Dextrose 5% Inj, 1000ml
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 nutrient replacement, carbohydrate
Pharmacologic Class
Monosaccharide, caloric agent, intravenous solution
Pregnancy Category
Category C (Generally considered safe for appropriate indications, but caution with fluid/glucose balance)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Dextrose 5% Injection is a sterile solution of sugar (dextrose) in water given through a vein (intravenously). It's used to provide your body with fluids and a source of energy (calories) when you can't eat or drink enough, or when you need extra hydration.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided to you. It is essential to follow the instructions carefully. This medication is administered intravenously over a specified period.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
Missing a Dose
If you miss a dose, contact your doctor to receive guidance on the next steps to take.
To use this medication correctly, follow your doctor's instructions and read all the information provided to you. It is essential to follow the instructions carefully. This medication is administered intravenously over a specified period.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
Missing a Dose
If you miss a dose, contact your doctor to receive guidance on the next steps to take.
Lifestyle & Tips
- This medication is given by a healthcare professional in a hospital or clinic setting.
- Report any discomfort at the injection site (pain, swelling, redness) immediately.
- Inform your healthcare provider if you experience any unusual symptoms during or after the infusion, such as shortness of breath, swelling, excessive thirst, or confusion.
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:
Individualized based on fluid, electrolyte, and caloric needs. Typical infusion rates for Dextrose 5% range from 1.25 to 2.5 mg/kg/min (e.g., 1000 mL of D5W over 8-12 hours).
Condition-Specific Dosing:
hydration:
As needed to maintain hydration and provide minimal calories.
hypoglycemia:
Rapid infusion may be used for acute hypoglycemia, followed by slower maintenance.
drug_diluent:
As per drug-specific dilution instructions.
Pediatric Dosing
Neonatal:
Individualized based on weight, age, and clinical condition. Slower rates (e.g., 4-6 mg/kg/min) are generally used to avoid hyperglycemia and fluid overload. Close monitoring of blood glucose and fluid balance is essential.
Infant:
Individualized based on weight, age, and clinical condition. Slower rates (e.g., 4-6 mg/kg/min) are generally used to avoid hyperglycemia and fluid overload. Close monitoring of blood glucose and fluid balance is essential.
Child:
Individualized based on weight, age, and clinical condition. Slower rates (e.g., 4-6 mg/kg/min) are generally used to avoid hyperglycemia and fluid overload. Close monitoring of blood glucose and fluid balance is essential.
Adolescent:
Individualized based on weight, age, and clinical condition. Similar to adult dosing, but with careful attention to fluid and glucose balance.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment for dextrose itself, but monitor fluid and electrolyte balance closely to prevent fluid overload.
Moderate:
Monitor fluid and electrolyte balance closely; adjust infusion rate to prevent fluid overload and hypernatremia/hyponatremia. May require lower infusion rates.
Severe:
Use with extreme caution. Contraindicated in anuric patients unless for specific indications (e.g., hyperkalemia treatment). Close monitoring of fluid balance, electrolytes, and glucose is critical. May require dialysis.
Dialysis:
May be used to provide calories and fluid, but fluid volume and electrolyte content must be carefully considered in conjunction with dialysis fluid removal.
Hepatic Impairment:
Mild:
No specific dose adjustment for dextrose itself, but monitor fluid and electrolyte balance.
Moderate:
No specific dose adjustment for dextrose itself, but monitor fluid and electrolyte balance, especially in patients with ascites or edema.
Severe:
No specific dose adjustment for dextrose itself, but monitor fluid and electrolyte balance closely, as fluid retention and electrolyte disturbances are common in severe liver disease.
