INPERSOL-ZM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for INPERSOL-ZM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER (INPERSOL-ZM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER).
Inpersol-ZM w/ Dextrose 1.5% is a peritoneal dialysis solution that acts by creating a concentration gradient across the peritoneal membrane. The dextrose component provides an osmotic driving force that promotes ultrafiltration and removal of waste products (e.g., urea, creatinine) and excess electrolytes from the blood into the dialysate fluid, which is then drained from the peritoneal cavity. The electrolyte composition (sodium, chloride, calcium, magnesium, lactate) helps correct acid-base and electrolyte imbalances.
| Metabolism | Dextrose is metabolized systemically via glycolysis and gluconeogenesis. The electrolytes and buffer (lactate) are metabolized by the liver and kidneys. Lactate is converted to bicarbonate in the liver, contributing to acid-base regulation. |
| Excretion | Renal: 100% (dialysis fluid containing dextrose is removed directly; glucose is metabolized and not excreted unchanged). Dextrose undergoes cellular metabolism to CO2 and water. |
| Half-life | Not applicable systemically; dextrose half-life is minutes due to rapid cellular uptake. In peritoneal dialysis, the half-life of glucose in the peritoneal cavity is approximately 30-60 minutes due to absorption into bloodstream. |
| Protein binding | 0% (glucose is not bound to plasma proteins). |
| Volume of Distribution | 0.2-0.3 L/kg (dextrose distributes primarily in extracellular fluid; rapidly enters cells). |
| Bioavailability | Intraperitoneal: 100% (dextrose is fully available for absorption into the circulation; 60-80% absorbed over a 4-6 hour dwell). |
| Onset of Action | Intraperitoneal: Ultrafiltration begins within 30 minutes; osmotic effect peaks at 1-2 hours. |
| Duration of Action | Ultrafiltration duration: 4-6 hours per exchange, depending on dwell time and glucose concentration. |
250 mL to 2 L intraperitoneally, instilled over 10-20 minutes, dwell for 4-6 hours, then drain. Typically 4 exchanges per day.
| Dosage form | SOLUTION |
| Renal impairment | No dose adjustment required; drug is for peritoneal dialysis and dosing is based on dialysis prescription. Monitor serum electrolytes and glucose. |
| Liver impairment | No specific dose adjustment; use with caution in severe hepatic impairment due to potential for metabolic acidosis. |
| Pediatric use | Initial dose: 30-40 mL/kg per exchange, up to 4 exchanges per day. Adjust based on dwell time and patient tolerance. |
| Geriatric use | Use lower initial fill volumes (e.g., 500-1000 mL) and longer dwell times; monitor for fluid overload and electrolyte imbalances. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for INPERSOL-ZM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER (INPERSOL-ZM W/ DEXTROSE 1.5% IN PLASTIC CONTAINER).
| Breastfeeding | Excretion in breast milk not known; considered safe due to low systemic absorption. |
| Teratogenic Risk | First trimester: No known teratogenicity. Second trimester: No known teratogenicity. Third trimester: No known teratogenicity. |
| Fetal Monitoring | Monitor maternal electrolytes, fluid balance, blood glucose; fetal growth and well-being via ultrasound. |
■ FDA Black Box Warning
None
| Serious Effects |
["Absolute: Known hypersensitivity to any component of the solution, documented loss of peritoneal function (sclerosing peritonitis, extensive adhesions), pre-existing severe hyperglycemia or hyperosmolality, severe lactic acidosis, severe hepatic failure.","Relative: Recent abdominal surgery, abdominal adhesions or bowel obstruction, diaphragmatic defects (risk of hydrothorax), severe respiratory disease, poor nutritional status, presence of chronic or recurrent peritonitis."]
| Precautions | ["Peritoneal dialysis solution must be warmed to body temperature to avoid cold infusion effects.","Monitor for peritonitis (cloudy effluent, abdominal pain, fever) and exit-site infections.","Risk of mechanical complications such as catheter obstruction, leakage, or hernias.","Fluid and electrolyte imbalances: hyperglycemia (especially with dextrose-containing solutions), hypokalemia, hypomagnesemia, hypernatremia, metabolic alkalosis (from lactate).","Hypotension or volume depletion from excessive ultrafiltration.","Use with caution in patients with severe liver disease (lactate metabolism impairment), severe malnutrition, or metabolic acidosis.","Do not use if solution is discolored, contains precipitate, or the container is damaged."] |
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| Fertility Effects | No known adverse effects on fertility. |