ISOLYTE P W/ DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for ISOLYTE P W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE P W/ DEXTROSE 5% IN PLASTIC CONTAINER).
ISOLYTE P with 5% Dextrose provides electrolyte replacement and caloric supplementation. Dextrose is metabolized to carbon dioxide and water, yielding energy. Electrolytes are essential for maintaining osmotic balance, acid-base equilibrium, and normal cellular function.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle. Electrolytes are not metabolized but are excreted or reabsorbed. |
| Excretion | Renal excretion of free water and electrolytes; dextrose is metabolized to CO2 and water, with negligible biliary or fecal elimination. Approximately 50-70% of infused water is excreted renally within 24 hours, adjusted by ADH and renal function. |
| Half-life | Dextrose: rapid clearance, half-life ~1.5-2 hours in normoglycemic patients; prolonged in renal impairment or diabetes. Electrolytes follow homeostatic regulation with no defined terminal half-life. |
| Protein binding | Dextrose: negligible (<1%). Electrolytes: sodium and potassium are not protein bound; chloride, acetate, and gluconate are free in plasma. |
| Volume of Distribution | Dextrose: ~0.2 L/kg (limited to extracellular fluid initially); electrolytes distribute according to body water compartments: sodium ~0.2 L/kg (ECF), potassium ~0.4 L/kg (ICF). |
| Bioavailability | Intravenous: 100% (complete bioavailability). No oral formulation; oral dextrose has variable absorption. |
| Onset of Action | Intravenous: immediate (seconds to minutes) for volume expansion and electrolyte distribution; dextrose metabolism begins within minutes. |
| Duration of Action | Intravenous: 2-4 hours for volume effect; electrolyte and glucose effects persist as long as infusion continues; rapid redistribution after cessation. |
Intravenous infusion. Adult dose: 1000-2000 mL over 24 hours, adjusted based on fluid and electrolyte needs. Typical rate: 125-150 mL/hour.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 10-50 mL/min: Monitor electrolytes closely; reduce infusion rate if hyperkalemia or fluid overload. GFR <10 mL/min: Contraindicated if severe renal impairment with oliguria or anuria; use with caution and adjust volume based on residual renal function. |
| Liver impairment | Child-Pugh A: No adjustment. Child-Pugh B and C: Monitor for fluid retention and electrolyte imbalances; adjust volume and rate accordingly. |
| Pediatric use | Weight-based: 20-100 mL/kg/day, adjusted for hydration status and maintenance needs. Maximum rate: 4-8 mL/kg/hour depending on age and clinical condition. |
| Geriatric use | Elderly patients: Use lower end of dose range due to decreased renal function and risk of fluid overload; monitor electrolytes and volume status closely. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for ISOLYTE P W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE P W/ DEXTROSE 5% IN PLASTIC CONTAINER).
| Breastfeeding | Dextrose and electrolytes are normal constituents of human milk. No specific data on M/P ratio; however, these components are not expected to accumulate or cause adverse effects in breastfed infants. Use during breastfeeding is considered safe when clinically indicated. |
| Teratogenic Risk | Dextrose 5% and electrolytes (Isolyte P) are generally considered to have low teratogenic risk. Dextrose solutions are essential for maintaining maternal glucose levels; severe electrolyte imbalances may pose risks. No specific teratogenic effects have been reported from the components at therapeutic doses. Trimester-specific risks: First trimester: No known teratogenicity. Second and third trimesters: Use is safe when indicated, but avoid hyperglycemia which may be associated with fetal macrosomia or neonatal hypoglycemia. |
■ FDA Black Box Warning
None
| Serious Effects |
["Hyperglycemia","Hypernatremia","Hypersensitivity to any component","Severe dehydration with electrolyte imbalance not corrected","Patients with increased intracranial pressure (relative)"]
| Precautions | ["Risk of hyperglycemia, especially in patients with diabetes mellitus","Monitor serum electrolytes, glucose, and fluid balance","May cause fluid overload in patients with renal or cardiac impairment","In neonates, rapid administration may cause hyperinsulinemia and rebound hypoglycemia","Use with caution in patients with severe electrolyte disturbances"] |
Loading safety data…
| Fetal Monitoring | Monitor maternal blood glucose, serum electrolytes (sodium, potassium, chloride, bicarbonate), and fluid balance. For fetal monitoring, assess uterine activity and fetal heart rate patterns during infusion if indicated for maternal condition. In prolonged use, monitor for signs of fluid overload or electrolyte disturbances. |
| Fertility Effects | No known effects on fertility. Dextrose and electrolyte solutions are used for fluid and electrolyte maintenance and do not impair reproductive function. |