ISOLYTE R W/ DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for ISOLYTE R W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE R W/ DEXTROSE 5% IN PLASTIC CONTAINER).
Isolyte R with Dextrose 5% is an intravenous solution providing electrolytes (sodium, potassium, magnesium, calcium, chloride, acetate, gluconate) and dextrose. Dextrose provides calories and may prevent ketosis; electrolytes maintain or restore acid-base balance and provide essential ions for cellular function.
| Metabolism | Dextrose is metabolized via glycolysis and subsequent pathways; electrolytes are excreted or reabsorbed as needed; acetate and gluconate are metabolized to bicarbonate in the liver. |
| Excretion | Renal: ~100% as water, electrolytes, and glucose; no biliary or fecal elimination of active drug components. |
| Half-life | Not applicable as a composite solution; glucose half-life ~1.5-2 h in normal individuals, extended in renal impairment; electrolytes follow body homeostasis. |
| Protein binding | None for water and electrolytes; glucose is not protein bound. |
| Volume of Distribution | 0.2 L/kg for water; electrolytes distribute according to body compartments (ECF ~0.2 L/kg, ICF ~0.4 L/kg); glucose initial Vd ~0.2 L/kg. |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: immediate upon infusion for fluid and electrolyte expansion; glucose metabolism begins within minutes. |
| Duration of Action | Intravenous: 1-2 hours for fluid compartment effects; glucose effects persist until metabolized or stored; electrolytes redistribute over several hours. |
| Molecular Weight | Isolyte R is a mixture; main components: sodium chloride (58.44 Da), potassium chloride (74.55 Da), magnesium (24.31 Da), dextrose (180.16 Da). As a solution, average molecular weight is not defined, but dextrose 5% contains dextrose with MW 180.16 Da. |
Intravenous infusion at a rate of 125-200 mL/hour (3 mL/kg/hour) for fluid and electrolyte maintenance, adjusted based on clinical status, serum electrolytes, and glucose monitoring.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment for GFR; use with caution in renal impairment due to risk of fluid overload and electrolyte disturbances. Monitor serum potassium, phosphate, and magnesium levels closely. In severe renal impairment (GFR <30 mL/min), consider alternative fluids with lower potassium and phosphate content. |
| Liver impairment | No specific Child-Pugh based adjustment. Use with caution in severe hepatic impairment due to altered metabolism of dextrose and lactate; monitor glucose and lactate levels. Avoid in patients with lactic acidosis or severe hepatic dysfunction. |
| Pediatric use | Intravenous infusion based on body weight: 5-10 mL/kg per dose for maintenance, repeated as needed; typical rate: 100-150 mL/kg/day for fluid maintenance, adjusted for clinical status. Monitor glucose and electrolytes frequently. |
| Geriatric use | Use with caution due to age-related decline in renal function and higher risk of fluid overload. Start at lower infusion rates (100-125 mL/hour) and titrate based on clinical response and monitoring of electrolytes, renal function, and volume status. |
| 1st trimester | Isolyte R with dextrose 5% is generally considered safe during the first trimester when used as clinically indicated for fluid and electrolyte replacement. However, use caution in patients with gestational diabetes due to dextrose content. |
| 2nd trimester | Safe for use in the second trimester for fluid and electrolyte maintenance. Monitor serum electrolytes and glucose levels. |
| 3rd trimester | Safe for use in the third trimester. Dextrose may cause maternal hyperglycemia and fetal hyperinsulinemia; use with caution in diabetic or glucose-intolerant patients. |
Clinical note
Comprehensive clinical and safety monograph for ISOLYTE R W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE R W/ DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Electrolytes (sodium, potassium, chloride, magnesium, acetate) cross the placenta freely, but at physiologic levels are not harmful. Dextrose also crosses the placenta. The solution is considered safe when used as needed. |
| Breastfeeding | Excretion of Isolyte R components (electrolytes) into breast milk is negligible. Dextrose is a normal constituent. However, consider the mother's underlying condition and the potential need for fluid/electrolyte therapy. No expected adverse effects in nursing infant. |
| Lactation Rating | L1 (Safe) - Compatible with breastfeeding. |
| Teratogenic Risk | No known teratogenic risk. Dextrose and electrolytes are physiologic components; no fetal harm reported with standard use. High dextrose concentrations may cause fetal hyperglycemia, particularly in gestational diabetes. |
| Fetal Monitoring | Monitor maternal blood glucose, electrolytes, fluid balance, and urine output. Fetal monitoring indicated for maternal hyperglycemia or excessive fluid administration. |
| Fertility Effects | No known adverse effects on fertility. Provides hydration and metabolic support without direct reproductive toxicity. |
■ FDA Black Box Warning
None.
| Serious Effects |
Hyperglycemia or glucose intolerance if dextrose is contraindicatedSevere electrolyte disturbances requiring restriction of any componentAnuria or severe renal impairment (if volume overload risk)Allergy to any component
| Precautions | Monitor serum electrolytes, fluid balance, and acid-base status closely, Use with caution in patients with heart failure, renal impairment, or conditions predisposing to fluid overload, Avoid rapid infusion or large volumes in patients with reduced renal function, Use with caution in patients with diabetes mellitus due to dextrose content |
| Food/Dietary | No specific food interactions with IV administration. However, oral intake should be coordinated with IV therapy to avoid fluid or electrolyte imbalance. In patients with diabetes, adjust oral carbohydrate intake to account for dextrose calories. |
| Clinical Pearls | Isolyte R w/ Dextrose 5% is an isotonic, balanced electrolyte solution with 5% dextrose, providing 170 kcal/L. It is contraindicated in patients with lactate metabolism disorders (e.g., severe hepatic failure) due to lactate content. Monitor serum glucose closely in diabetic patients; dextrose may cause hyperglycemia. Do not administer simultaneously with blood through same IV line due to risk of hemolysis. Check for particulate matter and container leaks before use. |
| Patient Advice | This intravenous solution provides fluids, sugars, and electrolytes to maintain hydration and nutritional balance. · Tell your healthcare provider if you have diabetes, kidney disease, liver disease, or a history of heart failure. · Report any signs of allergic reaction such as rash, itching, or difficulty breathing. · Inform your provider if you feel swelling in your arms or legs, shortness of breath, or rapid weight gain (signs of fluid overload). · Blood sugar and electrolyte levels will be monitored regularly during treatment. |
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