ISOLYTE H IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for ISOLYTE H IN DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE H IN DEXTROSE 5% IN PLASTIC CONTAINER).
Isolyte H in Dextrose 5% provides a balanced electrolyte solution with glucose to maintain fluid and electrolyte homeostasis. Dextrose is metabolized to carbon dioxide and water, providing calories. Electrolytes replenish losses and maintain acid-base balance.
| Metabolism | Dextrose is metabolized via glycolysis and the citric acid cycle to carbon dioxide and water, primarily in the liver; insulin promotes cellular uptake. Electrolytes are not metabolized but are excreted or reabsorbed by the kidneys. |
| Excretion | Electrolytes and dextrose are primarily excreted renally. Potassium, sodium, chloride, and magnesium are eliminated via kidneys. Dextrose is metabolized to CO2 and water, with negligible renal excretion. Biliary/fecal elimination is minimal (<5%). |
| Half-life | Not applicable as a fixed drug. Electrolytes have no defined half-life; dextrose is rapidly cleared with a metabolic half-life of approximately 5-10 minutes due to insulin-mediated uptake. |
| Protein binding | Negligible for electrolytes and dextrose (<5%). |
| Volume of Distribution | Not applicable as a single compound. Electrolytes distribute primarily in extracellular fluid (0.2 L/kg for sodium), total body water (0.6 L/kg for water). Dextrose distributes in total body water (0.55 L/kg). |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate (within seconds) for electrolyte and fluid effects; dextrose effects on blood glucose occur within 1-2 minutes. |
| Duration of Action | Intravenous: Variable; effects on fluid balance persist for 1-2 hours post-infusion; electrolyte effects depend on renal function and redistribution. Clinical monitoring required. |
| Molecular Weight | Dextrose: 180.16 Da; electrolytes (Na+: 23, K+: 39.1, Mg2+: 24.3, Cl-: 35.5, lactate: 89.07). Overall solution is a mixture; no single molecular weight for the combination. |
Intravenous infusion; rate determined by clinical condition, electrolyte requirements, and fluid balance. Typical adult maintenance: 100-200 mL/hour. Maximum infusion rate: 1000 mL/hour.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment required; monitor serum electrolytes and fluid status in renal impairment due to risk of hyperkalemia, hypernatremia, or fluid overload. |
| Liver impairment | No specific dose adjustment; use with caution in severe hepatic impairment due to potential for fluid and electrolyte disturbances. |
| Pediatric use | Weight-based: 2-6 mL/kg/hour or as per Holliday-Segar method for maintenance; monitor serum electrolytes closely. |
| Geriatric use | Use with caution; consider lower initial rates due to reduced renal function and increased risk of fluid overload; monitor electrolytes and volume status. |
| 1st trimester | ISOLYTE H IN DEXTROSE 5% is an electrolyte and glucose solution. Dextrose crosses the placenta; fetal insulin secretion may be stimulated, leading to neonatal hypoglycemia if infused near term. Generally considered safe when used to correct maternal fluid and electrolyte imbalances, but avoid excess glucose administration. Use only if clearly needed. |
| 2nd trimester | Same as T1: monitor maternal glucose and electrolytes. No known teratogenic risk from balanced electrolyte solutions. |
| 3rd trimester | Infusion near delivery may cause maternal hyperglycemia and subsequent neonatal hypoglycemia. Use with caution; adjust rate to avoid excessive glucose load. |
Clinical note
Comprehensive clinical and safety monograph for ISOLYTE H IN DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE H IN DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Dextrose readily crosses the placenta by facilitated diffusion. Electrolytes (sodium, potassium, magnesium, chloride, lactate) also cross; degree varies. Lacate is metabolized by mother and fetus. |
| Breastfeeding | ISOLYTE H IN DEXTROSE 5% is compatible with breastfeeding. Dextrose and electrolytes are normal milk constituents; infusion does not pose risk to infant. Use without special precautions. |
| Lactation Rating | Safe |
| Teratogenic Risk | Isolyte H in Dextrose 5% is a balanced electrolyte solution with multiple electrolytes and 5% dextrose. Teratogenic risk: minimal due to components being normal physiological constituents. However, maternal hyperglycemia from dextrose may increase fetal risks including macrosomia and congenital anomalies if glucose not controlled. First trimester: no direct teratogenicity, but dextrose-induced hyperglycemia may be associated with neural tube defects. Second/third trimester: risk of fetal hyperinsulinemia, macrosomia, neonatal hypoglycemia if maternal glucose elevated. |
| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, fluid status, renal function during prolonged use. Fetal monitoring with ultrasound for growth and amniotic fluid index if maternal glucose control is compromised. Watch for signs of fluid overload or electrolyte disturbances. |
| Fertility Effects | No known direct effects on fertility. Components are physiological. Dextrose may affect ovulation if glycemic control is impaired in diabetic women; otherwise no impact. |
■ FDA Black Box Warning
None for this product; however, caution is required in patients with congestive heart failure, renal impairment, or conditions predisposing to electrolyte imbalances.
| Serious Effects |
Hypersensitivity to any componentHyperglycemia with severe dehydrationHypernatremia or hyperkalemia contraindicating specific electrolyte compositionSevere metabolic acidosis (e.g., lactic acidosis) - lactate load may worsen acidosis
| Precautions | Risk of fluid overload in patients with compromised cardiac or renal function, Risk of electrolyte imbalances (hyperkalemia, hyponatremia, hypernatremia), Administration may cause phlebitis or thrombosis, Monitor serum electrolytes, glucose, and fluid balance, Use with caution in patients with diabetes or glucose intolerance, Not for use when hyperosmolality is present |
| Food/Dietary | No known food interactions. However, monitor dietary intake of sodium, potassium, and chloride to avoid electrolyte imbalances. |
| Clinical Pearls | ISOLYTE H IN DEXTROSE 5% is a hypertonic solution (approximately 554 mOsm/L) that provides free water, electrolytes, and calories. Use caution in patients with renal impairment or those at risk for fluid overload. Monitor serum sodium, potassium, chloride, and glucose levels during infusion. Do not administer if solution is discolored or contains particulate matter. Compatible with most IV lines but avoid adding other drugs without checking compatibility. |
| Patient Advice | This solution is given through a vein to provide fluids, electrolytes, and sugar. · Tell your healthcare provider if you have kidney problems, heart issues, or if you are on a low-sodium or low-potassium diet. · Report any signs of fluid overload such as swelling, shortness of breath, or rapid weight gain. · You may need blood tests to check your body's electrolyte levels and blood sugar. |
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