ISOLYTE S IN DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for ISOLYTE S IN DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE S IN DEXTROSE 5% IN PLASTIC CONTAINER).
Isolyte S in Dextrose 5% is a combination of electrolytes and dextrose. Dextrose provides caloric support and helps correct hypoglycemia. Electrolytes (sodium, potassium, magnesium, chloride, acetate, gluconate) replenish fluid and electrolyte deficits, maintaining osmotic balance and acid-base homeostasis.
| Metabolism | Dextrose is metabolized to carbon dioxide and water via glycolysis and the citric acid cycle, releasing energy. Electrolytes are not metabolized; they are excreted renally or utilized in physiological processes. |
| Excretion | Renal elimination of water and electrolytes; dextrose is metabolized to CO2 and water, with <1% excreted unchanged in urine. Sodium and potassium are primarily excreted renally; acetate is metabolized to bicarbonate and excreted via lungs as CO2. |
| Half-life | Not applicable as a fixed pharmacokinetic parameter; dextrose half-life ~10 minutes (rapidly metabolized); electrolytes distribute and are cleared according to renal function. In patients with normal renal function, elimination half-life of water and electrolytes varies with hydration status and GFR. |
| Protein binding | None for dextrose, sodium, potassium, chloride; acetate minimally bound (<10% to albumin). |
| Volume of Distribution | Dextrose: ~0.2 L/kg (total body water); sodium: ~0.6 L/kg (extracellular fluid); potassium: ~0.6 L/kg (total body water but primarily intracellular). Vd corresponds to total body water for electrolyte components. |
| Bioavailability | 100% bioavailability via intravenous route. |
| Onset of Action | Intravenous: Immediate upon infusion; electrolyte effects begin within minutes; dextrose increases blood glucose within 1-2 minutes. |
| Duration of Action | Duration depends on infusion rate and renal function; electrolyte effects persist as long as infusion continues; dextrose effect lasts 15-30 minutes after cessation due to rapid clearance. |
| Molecular Weight | Dextrose: 180.16 Da; Electrolytes: Sodium 23 Da, Potassium 39.1 Da, etc. (Not applicable as a single compound; mixture.) |
Intravenous infusion; rate and volume determined by clinical condition, fluid and electrolyte requirements. Typical adult dose: 500-1000 mL as a single infusion, administered at a rate not exceeding 50 mL/kg/day.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in patients with anuria or severe renal impairment (eGFR < 30 mL/min/1.73 m²). For mild to moderate impairment (eGFR 30-89 mL/min/1.73 m²), monitor serum potassium and renal function; adjust infusion rate based on fluid and electrolyte status. |
| Liver impairment | No specific Child-Pugh based dose adjustment required. Use with caution in patients with severe hepatic impairment due to risk of fluid overload and electrolyte imbalances; monitor serum sodium and potassium. |
| Pediatric use | Intravenous infusion; dose based on weight and clinical condition. Typical rate: 5-20 mL/kg as a single dose, not to exceed 50 mL/kg/day. Adjust based on serum electrolyte levels and fluid balance. |
| Geriatric use | Use with caution due to increased risk of fluid overload, renal impairment, and electrolyte disturbances. Initiate at lower infusion rates and monitor renal function, serum electrolytes, and volume status closely. |
| 1st trimester | Isolyte S in Dextrose 5% is generally considered safe during the first trimester when used for appropriate indications (e.g., replacement of fluid and electrolyte losses). However, as with all intravenous fluids, use only if clearly needed due to potential risks from dextrose (e.g., hyperglycemia) and electrolytes. No known teratogenic effects associated with balanced electrolyte solutions. |
| 2nd trimester | Safe during the second trimester for indicated uses. Monitor maternal glucose and electrolytes closely. Avoid fluid overload. |
| 3rd trimester | Use with caution in the third trimester due to potential for fluid overload and osmotic shifts. May affect fetal glucose levels. Use only if benefit outweighs risk. |
Clinical note
Comprehensive clinical and safety monograph for ISOLYTE S IN DEXTROSE 5% IN PLASTIC CONTAINER (ISOLYTE S IN DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | The components of Isolyte S (water, electrolytes, dextrose) readily cross the placenta. Dextrose and electrolytes equilibrate across the placenta. Degree of transfer is similar to endogenous substances; no active transport accumulation. Fetal levels mirror maternal levels. |
| Breastfeeding | Isolyte S in Dextrose 5% is compatible with breastfeeding. The components (electrolytes and dextrose) are endogenous substances normally present in breast milk. Intravenous administration may transiently alter maternal serum electrolytes or glucose, but no adverse effects on nursing infants are expected. Monitor maternal fluid balance. |
| Lactation Rating | L1 (Safe) |
| Teratogenic Risk | ISOLYTE S IN DEXTROSE 5% is an electrolyte and carbohydrate solution. No specific teratogenic effects are associated with the components at therapeutic doses. However, during pregnancy, hyperglycemia or electrolyte imbalances may harm the fetus. First trimester: No known structural teratogenicity; second and third trimesters: Potential for fetal hyperglycemia, hyperinsulinemia, and electrolyte disturbances if maternal levels are not controlled. Use only if clearly needed. |
| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, fluid balance, and renal function. Fetal monitoring: assess fetal heart rate and growth if prolonged infusion; avoid fluid overload and hyperglycemia. |
| Fertility Effects | No known adverse effects on fertility at therapeutic doses. Dextrose and electrolytes are physiologic; no impairment expected. |
■ FDA Black Box Warning
None.
| Serious Effects |
Severe fluid overload or hypervolemiaSevere hyperglycemia (especially with dextrose-containing solutions)Severe electrolyte imbalances (e.g., hypernatremia, hyperkalemia, hypercalcemia, hypermagnesemia, hyperphosphatemia)Renal failure with oliguria or anuria (unless specifically indicated for dialysis)Hypersensitivity to any componentUse as a carrier for incompatible medications
| Precautions | Avoid in patients with hyperglycemia, severe renal impairment, or anuria, Monitor serum electrolytes and glucose levels during administration, Use with caution in patients with heart failure, renal disease, or those receiving corticosteroids, Risk of fluid overload and electrolyte imbalances, Do not administer unless solution is clear and container is intact |
| Food/Dietary | No direct food interactions; however, dextrose content may affect blood glucose. Patients on a glucose-restricted diet should be monitored. No specific dietary restrictions required during administration. |
| Clinical Pearls | ISOLYTE S in 5% Dextrose is a balanced electrolyte solution with 5% dextrose for maintenance fluid therapy. Monitor serum glucose closely, especially in diabetic patients. The solution provides potassium, magnesium, and phosphate; avoid in severe hyperkalemia, hypermagnesemia, or hyperphosphatemia. Contains acetate as a bicarbonate precursor; use with caution in patients with metabolic alkalosis. Do not administer with blood products due to risk of hemolysis. Incompatible with many drugs; confirm compatibility prior to Y-site administration. |
| Patient Advice | This fluid contains sugar (dextrose) and electrolytes to maintain your body's balance. · Tell your healthcare provider if you have diabetes, as this may affect your blood sugar. · Report any signs of allergic reaction: rash, itching, swelling, or difficulty breathing. · Notify your nurse if you experience pain, redness, or swelling at the IV site. · This solution is provided in a plastic container; do not remove from the overwrap until ready to use. |
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