Dextrose 10% Inj, 250ml
It is used to treat low blood sugar. Some products are used to add fluid to the body after fluid loss, to mix with certain drugs that are given as an injection, or to add calories to a TPN.
Drug Class
Fluid and electrolyte replacement, carbohydrate source
Pharmacologic Class
Carbohydrate, nutrient
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Dextrose 10% Injection is a sugar solution given through a vein (intravenously) to provide your body with energy (calories) and to help raise your blood sugar levels if they are too low. It also helps to provide necessary fluids.
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and carefully read all accompanying information. Adhere to the guidelines provided to ensure safe and effective use. This medication is administered intravenously over a specified period.
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the appropriate storage method.
In the event that you miss a dose, contact your doctor promptly to receive guidance on the next steps to take.
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the appropriate storage method.
In the event that you miss a dose, contact your doctor promptly to receive guidance on the next steps to take.
Lifestyle & Tips
- This medication is given in a hospital or clinic setting, so no specific lifestyle changes are required by the patient.
- Patients should report any discomfort at the injection site or any new symptoms during the infusion.
Available Forms & Alternatives
Available Strengths:
- Dextrose 5% Inj, 1000ml
- Dextrose 5% Inj, 250ml
- Dextrose 5% Inj, 100ml
- Dextrose 5% Inj, 50ml
- Dextrose 5%/nacl 0.2% Inj, 1000ml
- Dextrose 5%/nacl 0.45% Inj, 1000ml
- D5w/nacl 0.9% Inj, 1000ml
- Dextrose 50% Injection Ftv 25x50ml
- Dextrose 5% Inj, 500ml
- Dextrose 70% Inj, 2000ml
- Dextrose 5%/nacl 0.45% Inj, 500ml
- Dextrose 50% Inj, 50ml
- Dextrose 10% Inj, 500ml
- Dextrose 10% Inj, 250ml
- Dextrose 5% Inj, 25ml
- Dextrose 5% Pgbk Inj, 100ml
- Dextrose 5%/nacl 0.3% Inj, 1000ml
- Dextrose 5% Inj, 150ml
- Dextrose 5%/nacl 0.45% Inj, 250ml
- Dextrose 5%/nacl 0.3% Inj, 500ml
- Dextrose 30% Inj, 500ml
- Dextrose 20% Inj, 500ml
- Dextrose 70% Inj, 500ml
- Dextrose 10% Inj, 1000ml
- Dextrose 5%/nacl 0.3% Inj, 250ml
Dosing & Administration
Adult Dosing
Standard Dose:
Highly variable, dependent on clinical need. For fluid and calorie replacement, typically 100-250 mL/hour. For hypoglycemia, often a bolus followed by infusion.
Condition-Specific Dosing:
hypoglycemia:
Variable, often 25-50 mL of D50W (equivalent to 5-10g dextrose) IV push, followed by D10 infusion if needed.
maintenance_fluid:
Rate adjusted to patient's fluid and caloric needs, typically 100-250 mL/hour (10-25 g dextrose/hour).
Pediatric Dosing
Neonatal:
Dosing highly individualized based on weight, gestational age, and glucose needs. Typical glucose infusion rate (GIR) 4-6 mg/kg/min, adjusted to maintain euglycemia.
Infant:
Dosing highly individualized based on weight and glucose needs. Typical GIR 4-8 mg/kg/min.
Child:
Dosing highly individualized based on weight and glucose needs. Typical GIR 3-5 mg/kg/min.
Adolescent:
Similar to adult dosing, individualized based on weight and glucose needs.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment, but monitor fluid and electrolyte balance closely.
Moderate:
No specific dose adjustment, but monitor fluid and electrolyte balance closely due to increased risk of fluid overload and electrolyte disturbances.
Severe:
No specific dose adjustment, but monitor fluid and electrolyte balance closely; consider lower infusion rates to prevent fluid overload.
Dialysis:
Administer with caution; monitor blood glucose and fluid balance closely. Dextrose may be removed during dialysis, requiring adjustment.
Hepatic Impairment:
Mild:
No specific adjustment.
Moderate:
No specific adjustment.
Severe:
No specific adjustment, but monitor blood glucose closely as hepatic glucose metabolism may be impaired.
Pharmacology
Mechanism of Action
Dextrose is a monosaccharide (glucose) that serves as a primary source of energy for cellular metabolism. When administered intravenously, it rapidly increases blood glucose levels, provides calories, and can help to restore fluid balance. It is metabolized via glycolysis and the Krebs cycle to carbon dioxide and water, releasing energy.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous administration)
Tmax:
Immediate
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately total body water (0.6 L/kg)
ProteinBinding:
Negligible
CnssPenetration:
Limited under normal conditions; increased with compromised blood-brain barrier
Elimination:
HalfLife:
Rapidly metabolized; no specific plasma half-life as it's continuously consumed
Clearance:
Rapid, dependent on metabolic rate
ExcretionRoute:
Carbon dioxide (exhaled), water (renal)
Unchanged:
Negligible
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Immediate
DurationOfAction:
Dependent on infusion rate and patient's metabolic needs; rapidly utilized
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
Signs of fluid and electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or fainting
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or changes in urine production
+ Dry mouth
+ Dry eyes
+ Severe stomach upset or vomiting
Blue or gray discoloration of the skin, lips, nail beds, fingers, or toes
Fever or chills
Shortness of breath, sudden weight gain, or swelling in the arms or legs
* Pain and irritation at the injection site
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any side effects that bother you or persist, contact your doctor for guidance.
