DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER (DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER).
The dextrose component provides osmotic pressure for peritoneal dialysis, promoting ultrafiltration of fluid and removal of solutes. Calcium and other electrolytes maintain physiologic balance.
| Metabolism | Dextrose is metabolized systemically to carbon dioxide and water via glycolysis and the Krebs cycle. Electrolytes are not metabolized. |
| Excretion | Primarily eliminated via peritoneal dialysis; glucose is metabolized systemically and excreted as CO2 and water; <5% renal excretion of metabolites |
| Half-life | Not applicable as a solution; glucose half-life ~20-30 min in circulation; clinical effect duration corresponds to dwell time (4-6 hours for standard exchange) |
| Protein binding | None (glucose does not bind to plasma proteins) |
| Volume of Distribution | Confined to peritoneal cavity and systemic circulation after absorption; approx 0.2-0.3 L/kg for glucose distribution |
| Bioavailability | 100% via intraperitoneal route (directly absorbed into circulation) |
| Onset of Action | Immediate upon instillation into peritoneal cavity; ultrafiltration begins within minutes |
| Duration of Action | 4-6 hours for standard dwell; longer dwells (8-12 hours) used overnight |
Intraperitoneal: Continuous ambulatory peritoneal dialysis (CAPD): 2-2.5 L per exchange, 4-5 exchanges per day; Continuous cyclic peritoneal dialysis (CCPD): 2-2.5 L per exchange, 3-5 nocturnal exchanges plus one daytime dwell.
| Dosage form | SOLUTION |
| Renal impairment | No dose adjustment necessary; dialysate composition and exchange volume may be adjusted based on peritoneal membrane function and residual renal function. |
| Liver impairment | No specific dose adjustment needed; monitor glucose and electrolytes. |
| Pediatric use | Intraperitoneal: 30-40 mL/kg per exchange, 4-5 exchanges per day for CAPD; 20-30 mL/kg per exchange for CCPD, adjusted to achieve adequate ultrafiltration and solute clearance. |
| Geriatric use | No specific dose adjustment; monitor for dehydration, electrolyte imbalances, and glucose absorption, particularly in elderly patients with comorbidities. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER (DIANEAL LOW CALCIUM W/DEXTROSE 2.5% IN PLASTIC CONTAINER).
| Breastfeeding | Excretion in breast milk is minimal; M/P ratio not determined. Use caution, consider benefits of breastfeeding. |
| Teratogenic Risk | No evidence of teratogenicity from intraperitoneal administration of dextrose or calcium. No fetal risk identified in human studies. |
| Fetal Monitoring |
■ FDA Black Box Warning
No FDA black box warning.
| Serious Effects |
["Hypersensitivity to any component.","Severe hyperglycemia or uncontrolled diabetes.","Pre-existing severe electrolyte imbalances.","Conditions incompatible with peritoneal dialysis (e.g., recent abdominal surgery, bowel obstruction, diaphragmatic defects)."]
| Precautions | ["Monitor serum electrolytes, glucose, and fluid balance.","Risk of peritonitis, catheter-related infections.","May cause hyperglycemia in diabetic patients.","Use with caution in patients with severe electrolyte disturbances.","Not for intravenous use."] |
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| Monitor serum electrolytes, glucose, renal function, and fluid balance. Assess for infection at catheter site. |
| Fertility Effects | No adverse effects on fertility reported. |