Dextrose 5% 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, caloric agent
Pharmacologic Class
Carbohydrate, parenteral nutrition component
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Dextrose 5% Injection is a sterile solution of sugar (glucose) in water, given through a vein (intravenously). It's used to provide your body with fluids, energy (calories), and to help maintain proper sugar levels, especially when you can't eat or drink normally.
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and carefully read all accompanying information. Take this medication exactly as directed, and adhere to all guidelines provided. This drug 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 proper storage procedure.
In the event that you miss a dose, contact your doctor promptly to receive guidance on the appropriate course of action.
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
In the event that you miss a dose, contact your doctor promptly to receive guidance on the appropriate course of action.
Lifestyle & Tips
- Maintain good hydration as advised by your healthcare provider.
- Report any unusual symptoms or discomfort during or after 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 individualized based on patient's fluid, electrolyte, and caloric needs. Typically administered intravenously at rates determined by clinical condition.
Condition-Specific Dosing:
hydration:
500 mL to 3 L per 24 hours, adjusted to maintain fluid balance.
vehicle:
As required for dilution of compatible medications.
hypoglycemia:
Rapid infusion (e.g., 20-50 mL) for acute hypoglycemia, followed by maintenance infusion.
Pediatric Dosing
Neonatal:
Individualized based on weight, gestational age, and clinical condition. Typically 60-100 mL/kg/day, adjusted for glucose and fluid balance.
Infant:
Individualized based on weight and clinical condition. Typically 100-150 mL/kg/day, adjusted for glucose and fluid balance.
Child:
Individualized based on weight and clinical condition. Typically 50-100 mL/kg/day, adjusted for glucose and fluid balance.
Adolescent:
Similar to adult dosing, individualized based on weight and clinical condition.
Dose Adjustments
Renal Impairment:
Mild:
Careful monitoring of fluid and electrolyte balance. No specific dose adjustment for dextrose itself.
Moderate:
Careful monitoring of fluid and electrolyte balance, risk of fluid overload. No specific dose adjustment for dextrose itself.
Severe:
Use with extreme caution due to risk of fluid overload and electrolyte disturbances. Close monitoring of fluid balance, serum electrolytes, and glucose is essential. May require reduced infusion rates.
Dialysis:
Considerations for fluid removal during dialysis. Infusion rates must be carefully managed to avoid interdialytic weight gain and fluid overload.
Hepatic Impairment:
Mild:
No specific dose adjustment for dextrose itself. Monitor for fluid and electrolyte imbalances.
Moderate:
No specific dose adjustment for dextrose itself. Monitor for fluid and electrolyte imbalances, especially in patients with ascites or edema.
Severe:
No specific dose adjustment for dextrose itself. Monitor for fluid and electrolyte imbalances, particularly in patients with severe liver disease who may have altered fluid regulation.
Pharmacology
Mechanism of Action
Dextrose (D-glucose) is a monosaccharide that serves as a primary source of energy for cells. When administered intravenously, it is rapidly metabolized, providing calories and reducing protein catabolism. It also helps to prevent ketosis and can be used to treat hypoglycemia. As a 5% solution, it is isotonic with blood plasma, but once metabolized, it provides free water, which helps to hydrate cells and promote renal excretion of solutes.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Not applicable (immediate distribution upon IV administration)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.6 L/kg (total body water)
ProteinBinding:
0%
CnssPenetration:
Yes
Elimination:
HalfLife:
Variable (depends on metabolic rate and infusion rate)
Clearance:
Variable (depends on metabolic rate)
ExcretionRoute:
Metabolized to CO2 (exhaled) and H2O (renal excretion)
Unchanged:
Negligible
Pharmacodynamics
OnsetOfAction:
Immediate (upon infusion)
PeakEffect:
Rapid (within minutes of infusion, depending on rate)
DurationOfAction:
Dependent on infusion rate and patient's metabolic needs; typically sustained as long as infusion continues.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience 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 have 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, this medication can cause severe and potentially life-threatening side effects. If you experience 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 have 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:
- Swelling in your hands, feet, or ankles
- Difficulty breathing or shortness of breath
- Unusual thirst or dry mouth
- Increased urination
- Feeling confused or disoriented
- Headache
- Nausea or vomiting
- Pain, redness, or swelling at the injection 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
Please note that this is not an exhaustive list of all potential interactions between this medication and other health issues.
To ensure your safety, it is crucial to discuss all of the following with your doctor and pharmacist:
All medications you are currently taking, including prescription and over-the-counter drugs, natural products, and vitamins
Any health problems you have
Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to confirm that it is safe to do so in conjunction with your other medications and health conditions.
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
Please note that this is not an exhaustive list of all potential interactions between this medication and other health issues.
To ensure your safety, it is crucial to discuss all of the following with your doctor and pharmacist:
All medications you are currently taking, including prescription and over-the-counter drugs, natural products, and vitamins
Any health problems you have
Before starting, stopping, or changing the dose of any medication, including this one, you must consult with your doctor to confirm that it is safe to do so in conjunction with your other medications and health conditions.
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. Be sure to discuss any concerns or questions 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 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 instances, these complications can be fatal. If you have any questions or concerns, be sure to discuss them with your doctor.
When used in newborns, this medication requires careful consideration. Your doctor will need to weigh the potential benefits and risks, so it is essential to have an open discussion with them.
If you are pregnant, planning to become pregnant, or are breast-feeding, it is vital 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.
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 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 instances, these complications can be fatal. If you have any questions or concerns, be sure to discuss them with your doctor.
