INPERSOL-LC/LM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for INPERSOL-LC/LM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER (INPERSOL-LC/LM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER).
Removes uremic toxins and excess fluid via diffusion and ultrafiltration across the peritoneal membrane.
| Metabolism | Dextrose is absorbed systemically and metabolized via glycolysis; other components are not significantly metabolized. |
| Excretion | Renal: 80-90% of dextrose metabolites (CO2 and H2O) are excreted via lungs and kidneys; electrolytes and water are eliminated renally. Biliary/fecal: minimal (<5%). |
| Half-life | Dextrose: approximately 1-2 hours (terminal half-life of glucose in plasma); clinical context: continuous peritoneal dialysis (CAPD) maintains steady-state glucose levels. |
| Protein binding | Dextrose: negligible (<5%); electrolytes (e.g., calcium, magnesium): 40-50% bound to albumin (for calcium), 30% for magnesium. |
| Volume of Distribution | Dextrose: total body water distribution, approximately 0.5-0.7 L/kg; clinical meaning: reflects distribution into extracellular and intracellular compartments. |
| Bioavailability | Intraperitoneal: 70-80% of dextrose is absorbed systemically over dwell time (4-6 hours) via peritoneal capillaries. |
| Onset of Action | Intraperitoneal: ultrafiltration begins within 30-60 minutes after instillation; peak glucose absorption at 1-2 hours. |
| Duration of Action | Dwell time for CAPD: 4-6 hours (standard); ultrafiltration rate declines after 2-4 hours due to glucose absorption. |
Intraperitoneal: For continuous ambulatory peritoneal dialysis (CAPD), instill 2 liters of 4.25% dextrose solution into the peritoneal cavity four times daily (4 exchanges/day). For automated peritoneal dialysis (APD), use 2-3 liters per cycle with multiple cycles overnight. Adjust volume and frequency based on patient's fluid and electrolyte status.
| Dosage form | SOLUTION |
| Renal impairment | No dose adjustment required for renal impairment as the drug is used for peritoneal dialysis in patients with end-stage renal disease. The dialysis prescription itself is adjusted based on residual renal function (e.g., increasing dwell time or exchange volume for low GFR). |
| Liver impairment | No specific pediatric dose adjustments; use weight-based dosing. For CAPD: 30-40 mL/kg per exchange, up to 2 liters, 4-5 exchanges/day. For APD: 30-40 mL/kg per cycle, with total dialysate volume adjusted to achieve adequate clearance. Monitor glucose absorption and fluid balance. |
| Pediatric use | No specific pediatric dose adjustments; use weight-based dosing. For CAPD: 30-40 mL/kg per exchange, up to 2 liters, 4-5 exchanges/day. For APD: 30-40 mL/kg per cycle, with total dialysate volume adjusted to achieve adequate clearance. Monitor glucose absorption and fluid balance. |
| Geriatric use |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for INPERSOL-LC/LM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER (INPERSOL-LC/LM W/ DEXTROSE 4.25% IN PLASTIC CONTAINER).
| Breastfeeding | No data on excretion into breast milk. Dextrose and electrolytes are normal plasma constituents; minimal transfer expected. M/P ratio not determined. Use with caution during breastfeeding. |
| Teratogenic Risk | Inpersol-LC/LM w/ Dextrose 4.25% is a peritoneal dialysis solution. No specific teratogenic risk data are available. Dextrose and electrolytes are generally considered low risk. First trimester: Theoretical risk from hyperglycemia if systemic absorption causes high glucose. Second/third trimesters: No known teratogenic effects; however, peritonitis risk may increase during pregnancy. |
■ FDA Black Box Warning
Not for intravenous administration. Use only for intraperitoneal administration.
| Serious Effects |
["Pre-existing severe hyperglycemia","Hypokalemia","Hypomagnesemia","Lactic acidosis (for lactate-containing solutions)","Peritoneal fibrosis","Abdominal wall infection"]
| Precautions | ["Peritonitis risk","Fluid and electrolyte imbalance","Hyperglycemia","Hypokalemia","Hypomagnesemia","Catheter-related complications"] |
Loading safety data…
| Initiate with lower exchange volumes (1.5-2 liters) and longer dwell times due to reduced peritoneal membrane function and increased risk of fluid overload. Monitor serum glucose, electrolytes, and ultrafiltration carefully; adjust dextrose concentration as needed. |
| Fetal Monitoring | Monitor maternal glucose levels due to dextrose absorption. Assess for peritonitis signs. In pregnancy, monitor fetal growth and amniotic fluid volume (due to potential glucose effects). Regular assessment of dialysis adequacy and electrolyte balance. |
| Fertility Effects | No specific data on fertility effects. Peritoneal dialysis may improve fertility in end-stage renal disease by improving uremic environment, but underlying renal disease may impair fertility. |