XYLOSE
Clinical safety rating: caution
Comprehensive clinical and safety monograph for XYLOSE (XYLOSE).
Xylose is a pentose sugar that is absorbed in the small intestine via passive diffusion and active transport. It is used to assess intestinal mucosal integrity; its absorption reflects the function of the enterocytes. After absorption, it is not metabolized and is excreted unchanged in urine, making it a marker for intestinal absorption and renal function.
| Metabolism | Xylose is not significantly metabolized in humans; it is excreted unchanged primarily by the kidneys via glomerular filtration. |
| Excretion | Renal: approximately 85-90% eliminated unchanged in urine; biliary/fecal: negligible (<5%). |
| Half-life | Terminal elimination half-life: 1.2-2.5 hours in adults with normal renal function; prolonged in renal impairment (up to 10 hours). |
| Protein binding | <5% bound to plasma proteins (primarily albumin). |
| Volume of Distribution | 0.2-0.3 L/kg; indicates distribution primarily in extracellular fluid. |
| Bioavailability | Oral: 30-50% (due to first-pass metabolism and incomplete absorption); intravenous: 100%. |
| Onset of Action | Oral: onset of action within 30 minutes; peak effect at 1-2 hours. Intravenous: immediate onset. |
| Duration of Action | Duration: 2-4 hours for diagnostic effects (D-xylose absorption test); prolonged in malabsorption states. |
Adults: 25 g orally in 500 mL water, administered as a single dose for D-xylose absorption test.
| Dosage form | POWDER |
| Renal impairment | No specific dose adjustment guidelines; caution in severe renal impairment due to potential accumulation if used systemically (not typical). |
| Liver impairment | No specific adjustments for Child-Pugh class. |
| Pediatric use | Pediatric: 0.5 g/kg body weight (max 25 g) orally in 200-500 mL water, given as a single dose. |
| Geriatric use | No specific adjustment required; use same dosing as adults, monitor for adequate hydration. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for XYLOSE (XYLOSE).
| Breastfeeding | Xylose is present in breast milk; the M/P ratio is not established. Due to limited data, caution is advised. It is generally considered compatible with breastfeeding when used in diagnostic tests as a single dose, as systemic absorption is minimal. |
| Teratogenic Risk | Xylose is a naturally occurring sugar and is generally considered to have low teratogenic potential. There are no well-controlled studies in pregnant women; animal studies have not reported fetal harm. First trimester: unlikely to cause major malformations. Second and third trimesters: no known adverse fetal effects. Use with caution only if clearly needed. |
■ FDA Black Box Warning
No FDA black box warnings.
| Serious Effects |
Hypersensitivity to xylose, severe renal failure (creatinine clearance <30 mL/min), anuria, severe dehydration.
| Precautions | Use with caution in patients with renal impairment (may affect excretion and test interpretation), dehydration, or ascites. False-positive results may occur in patients with decreased renal function. Ensure adequate hydration during the test. |
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| Fetal Monitoring | Monitor maternal renal function and glucose levels if xylose is used in renal function tests. No specific fetal monitoring required; standard prenatal care is adequate. |
| Fertility Effects | No known effects on fertility in animal studies. Insufficient human data to determine impact on fertility. |