Reporting Side Effects
If you have questions or concerns about side effects, don't hesitate to reach out to your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin with or without fever
+ Wheezing
+ Tightness in the chest or throat
+ Trouble breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Severe dizziness or fainting
Signs of fluid and electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or fainting
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or changes in urine production
+ Dry mouth
+ Dry eyes
+ Severe stomach upset or vomiting
Blue or gray discoloration of the skin, lips, nail beds, fingers, or toes
Fever or chills
Shortness of breath, sudden weight gain, or swelling in the arms or legs
* Pain and irritation at the injection site
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any side effects that bother you or persist, contact your doctor for guidance.
Reporting Side Effects
If you have questions or concerns about side effects, don't hesitate to reach out to your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Excessive thirst or urination (signs of high blood sugar)
- Swelling in the hands, ankles, or feet (signs of fluid overload)
- Difficulty breathing or shortness of breath (signs of fluid overload in lungs)
- Headache, confusion, or dizziness (can be signs of electrolyte imbalance or fluid shifts)
- Pain, redness, or swelling at the IV site
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
Certain health conditions, including:
+ Bleeding in the brain or spine
+ Severe dehydration
+ Severe liver problems
+ Difficulty passing urine
This list is not exhaustive, and it is crucial to discuss all your health problems with your doctor.
Additionally, provide your doctor and pharmacist with a comprehensive list of all the medications you are taking, including:
Prescription medications
Over-the-counter (OTC) medications
Natural products
Vitamins
It is vital to verify that it is safe to take this medication with all your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
Certain health conditions, including:
+ Bleeding in the brain or spine
+ Severe dehydration
+ Severe liver problems
+ Difficulty passing urine
This list is not exhaustive, and it is crucial to discuss all your health problems with your doctor.
Additionally, provide your doctor and pharmacist with a comprehensive list of all the medications you are taking, including:
Prescription medications
Over-the-counter (OTC) medications
Natural products
Vitamins
It is vital to verify that it is safe to take this medication with all your other medications and health conditions. Never start, stop, or change the dose of any medication without first consulting your doctor.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Discuss any concerns or questions you have with your doctor.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. It is crucial to discuss this potential risk with your doctor.
In some cases, this medication may be added to parenteral nutrition (PN). However, PN has been associated with serious complications, including blood clots in the lungs, infections, high blood sugar, and liver problems. In rare instances, these complications can be fatal. If you have any questions or concerns about these risks, be sure to discuss them with your doctor.
When used in newborns, this medication requires careful consideration and monitoring. Your doctor will need to assess the potential benefits and risks of using this medication in this population.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is essential to inform your doctor. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision about its use.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. It is crucial to discuss this potential risk with your doctor.
In some cases, this medication may be added to parenteral nutrition (PN). However, PN has been associated with serious complications, including blood clots in the lungs, infections, high blood sugar, and liver problems. In rare instances, these complications can be fatal. If you have any questions or concerns about these risks, be sure to discuss them with your doctor.
When used in newborns, this medication requires careful consideration and monitoring. Your doctor will need to assess the potential benefits and risks of using this medication in this population.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is essential to inform your doctor. You and your doctor will need to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision about its use.
Overdose Information
Overdose Symptoms:
- Severe hyperglycemia (very high blood sugar)
- Osmotic diuresis (excessive urination leading to dehydration)
- Fluid overload (edema, pulmonary congestion, heart failure)
- Electrolyte disturbances (e.g., hyponatremia, hypokalemia)
- Hyperosmolar hyperglycemic state (HHS) in susceptible individuals
What to Do:
Discontinue infusion, administer insulin as needed to lower blood glucose, correct fluid and electrolyte imbalances, and provide supportive care. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Moderate Interactions
- Insulin (pharmacodynamic antagonism)
- Corticosteroids (may increase blood glucose)
Monitoring
Baseline Monitoring
Blood Glucose
Rationale: To establish baseline glycemic status and guide initial dosing.
Timing: Prior to initiation of therapy.
Serum Electrolytes (Na, K, Cl, Mg, Phos)
Rationale: To assess baseline electrolyte balance and identify pre-existing imbalances.
Timing: Prior to initiation of therapy.
Renal Function (BUN, Creatinine)
Rationale: To assess kidney function, which influences fluid and electrolyte handling.
Timing: Prior to initiation of therapy.
