ISOLYTE R W/ DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive 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. |
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 | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for ISOLYTE R W/ DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE R W/ DEXTROSE 5% IN PLASTIC CONTAINER).
| Breastfeeding | Compatible with breastfeeding. Dextrose and electrolytes are normal milk constituents; no adverse effects expected. M/P ratio not applicable. |
| 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 |
■ FDA Black Box Warning
None.
| Serious Effects |
["Hypernatremia","Hypersensitivity to any component","Severe metabolic alkalosis","Anuria or oliguria (unless due to hypovolemia)"]
| 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"] |
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| 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. |