Pharmacology
Mechanism of Action
Dextrose is a monosaccharide that provides a source of calories and fluid. It is readily metabolized by the body to produce energy, carbon dioxide, and water. It helps to prevent ketosis, reduce protein catabolism, and correct dehydration. Dextrose 5% is isotonic or slightly hypotonic in the body after metabolism, providing free water.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous administration)
Tmax:
Not applicable (continuously infused and metabolized)
FoodEffect:
Not applicable (intravenous administration)
Distribution:
Vd:
Distributes rapidly into total body water (approximately 0.6 L/kg)
ProteinBinding:
Negligible
CnssPenetration:
Yes (crosses blood-brain barrier)
Elimination:
HalfLife:
Not applicable (continuously metabolized)
Clearance:
Highly variable, dependent on metabolic rate and caloric needs
ExcretionRoute:
Carbon dioxide (lungs), water (kidneys)
Unchanged:
Negligible (rapidly metabolized)
Pharmacodynamics
OnsetOfAction:
Rapid (minutes)
PeakEffect:
Dependent on infusion rate and metabolic demand
DurationOfAction:
Dependent on infusion rate and metabolic demand (continuous effect during infusion)
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, significant 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. However, many people may not experience any side effects or only minor ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult 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, significant 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. However, many people may not experience any side effects or only minor ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult 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:
- Swelling in your hands, ankles, or feet (signs of fluid overload)
- Shortness of breath or difficulty breathing
- Increased thirst or frequent urination (signs of high blood sugar)
- Dizziness, confusion, or unusual weakness
- 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 urinating
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 urinating
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 higher if you have kidney problems or if you are a premature infant. Your doctor will need to monitor you closely to minimize this risk.
In some cases, this medication may be mixed with 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 cases, these complications can be fatal. If you have any questions or concerns about PN, discuss them with your doctor.
When used in newborns, this medication requires careful monitoring. Your doctor will need to weigh the potential benefits and risks of using this medication in this population.
If you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor. You and your doctor will need to discuss the potential benefits and risks of using this medication during this time to ensure the best possible outcome for you and your baby.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is higher if you have kidney problems or if you are a premature infant. Your doctor will need to monitor you closely to minimize this risk.
In some cases, this medication may be mixed with 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 cases, these complications can be fatal. If you have any questions or concerns about PN, discuss them with your doctor.
When used in newborns, this medication requires careful monitoring. Your doctor will need to weigh the potential benefits and risks of using this medication in this population.
If you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor. You and your doctor will need to discuss the potential benefits and risks of using this medication during this time to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Hyperglycemia (high blood sugar): increased thirst, increased urination, fatigue, blurred vision, nausea, vomiting.
- Fluid overload/hypervolemia: edema (swelling), pulmonary congestion (shortness of breath, crackles in lungs), elevated blood pressure, headache.
- Electrolyte disturbances: hyponatremia (low sodium) due to dilution, hypokalemia (low potassium) due to intracellular shift with insulin release.
What to Do:
Discontinue infusion, administer insulin if hyperglycemia is severe, administer diuretics for fluid overload, correct electrolyte imbalances. Call 1-800-222-1222 (Poison Control) for specific guidance if needed, or seek immediate medical attention.
Drug Interactions
Contraindicated Interactions
- Patients with known allergy to corn or corn products (rare)
- Anuric patients (unless for specific indications like hyperkalemia)
- Severe hyperglycemia or diabetic coma (unless insulin is co-administered)
- Intracranial or intraspinal hemorrhage (unless specifically indicated for fluid replacement and carefully monitored)
Major Interactions
- Blood products (risk of pseudoagglutination or hemolysis if mixed directly due to hypotonicity or pH changes)
Moderate Interactions
- Corticosteroids (may increase blood glucose levels, requiring closer monitoring)
- Insulin (requires careful monitoring of blood glucose to avoid hypoglycemia or hyperglycemia)
- Diuretics (may alter fluid and electrolyte balance, requiring closer monitoring)
Monitoring
Baseline Monitoring
Fluid status (intake/output, edema)
Rationale: To assess hydration status and prevent fluid overload.
Timing: Prior to initiation of therapy
Serum electrolytes (Na, K, Cl)
Rationale: To assess baseline electrolyte balance and prevent imbalances.
Timing: Prior to initiation of therapy
Blood glucose
Rationale: To assess baseline glucose levels and prevent hyperglycemia or hypoglycemia.
Timing: Prior to initiation of therapy
Renal function (BUN, creatinine)
Rationale: To assess kidney's ability to handle fluid and electrolytes.