When used in newborns, this medication requires careful consideration. Your doctor will need to weigh the potential benefits and risks, so it is essential to have an open discussion with them.
If you are pregnant, planning to become pregnant, or are breast-feeding, it is vital 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.
Overdose Information
Overdose Symptoms:
- Fluid overload (edema, pulmonary congestion, dyspnea)
- Hyperglycemia (high blood sugar, leading to increased urination, thirst, confusion)
- Electrolyte imbalances (e.g., hyponatremia due to dilution, hypokalemia)
- Osmotic diuresis (excessive urination due to high glucose)
What to Do:
Discontinue infusion, administer diuretics for fluid overload, insulin for hyperglycemia, and correct electrolyte imbalances as needed. Call 1-800-222-1222 (Poison Control) or seek immediate medical attention.
Drug Interactions
Major Interactions
- Blood products (risk of pseudoagglutination or hemolysis if mixed directly)
- Certain medications with known incompatibility (e.g., phenytoin, ampicillin, some insulins if not properly diluted/administered)
Moderate Interactions
- Insulin (exogenous insulin will promote glucose uptake, requiring careful monitoring of blood glucose)
- Diuretics (may exacerbate electrolyte imbalances, especially hypokalemia, if not monitored)
- Corticosteroids (may increase blood glucose, requiring adjustment of dextrose infusion rate)
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl)
Rationale: To establish baseline fluid and electrolyte status and identify pre-existing imbalances.
Timing: Prior to initiation of therapy
Blood Glucose
Rationale: To establish baseline glucose level and guide initial infusion rate.
Timing: Prior to initiation of therapy
Renal Function (BUN, Creatinine)
Rationale: To assess kidney function, which influences fluid and electrolyte excretion.
Timing: Prior to initiation of therapy
Fluid Status (Weight, I&O, Edema)
Rationale: To assess hydration status and risk of fluid overload.
Timing: Prior to initiation of therapy
Routine Monitoring
Blood Glucose
Frequency: Every 4-6 hours initially, then daily or as clinically indicated
Target: 70-180 mg/dL (individualized)
Action Threshold: <70 mg/dL (hypoglycemia), >180-200 mg/dL (hyperglycemia)
Serum Electrolytes (Na, K)
Frequency: Daily or as clinically indicated
Target: Na: 135-145 mEq/L, K: 3.5-5.0 mEq/L
Action Threshold: Significant deviations from normal range (e.g., hyponatremia, hypokalemia)
Fluid Balance (Intake & Output, Daily Weight)
Frequency: Every 8-24 hours
Target: Balanced I&O, stable weight
Action Threshold: Significant positive or negative fluid balance, rapid weight changes
Signs of Fluid Overload (Edema, Dyspnea, Crackles)
Frequency: Continuously
Target: Absence of signs
Action Threshold: Presence of signs of fluid overload
Symptom Monitoring
- Thirst
- Dry mouth
- Frequent urination
- Fatigue
- Confusion
- Headache
- Nausea
- Vomiting
- Swelling (edema) in extremities or face
- Shortness of breath
- Rapid weight gain
- Muscle weakness or cramps (due to electrolyte imbalance)
- Injection site reactions (pain, redness, swelling)
Special Patient Groups
Pregnancy
Dextrose 5% Injection is commonly used in pregnant women for hydration, caloric support, and management of hypoglycemia. It is generally considered safe when administered appropriately and with careful monitoring of fluid and glucose balance.
Trimester-Specific Risks:
First Trimester:
Generally considered safe; no known specific risks.
Second Trimester:
Generally considered safe; no known specific risks.
Third Trimester:
Generally considered safe; commonly used during labor and delivery for hydration and energy.
Lactation
Dextrose is a natural component of the body and is not expected to cause adverse effects in breastfed infants. It is considered compatible with breastfeeding.
Infant Risk:
Low risk (L1)
Pediatric Use
Use with caution and close monitoring of blood glucose, fluid balance, and electrolytes. Neonates and infants are particularly susceptible to fluid overload and hyperglycemia/hypoglycemia due to immature renal and metabolic systems. Dosing must be carefully calculated based on weight and clinical need.
Geriatric Use
Use with caution due to increased risk of fluid overload, electrolyte imbalances, and pre-existing cardiovascular or renal conditions. Close monitoring of fluid status, electrolytes, and blood glucose is essential. Lower infusion rates may be necessary.
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 kcal/L for D5W).
- Not suitable for sole maintenance fluid therapy due to lack of electrolytes; prolonged use without electrolyte supplementation can lead to hyponatremia and other imbalances.
- Always check for physical and chemical compatibility before mixing other medications with D5W.
- Avoid rapid infusion in patients at risk for cerebral edema (e.g., severe hyponatremia, head trauma) as it can exacerbate swelling due to its hypotonic effect after metabolism.
- Monitor blood glucose closely, especially in diabetic patients or those receiving large volumes, to prevent hyperglycemia.
Alternative Therapies
- 0.9% Sodium Chloride (Normal Saline) for hydration and electrolyte replacement
- Lactated Ringer's Solution for hydration and electrolyte replacement
- Total Parenteral Nutrition (TPN) for comprehensive nutritional support
- Oral rehydration solutions for mild to moderate dehydration
Cost & Coverage
Average Cost:
$5 - $20 per 250 mL bag
Generic Available:
Yes
Insurance Coverage:
Generally covered by most health insurance plans (medical benefit) as it is a common hospital supply/medication.
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 for 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 to do so by a healthcare professional, do not flush medications down the toilet or pour them down the drain. If you are unsure about the proper disposal method, consult your pharmacist for advice. 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.