DIALYTE W/ DEXTROSE 1.5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DIALYTE W/ DEXTROSE 1.5% IN PLASTIC CONTAINER (DIALYTE W/ DEXTROSE 1.5% IN PLASTIC CONTAINER).
Removes uremic toxins, corrects electrolyte imbalances, and removes excess fluid via peritoneal dialysis.
| Metabolism | Not metabolized; components are eliminated via dialysis fluid exchange. |
| Excretion | Primarily renal; glucose and electrolytes are reabsorbed or excreted by kidneys. For IP administration, dialysis fluid components (e.g., dextrose, sodium, chloride, lactate) are absorbed and then eliminated via renal and metabolic pathways: ~60% of absorbed dextrose is metabolized, remainder excreted renally; electrolytes are excreted renally; lactate is metabolized to bicarbonate. |
| Half-life | Dextrose: ~2-2.5 hours (glucose turnover); electrolytes and lactate have rapid distribution and elimination half-lives of minutes to hours. In renal impairment, half-life of dialyzed solutes may be prolonged. |
| Protein binding | Dextrose: negligible binding (<5%). Electrolytes and lactate: minimal to no protein binding. |
| Volume of Distribution | Dextrose: Vd ~0.2-0.4 L/kg (total body water). Electrolytes distribute according to body water compartments; lactate distributes into extracellular fluid (~0.3 L/kg). |
| Bioavailability | Intraperitoneal: 100% for absorbed components; dextrose absorption varies from 60-80% over a dwell; electrolytes are fully absorbed; lactate is metabolized to bicarbonate with first-pass metabolism in the liver, but systemic bioavailability of lactate is near 100% as it is rapidly converted. |
| Onset of Action | Intraperitoneal (IP) administration: Onset of fluid removal and electrolyte correction begins within 15-30 minutes of dwell initiation; blood glucose elevation from dextrose absorption occurs within 30-60 minutes. |
| Duration of Action | IP dwell time dictates duration of action for fluid and solute removal. Typical dwell times of 4-6 hours provide sustained ultrafiltration and waste removal; short dwells (1-2 hours) limit effectiveness. Duration of dextrose effect is ~2-4 hours post-absorption. |
Intraperitoneal administration: 2 liters per exchange, 4 exchanges per day (typical for continuous ambulatory peritoneal dialysis).
| Dosage form | SOLUTION |
| Renal impairment | Not applicable; drug is for renal replacement therapy and dose is based on peritoneal dialysis prescription. |
| Liver impairment | No dosage adjustment required. |
| Pediatric use | Dose based on body weight and clinical status; typical initial exchange volume: 30-40 mL/kg per exchange. |
| Geriatric use | No specific adjustments; individualize based on peritoneal membrane function and metabolic status. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DIALYTE W/ DEXTROSE 1.5% IN PLASTIC CONTAINER (DIALYTE W/ DEXTROSE 1.5% IN PLASTIC CONTAINER).
| Breastfeeding | Breastfeeding is considered safe during peritoneal dialysis with DIALYTE W/ DEXTROSE 1.5%. Dextrose and electrolytes are normal blood constituents and not excreted in milk in clinically significant amounts. M/P ratio is not applicable as dextrose is endogenous. No adverse effects on nursing infant reported. |
| Teratogenic Risk | Dialysis with DIALYTE W/ DEXTROSE 1.5% IN PLASTIC CONTAINER is not associated with teratogenic risk. Dextrose solutions are essential for energy and do not cross the placenta in amounts that cause fetal harm. There is no evidence of teratogenicity from peritoneal dialysis solutions in any trimester. |
■ FDA Black Box Warning
Not for intravenous use. Strict aseptic technique required. Risk of peritonitis.
| Serious Effects |
Hypersensitivity to any component, pre-existing severe hyperglycemia, hypokalemia, or lactic acidosis.
| Precautions | Monitor for peritonitis, fluid/electrolyte imbalances, and hyperglycemia. Use caution in patients with glucose intolerance. |
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| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, fluid balance, and renal function regularly. Assess for signs of peritonitis (abdominal pain, cloudy effluent). Fetal assessment includes serial ultrasound for growth and amniotic fluid volume. Monitor for preterm labor and maternal hypertension. |
| Fertility Effects | No direct effects on fertility. However, chronic kidney disease and dialysis can impair fertility due to hormonal imbalances. Dialysis may improve overall health and potentially restore ovulatory cycles, but data specific to DIALYTE W/ DEXTROSE 1.5% are lacking. |