Timing: Prior to initiation of therapy
Routine Monitoring
Fluid balance (intake/output)
Frequency: Every 4-8 hours or as clinically indicated
Target: Balanced or as per clinical need
Action Threshold: Significant positive or negative balance, signs of fluid overload/dehydration
Serum electrolytes (Na, K, Cl)
Frequency: Daily or as clinically indicated
Target: Within normal limits
Action Threshold: Abnormal levels (e.g., hyponatremia, hypernatremia)
Blood glucose
Frequency: Every 4-6 hours initially, then daily or as clinically indicated
Target: 70-180 mg/dL (or as per institutional protocol)
Action Threshold: Below 70 mg/dL or above 180-200 mg/dL
Signs of fluid overload (edema, crackles, dyspnea)
Frequency: Regularly during infusion
Target: Absence of signs
Action Threshold: Presence of signs
Symptom Monitoring
- Signs of fluid overload (swelling, shortness of breath, rapid weight gain)
- Signs of hyperglycemia (increased thirst, increased urination, fatigue, blurred vision)
- Signs of hypoglycemia (sweating, shakiness, dizziness, confusion)
- Signs of electrolyte imbalance (muscle weakness, cramps, irregular heartbeat, confusion)
Special Patient Groups
Pregnancy
Dextrose 5% Injection is commonly used in pregnancy for hydration and caloric support. While generally considered safe, careful monitoring of fluid and glucose balance is essential to avoid maternal hyperglycemia, which can lead to fetal hyperglycemia and subsequent neonatal hypoglycemia.
Trimester-Specific Risks:
First Trimester:
Generally considered safe for appropriate indications. Monitor fluid and glucose.
Second Trimester:
Generally considered safe for appropriate indications. Monitor fluid and glucose.
Third Trimester:
Generally considered safe for appropriate indications. Monitor fluid and glucose, especially in late pregnancy due to potential for fetal effects from maternal hyperglycemia.
Lactation
Dextrose is a natural component of the body and is generally considered safe for use during lactation. It is unlikely to cause adverse effects in a breastfed infant when administered to the mother in appropriate therapeutic doses.
Infant Risk:
Low risk
Pediatric Use
Use with caution, especially in neonates and infants, due to immature renal function and glucose regulation. Higher risk of hyperglycemia, hypoglycemia, and fluid overload. Close monitoring of blood glucose, fluid balance, and electrolytes is crucial. Infusion rates should be carefully calculated based on weight and metabolic needs.
Geriatric Use
Use with caution due to increased risk of fluid overload, electrolyte imbalances, and impaired glucose tolerance. Start with lower infusion rates and monitor fluid status, electrolytes, and blood glucose closely. Pre-existing cardiac or renal conditions may necessitate slower infusions.
Clinical Information
Clinical Pearls
- Dextrose 5% in water (D5W) is isotonic in the bag but becomes physiologically hypotonic after dextrose is metabolized, providing free water.
- It is primarily used for hydration and to provide minimal caloric support (170 calories per 1000 mL).
- Not suitable for rapid volume expansion alone; for significant volume resuscitation, isotonic saline (0.9% NaCl) or balanced salt solutions are preferred.
- Always check for compatibility when adding other medications to D5W.
- Avoid rapid infusion in patients with impaired glucose tolerance, diabetes, or those at risk of cerebral edema (e.g., head trauma) due to the risk of hyperglycemia and subsequent osmotic shifts.
Alternative Therapies
- 0.9% Sodium Chloride (Normal Saline) for isotonic fluid replacement
- Lactated Ringer's Solution for balanced electrolyte and fluid replacement
- Total Parenteral Nutrition (TPN) for comprehensive nutritional support
- Oral rehydration solutions for mild to moderate dehydration
Cost & Coverage
Average Cost:
$5 - $20 per 1000ml bag
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
General Drug Facts
If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and 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, do not flush medications down the toilet or drain. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities have drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet; check with your pharmacist to see if this applies to your prescription. 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 emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was taken to ensure prompt and effective treatment.