Fluid Status (Weight, I&O)
Rationale: To assess baseline hydration status and risk of fluid overload.
Timing: Prior to initiation of therapy.
Routine Monitoring
Blood Glucose
Frequency: Every 1-4 hours initially, then as clinically indicated (e.g., every 4-6 hours) once stable.
Target: 70-180 mg/dL (individualized based on patient condition)
Action Threshold: <70 mg/dL (hypoglycemia) or >180-200 mg/dL (hyperglycemia) requiring intervention.
Serum Electrolytes (Na, K, Cl)
Frequency: Daily or every 12-24 hours, more frequently if abnormalities are detected or large volumes are infused.
Target: Within normal physiological range
Action Threshold: Significant deviations (e.g., hyponatremia, hypokalemia) requiring intervention.
Fluid Balance (Intake and Output, Daily Weight)
Frequency: Every 8-24 hours, or more frequently if fluid status is critical.
Target: Balanced I&O, stable weight (unless fluid shifts are desired)
Action Threshold: Significant positive fluid balance, rapid weight gain, or signs of fluid overload.
Vital Signs (BP, HR, RR)
Frequency: Every 4-8 hours, or as clinically indicated.
Target: Within normal limits for patient
Action Threshold: Changes indicative of fluid overload (e.g., elevated BP, tachypnea) or dehydration.
Symptom Monitoring
- Signs of hyperglycemia (polyuria, polydipsia, blurred vision, fatigue, nausea)
- Signs of fluid overload (peripheral edema, pulmonary edema, dyspnea, crackles, jugular venous distension, rapid weight gain)
- Signs of electrolyte imbalance (muscle weakness, cramps, cardiac arrhythmias, altered mental status)
- Local signs at infusion site (pain, redness, swelling, phlebitis)
Special Patient Groups
Pregnancy
Dextrose is generally considered safe for use during pregnancy when clinically indicated. However, careful monitoring of maternal blood glucose levels is essential to avoid hyperglycemia, which can lead to fetal complications (e.g., fetal macrosomia, neonatal hypoglycemia).
Trimester-Specific Risks:
First Trimester:
No known specific risks, but maintain euglycemia.
Second Trimester:
Monitor blood glucose closely; hyperglycemia can affect fetal growth.
Third Trimester:
Monitor blood glucose closely; hyperglycemia can lead to fetal macrosomia and neonatal hypoglycemia.
Lactation
Dextrose is compatible with breastfeeding. It is a natural component of breast milk and is not expected to cause adverse effects in the infant.
Infant Risk:
Low risk (L1)
Pediatric Use
Use with extreme caution in neonates and infants due to their immature glucose regulatory systems and higher risk of hyperglycemia or hypoglycemia. Close monitoring of blood glucose, fluid balance, and electrolytes is critical. Infusion rates should be carefully calculated based on weight and metabolic needs to avoid fluid overload and electrolyte disturbances.
Geriatric Use
Administer with caution in elderly patients due to increased risk of fluid overload, electrolyte imbalances (especially hyponatremia), and pre-existing cardiovascular or renal conditions. Close monitoring of fluid status, electrolytes, and blood glucose is recommended. Lower infusion rates may be appropriate.
Clinical Information
Clinical Pearls
- Dextrose 10% is hypertonic (374 mOsm/L) and should be administered via a central venous catheter if possible, especially for prolonged infusions, to minimize the risk of phlebitis and vein irritation. Peripheral administration is acceptable for short-term use or if a central line is not feasible, but monitor the site closely.
- Rapid infusion of Dextrose 10% can lead to hyperglycemia, osmotic diuresis, and fluid shifts. Administer slowly and adjust rate based on patient's glucose levels and fluid needs.
- Always monitor blood glucose levels frequently, especially in diabetic patients, critically ill patients, or those receiving corticosteroids.
- Monitor serum electrolytes (especially sodium and potassium) and fluid balance (intake/output, daily weights) to prevent hyponatremia, hypokalemia, or fluid overload.
- Dextrose solutions should not be used as the sole source of fluid and electrolytes for prolonged periods without appropriate electrolyte supplementation.
- In patients with severe dehydration, Dextrose 10% should be used cautiously as it is hypotonic once dextrose is metabolized, which can worsen hyponatremia if present.
Alternative Therapies
- 0.9% Sodium Chloride (Normal Saline) for fluid replacement without caloric support.
- Lactated Ringer's solution for fluid and electrolyte replacement.
- Oral glucose (for conscious patients with mild hypoglycemia).
- Glucagon (for severe hypoglycemia when IV access is not available).
Cost & Coverage
Average Cost:
Low cost per 250ml bag
Generic Available:
Yes
Insurance Coverage:
Generally covered by most insurance plans as it is a generic, essential IV fluid. Typically Tier 1 or preferred generic.
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed to someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly. Unless instructed otherwise, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately contact your local poison control center or seek medical attention. Be prepared to provide information about the medication taken, the amount, and the time of ingestion to ensure prompt and effective treatment.