NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER (NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER).
Normosol-R and Dextrose 5% is a balanced electrolyte solution with dextrose. The dextrose provides caloric support and prevents ketosis. The electrolytes (sodium, potassium, magnesium, chloride, acetate, gluconate) maintain osmotic balance and acid-base homeostasis. Acetate and gluconate serve as bicarbonate precursors to correct acidosis.
| Metabolism | Dextrose is metabolized via glycolysis and the Krebs cycle to carbon dioxide and water, yielding energy. Electrolytes (sodium, potassium, magnesium, chloride, acetate, gluconate) are not metabolized but are excreted or incorporated into body pools. |
| Excretion | Renal elimination of water and electrolytes; dextrose is metabolized to CO2 and water, with <5% excreted unchanged. Biliary/fecal excretion negligible. |
| Half-life | Dextrose: <15 minutes (rapid cellular uptake and metabolism). Electrolytes distribute and are excreted with kinetics dependent on renal function; no plasma half-life defined. |
| Protein binding | None to minimal (<1%) for electrolytes and dextrose. |
| Volume of Distribution | Electrolytes distribute in total body water (~0.6 L/kg); dextrose distributes in extracellular fluid (~0.2 L/kg). Clinical meaning: glucose distributes primarily in ECF, electrolytes throughout TBW. |
| Bioavailability | Intravenous: 100%. |
| Onset of Action | Intravenous: Immediate for volume expansion; glucose effect within minutes. |
| Duration of Action | Intravenous: 1–2 hours for volume effect; glucose effect persists during infusion; clinical duration depends on rate and patient status. |
| Molecular Weight | Dextrose: 180.16 Da; Sodium: 22.99 Da; Potassium: 39.10 Da; Magnesium: 24.31 Da; Chloride: 35.45 Da; Acetate: 59.04 Da; Gluconate: 195.15 Da. The solution contains multiple components; dextrose is the largest molecule. |
Intravenous infusion; dose depends on fluid and electrolyte needs. Typical adult dose: 500-1000 mL over 1-4 hours, may repeat based on clinical status.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (oliguria, anuria) due to risk of fluid overload and electrolyte abnormalities. Use with caution in mild-moderate impairment; monitor fluid balance and serum electrolytes. |
| Liver impairment | Caution in severe hepatic impairment due to risk of fluid retention and electrolyte imbalances. No specific dose adjustment guidelines; monitor closely. |
| Pediatric use | Weight-based: 10-20 mL/kg as an initial bolus; maintenance based on calculated daily fluid requirements. Adjust for ongoing losses. Monitor electrolytes and glucose. |
| Geriatric use | Use caution due to increased risk of fluid overload, renal impairment, and electrolyte disturbances. Initiate at lower doses and monitor vital signs, urine output, and serum electrolytes frequently. |
| 1st trimester | Generally considered safe at physiologic doses; use only if clearly needed. Contains dextrose and electrolytes; avoid excessive fluid administration in pregnancy complications. |
| 2nd trimester | Generally considered safe at physiologic doses; use only if clearly needed. Monitor for fluid overload and electrolyte imbalances. |
| 3rd trimester | Generally considered safe at physiologic doses; use only if clearly needed. May affect fetal glucose and electrolyte balance if given in excess. |
Clinical note
Comprehensive clinical and safety monograph for NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER (NORMOSOL-R AND DEXTROSE 5% IN PLASTIC CONTAINER).
| Placental transfer | Dextrose and electrolytes freely cross the placenta. Maternal glucose elevation may cause fetal hyperglycemia and insulin release. Electrolytes are actively regulated by the placenta; levels in fetal serum are maintained within physiologic range unless maternal levels are significantly abnormal. |
| Breastfeeding | Dextrose and electrolytes (sodium, potassium, magnesium, chloride, acetate, gluconate) in Normosol-R are normal constituents of breast milk and are not expected to cause adverse effects in the nursing infant. Use with caution if maternal fluid or electrolyte imbalance exists. No special precautions needed at standard infusion rates. |
| Lactation Rating | L1 (Compatible) |
| Teratogenic Risk | Normosol-R and Dextrose 5% is a balanced electrolyte solution with dextrose. No known teratogenic effects in first trimester; safe when used appropriately. In second and third trimesters, avoid excess fluid to prevent maternal hyperglycemia and neonatal hypoglycemia. Dextrose can cause fetal hyperinsulinemia and rebound hypoglycemia if maternal glucose poorly controlled. |
| Fetal Monitoring | Monitor maternal serum electrolytes, glucose, fluid balance, and urine output. Fetal monitoring for heart rate and growth if prolonged use or maternal hyperglycemia. |
| Fertility Effects | No known adverse effects on fertility. As a replacement solution, it does not alter reproductive function. |
■ FDA Black Box Warning
None.
| Serious Effects |
Hypersensitivity to any componentClinically significant hyperglycemia (e.g., diabetic ketoacidosis without insulin)Severe fluid overload (e.g., pulmonary edema, oliguric renal failure)Hyperkalemia (Normosol-R contains potassium)Hypermagnesemia
| Precautions | Monitor serum electrolytes, glucose, and fluid balance; risk of hyperglycemia, hyperosmolarity, and fluid overload in renal or cardiac impairment; caution in patients with hyponatremia or hypokalemia; acetate and gluconate can worsen metabolic alkalosis. |
| Food/Dietary | No direct food interactions. However, dextrose content may affect blood glucose; patients should maintain usual dietary guidelines for diabetes management. No specific dietary restrictions during administration. |
| Clinical Pearls | Normosol-R and Dextrose 5% is a balanced isotonic solution for fluid resuscitation, containing electrolytes (Na, K, Mg, Cl, acetate, gluconate) and dextrose. Avoid in patients with known allergy to corn or corn products due to dextrose source. Monitor serum glucose closely in diabetic patients; dextrose may cause hyperglycemia. Do not administer simultaneously with blood products via same IV line due to risk of hemolysis and agglutination. Use with caution in renal impairment, heart failure, or hyperkalemia. Check for particulate matter and container integrity before use. |
| Patient Advice | This intravenous solution provides fluids, sugar, and electrolytes to maintain hydration and balance. · Report any symptoms of allergic reaction such as rash, itching, swelling, or difficulty breathing. · Inform your healthcare provider if you have diabetes, kidney disease, heart problems, or high potassium levels. · Tell your provider about any medications you are taking, especially diuretics, ACE inhibitors, or potassium supplements. · Do not stop the infusion suddenly; the rate will be controlled by your healthcare team. |
Loading safety data…