ISOLYTE M W/ DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for ISOLYTE M W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE M W/ DEXTROSE 5% IN PLASTIC CONTAINER).
ISOLYTE M W/ DEXTROSE 5% IN PLASTIC CONTAINER is an intravenous solution that provides electrolytes and calories. Dextrose serves as a source of calories and water for hydration. Electrolytes (sodium, potassium, magnesium, chloride, acetate) help maintain acid-base balance and osmotic pressure. Acetate is a bicarbonate precursor that helps correct metabolic acidosis.
| Metabolism | Dextrose undergoes glycolysis and subsequent metabolism via the citric acid cycle. Electrolytes are not metabolized but are excreted or retained as needed by the kidneys. Acetate is metabolized in the liver and peripheral tissues to bicarbonate. |
| Excretion | Renal: 90% (as water, electrolytes, and glucose), Fecal: <5%, Biliary: <1% |
| Half-life | Not applicable (isotonic solution components; glucose half-life ~1.5-2 h in healthy; electrolytes are distributed and excreted per homeostasis) |
| Protein binding | <5% (no significant binding; electrolytes and glucose are free) |
| Volume of Distribution | For water: ~0.6 L/kg (total body water); for electrolytes: variable (sodium ~0.4 L/kg, potassium ~0.5 L/kg); glucose ~0.2 L/kg |
| Bioavailability | Intravenous: 100% |
| Onset of Action | Intravenous: Immediate (volume expansion, electrolyte correction); onset of glucose utilization within seconds |
| Duration of Action | Intravenous: Variable; volume effect ~1-2 h depending on renal function; electrolyte and glucose effects sustained during infusion |
| Molecular Weight | Dextrose: 180.16 Da; electrolytes (Na, K, Mg, Cl, acetate) are ionic (e.g., Na+ 23 Da, K+ 39 Da, Mg2+ 24 Da, Cl- 35.5 Da, acetate 59 Da). |
Intravenous infusion; dose is individualized based on fluid and electrolyte requirements. Typical adult dose is 500-1000 mL per hour initially, then adjusted to clinical response.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR < 30 mL/min) due to risk of hyperkalemia and metabolic acidosis. In mild-moderate impairment (GFR 30-89 mL/min), use with caution and monitor electrolytes, reduce infusion rate. |
| Liver impairment | No specific adjustment for Child-Pugh class A or B. In severe hepatic impairment (Child-Pugh class C), use with caution due to risk of fluid overload and electrolyte imbalances; monitor closely. |
| Pediatric use | Weight-based dosing: 10-20 mL/kg intravenously as a bolus for rehydration, then maintenance at 100-150 mL/kg/day for infants, 80-120 mL/kg/day for children, adjusted based on clinical status. |
| Geriatric use | Elderly patients may have decreased renal function; use with caution, monitor renal function and electrolytes. Start at lower end of dose range (e.g., 100-500 mL/hour) and titrate slowly. |
| 1st trimester | Generally considered safe; dextrose and electrolytes are essential for maternal and fetal nutrition. Monitor for fluid/electrolyte imbalance. |
| 2nd trimester | Safe when used as indicated; caution in conditions like gestational diabetes due to dextrose content. |
| 3rd trimester | Safe; use with caution in preeclampsia or fluid overload. Dextrose may affect fetal insulin levels. |
Clinical note
Comprehensive clinical and safety monograph for ISOLYTE M W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE M W/ DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Dextrose and electrolytes cross the placenta readily via passive diffusion and active transport; no known harm at therapeutic doses. |
| Breastfeeding | Dextrose and electrolytes are normal constituents of breast milk; no risk when used therapeutically. Monitor maternal fluid status. |
| Lactation Rating | Safe |
| Teratogenic Risk | No teratogenic risk in any trimester. Isolyte M with Dextrose 5% is a balanced electrolyte and glucose solution. Dextrose and electrolytes are endogenous substances; no fetal harm is expected with appropriate maternal administration. However, maternal hyperglycemia (e.g., from excessive dextrose) may cause fetal hyperinsulinism and rebound neonatal hypoglycemia, especially in third trimester. |
| Fetal Monitoring | Monitor maternal serum electrolytes, blood glucose, and fluid balance. In pregnancy, monitor for signs of fluid overload (edema, hypertension). Fetal heart rate monitoring during labor if administered intravenously. Assess for neonatal hypoglycemia if mother received high dextrose loads before delivery. |
| Fertility Effects | No known effect on fertility. Dextrose and electrolytes do not impair reproductive function. |
■ FDA Black Box Warning
Not for use in patients with known hypersensitivity to any component. Do not administer unless solution is clear and container undamaged. Discard unused portion.
| Serious Effects |
HyperglycemiaSevere fluid overloadSevere electrolyte imbalancesSevere renal impairment with oliguria
| Precautions | Monitor serum electrolytes, fluid balance, and renal function during prolonged therapy, Use with caution in patients with heart failure, renal impairment, or conditions predisposing to hyperkalemia, Avoid rapid infusion to prevent hyperglycemia and osmotic diuresis, Risk of phlebitis and infection at injection site |
| Food/Dietary | No known direct food interactions. However, patients should maintain a balanced diet as recommended by their physician. Avoid excessive intake of potassium-rich foods or salt substitutes if at risk of hyperkalemia, especially with impaired renal function. |
| Clinical Pearls | ISOLYTE M with dextrose 5% is a maintenance IV solution containing electrolytes and dextrose. Monitor serum electrolytes and glucose, especially in patients with renal impairment or diabetes. Do not administer simultaneously with blood through same tubing due to risk of hemolysis. Use inline filter if particulate contamination is suspected. Inspect for leaks and precipitate before administration. Adjust flow rate based on clinical status and fluid balance. |
| Patient Advice | This solution provides fluids, sugar, and electrolytes to maintain body balance. · Inform your healthcare provider if you have diabetes, kidney problems, or heart disease. · Tell your doctor if you experience swelling, shortness of breath, or irregular heartbeat during infusion. · Avoid consuming extra salt or potassium without medical advice while receiving this treatment. |
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