% IN PLASTIC CONTAINER).
Dialysis solution containing dextrose and electrolytes; dextrose provides osmotic gradient for ultrafiltration and caloric supplementation, while electrolytes maintain acid-base and electrolyte balance in peritoneal dialysis.
| Metabolism | Dextrose is metabolized via glycolysis to pyruvate and lactate, primarily in the liver; electrolytes are not metabolized but regulated via renal/pathways. |
| Excretion | Renal: >95% as unchanged drug and metabolites. Biliary/fecal: <5%. |
| Half-life | Terminal half-life: 2.5–3.5 hours. Clinically, this allows for rapid clearance; accumulation may occur in renal impairment. |
| Protein binding | Less than 5% bound; albumin and globulins. |
| Volume of Distribution | 0.55–0.7 L/kg. Distributes primarily in extracellular fluid. |
| Bioavailability | IV: 100% (only route). Oral: not applicable. |
| Onset of Action | IV: immediate, within 1–2 minutes. |
| Duration of Action | IV: 2–4 hours. Clinical note: Effect persists as long as IV infusion continues; short duration after discontinuation. |
Intravenous infusion, 500-2000 mL per day as maintenance fluid; rate adjusted based on clinical status, typically 1-2 mL/kg/hour in adults.
| Dosage form | SOLUTION |
| Renal impairment | For GFR <30 mL/min: reduce volume by 25-50% and monitor potassium and magnesium levels. Avoid if anuria or severe renal impairment (GFR <15 mL/min) without dose adjustment based on electrolyte monitoring. |
| Liver impairment | No specific dose adjustment required per Child-Pugh class; monitor for fluid overload and electrolyte disturbances, particularly sodium and potassium, due to altered metabolism. |
| Pediatric use | Weight-based: 100-150 mL/kg/day for maintenance; adjust based on ongoing losses and clinical condition. Rate typically 1-2 mL/kg/hour for continuous infusion. Monitor glucose and electrolytes. |
| Geriatric use | Start at low end of dosing range (500-1000 mL/day) due to decreased renal function and increased risk of fluid overload; monitor renal function, electrolytes, and fluid balance closely. Avoid rapid infusion. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DIALYTE LM/ DEXTROSE 2.5% IN PLASTIC CONTAINER (DIALYTE LM/ DEXTROSE 2.5% IN PLASTIC CONTAINER).
| Breastfeeding | Compatible with breastfeeding; dextrose and electrolytes are normal milk components. M/P ratio not applicable. |
| Teratogenic Risk | No evidence of teratogenicity in first trimester; used as an electrolyte replenisher and caloric source. no known fetal risks. |
| Fetal Monitoring | Monitor for fluid and electrolyte imbalances, signs of hyperglycemia in mother, and fetal well-being if used for prolonged periods. |
■ FDA Black Box Warning
None
| Serious Effects |
Pre-existing severe hyperglycemia, hypokalemia, or lactic acidosis; known hypersensitivity to any component; severe abdominal disorders or infection.
| Precautions | Monitor serum glucose, electrolytes, and fluid balance; risk of hyperglycemia, hypokalemia, peritonitis, and abdominal complications; not for IV use. |
| Food/Dietary | No specific food interactions. However, ensure adequate nutrition with controlled protein intake as per renal diet. Avoid high-sodium and high-potassium foods unless otherwise advised. Monitor fluid intake as prescribed. Dextrose absorption may affect blood glucose; coordinate meals and insulin regimen. |
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| Fertility Effects | No known adverse effects on fertility. |
| Clinical Pearls |
| This is a peritoneal dialysis solution containing lactate (metabolized to bicarbonate) and 2.5% dextrose. Use the lowest dextrose concentration needed to achieve ultrafiltration to minimize metabolic complications. Monitor serum glucose closely in diabetic patients; hyperglycemia may require insulin adjustment. Ensure solution is warmed to body temperature before infusion. Check for clarity and absence of leaks before use. Do not administer intravenously. |
| Patient Advice | Wash hands thoroughly before handling the solution and catheter. · Inspect the bag for cloudiness, particles, or leaks before use. · Warm the solution to body temperature using a dry heat warmer (do not microwave). · Follow the prescribed dwell time and drainage schedule exactly. · Record your weight daily and report sudden weight gain, shortness of breath, or swelling. · Monitor blood sugar if diabetic and adjust insulin as directed by your doctor. · Report signs of infection: redness, tenderness, cloudy drainage, or fever. · Do not reuse the solution; discard any unused portion. · Store unopened bags in a cool, dry place away from direct sunlight. · Keep a dialysis log to track exchanges, weight, and any symptoms. |