DIALYTE LM/ DEXTROSE 4.25% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DIALYTE LM/ DEXTROSE 4.25% IN PLASTIC CONTAINER (DIALYTE LM/ DEXTROSE 4.25% IN PLASTIC CONTAINER).
Removes waste products (e.g., urea, creatinine) and excess electrolytes via diffusion and ultrafiltration across the peritoneal membrane; dextrose acts as osmotic agent to generate ultrafiltration.
| Metabolism | Dextrose is metabolized via glycolysis and oxidative phosphorylation; electrolytes are not metabolized. |
| Excretion | Renal: 100% (electrolytes and dextrose are completely reabsorbed or metabolized; water is excreted renally). Biliary/fecal: 0%. |
| Half-life | Not applicable; dextrose is rapidly metabolized (half-life ~2-5 min), electrolytes are distributed and excreted renally with half-life dependent on renal function. |
| Protein binding | Negligible (<5%); electrolytes and dextrose are not significantly protein-bound. |
| Volume of Distribution | Electrolytes and dextrose distribute into total body water (Vd ~0.6 L/kg). |
| Bioavailability | Intraperitoneal: 100% (systemic absorption of dextrose and electrolytes occurs). Intravenous: 100%. |
| Onset of Action | Intraperitoneal: immediate (within minutes) upon instillation; intravenous: immediate. |
| Duration of Action | Peritoneal dialysis dwell time: 4-6 hours for standard exchanges; continuous ambulatory peritoneal dialysis (CAPD) maintains continuous effect. |
Intraperitoneal administration: 2 to 2.5 liters per exchange, 4 to 5 exchanges daily, as part of continuous ambulatory peritoneal dialysis (CAPD).
| Dosage form | SOLUTION |
| Renal impairment | Not applicable; drug is used for renal replacement therapy in end-stage renal disease; dosing determined by dialysis prescription. |
| Liver impairment | No adjustment required; hepatic metabolism not significant. |
| Pediatric use | Weight-based: 30-40 mL/kg per exchange, 4-6 exchanges daily, adjusted to achieve target ultrafiltration and solute clearance. |
| Geriatric use | No specific adjustment, but monitor for fluid and electrolyte imbalances due to age-related decline in renal function. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DIALYTE LM/ DEXTROSE 4.25% IN PLASTIC CONTAINER (DIALYTE LM/ DEXTROSE 4.25% IN PLASTIC CONTAINER).
| Breastfeeding | No data on excretion in breast milk. Dextrose and electrolytes are normal blood constituents; M/P ratio not established. Likely compatible with breastfeeding but use with caution. |
| Teratogenic Risk | No evidence of teratogenic risk in any trimester. This is a peritoneal dialysis solution containing dextrose and electrolytes, not systemically absorbed in significant amounts. No fetal risk documented. |
| Fetal Monitoring |
■ FDA Black Box Warning
Not for intravenous use. Peritoneal dialysis products are for intraperitoneal administration only.
| Serious Effects |
["Pre-existing severe hyperglycemia or metabolic acidosis","Peritoneal membrane failure or extensive adhesions","Abdominal wall infections or recent abdominal surgery","Documented hypersensitivity to any component","Severe hypotension or hypovolemia"]
| Precautions | ["Monitor serum electrolytes, glucose, and fluid balance regularly","Risk of peritonitis, catheter-related infections, and abdominal complications","Hyperglycemia and hyperosmolar syndrome in diabetic patients","Hypokalemia, hypomagnesemia, or other electrolyte disturbances","Patients with severe hypotension or shock may not tolerate fluid removal"] |
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| Monitor maternal serum electrolytes, glucose, acid-base status. Fetal monitoring standard for high-risk pregnancies. Assess for peritonitis. |
| Fertility Effects | No known adverse effects on fertility. Peritoneal dialysis may improve fertility in women with ESRD by improving uremic milieu. |