Dextrose 5% Inj, 25ml
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
Intravenous nutritional therapy; Fluid and electrolyte replenisher
Pharmacologic Class
Carbohydrate; Monosaccharide
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) and water given through a vein (intravenously). It's used to provide fluids, some calories, and to raise blood sugar levels if they are too low. It can also be used to dilute other medications before they are given intravenously.
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and read all accompanying information carefully. Take this medication exactly as directed, and be sure to follow all instructions provided. This medication is administered intravenously over a specified period of time.
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
If you miss a dose, contact your doctor immediately 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 proper storage procedure.
If you miss a dose, contact your doctor immediately to receive guidance on the next steps to take.
Lifestyle & Tips
- Maintain good hygiene around the IV site to prevent infection.
- Report any discomfort, swelling, redness, or pain at the IV site immediately.
- Report any unusual symptoms such as dizziness, confusion, excessive thirst, or difficulty breathing.
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 fluid, electrolyte, and caloric needs. Typically administered at rates of 1.25 to 2.5 mL/kg/hour (for D5W) or 70-175 mL/hour for maintenance, or as a vehicle for other medications.
Condition-Specific Dosing:
Hypoglycemia:
Rapid IV push of higher concentration (e.g., D50W) followed by D5W infusion if needed.
Maintenance Fluid:
Typically 70-175 mL/hour, adjusted based on patient's fluid status and output.
Pediatric Dosing
Neonatal:
Highly individualized based on fluid, electrolyte, and caloric needs, typically 60-100 mL/kg/day initially, adjusted based on glucose and fluid balance.
Infant:
Highly individualized, typically 100-150 mL/kg/day, adjusted based on glucose and fluid balance.
Child:
Highly individualized, typically 100-150 mL/kg/day, adjusted based on glucose and fluid balance.
Adolescent:
Similar to adult dosing, highly individualized based on weight and metabolic needs.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment, monitor fluid and electrolyte balance closely.
Moderate:
No specific adjustment, monitor fluid and electrolyte balance closely, adjust rate to prevent fluid overload.
Severe:
Reduced rate of administration to prevent fluid overload and electrolyte disturbances; close monitoring of fluid balance, electrolytes, and glucose is critical.
Dialysis:
Administer with extreme caution, adjust rate based on fluid removal during dialysis and patient's fluid status; close monitoring of glucose and electrolytes.
Hepatic Impairment:
Mild:
No specific adjustment.
Moderate:
No specific adjustment.
Severe:
No specific adjustment, but monitor for fluid and electrolyte imbalances, especially in patients with ascites or edema.
Pharmacology
Mechanism of Action
Dextrose is a monosaccharide (glucose) that provides a source of calories and fluid. It is readily metabolized by the body to produce energy, carbon dioxide, and water. It helps restore blood glucose levels in hypoglycemia and provides hydration. As a 5% solution, it is isotonic initially but becomes hypotonic in vivo as dextrose is metabolized, leading to free water distribution.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous)
Tmax:
Not applicable (continuously infused)
FoodEffect:
Not applicable (intravenous)
Distribution:
Vd:
Approximately 0.6 L/kg (total body water)
ProteinBinding:
None
CnssPenetration:
Yes
Elimination:
HalfLife:
Not applicable (continuously metabolized)
Clearance:
Highly variable, dependent on metabolic rate and glucose utilization.
ExcretionRoute:
Renal (small amounts of unmetabolized glucose if blood glucose levels exceed renal threshold); primarily metabolized.
Unchanged:
Minimal
Pharmacodynamics
OnsetOfAction:
Immediate (upon intravenous administration)
PeakEffect:
Continuous (as long as infusion is maintained)
DurationOfAction:
Dependent on infusion rate and metabolic needs.
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. 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, 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. 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, 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 or pain at the injection site
- Shortness of breath or difficulty breathing
- Sudden weight gain or swelling in the ankles/legs
- Increased thirst or urination
- Feeling dizzy, confused, or unusually tired
- Muscle weakness or cramps
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 symptoms you experienced.
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 and medications with your doctor.
To ensure your safety, please provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Natural products and vitamins you are using
* Any health problems you have
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe for you to do so.
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 symptoms you experienced.
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 and medications with your doctor.
To ensure your safety, please provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are taking
Natural products and vitamins you are using
* Any health problems you have
Before starting, stopping, or changing the dose of any medication, including this one, consult with your doctor to confirm it is safe for you to do so.
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 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 about these potential risks, consult your doctor.
When administering this medication to newborns, caution is advised. Your doctor will need to carefully evaluate the 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 discuss the potential benefits and risks of this medication with your doctor. This will help you make an informed decision about your treatment and 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 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 about these potential risks, consult your doctor.
When administering this medication to newborns, caution is advised. Your doctor will need to carefully evaluate the 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 discuss the potential benefits and risks of this medication with your doctor. This will help you make an informed decision about your treatment and ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., pulmonary edema, peripheral edema, hypertension)
- Hyperglycemia (e.g., polyuria, polydipsia, dehydration, osmotic diuresis, hyperosmolar hyperglycemic state)
- Electrolyte imbalances (e.g., hyponatremia due to dilution)
What to Do:
Discontinue infusion, administer diuretics for fluid overload, insulin for hyperglycemia, correct electrolyte imbalances. Call 1-800-222-1222 (Poison Control) or seek immediate medical attention.
Drug Interactions
Moderate Interactions
- Corticosteroids (may increase blood glucose levels, requiring adjustment of dextrose infusion)
- Insulin (dextrose infusion may counteract insulin's hypoglycemic effect, requiring careful titration)
- Diuretics (especially loop diuretics, may alter fluid and electrolyte balance, requiring close monitoring)
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl, Mg, Phos)
Rationale: To establish baseline fluid and electrolyte status before initiating IV fluid therapy.
Timing: Prior to initiation of therapy.
Blood Glucose
Rationale: To assess baseline glucose levels, especially in patients at risk for hyperglycemia or hypoglycemia.
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 mg/dL (hyperglycemia)
Serum Electrolytes (Na, K)
Frequency: Daily or as clinically indicated, especially with large volumes or rapid rates.
Target: Na: 135-145 mEq/L, K: 3.5-5.0 mEq/L
Action Threshold: Significant deviations from normal range (e.g., hyponatremia, hyperkalemia)
Fluid Balance (Intake & Output)
Frequency: Every 8-24 hours or more frequently if clinically unstable.
Target: Balanced or as per fluid restriction/repletion goals.
Action Threshold: Significant positive or negative fluid balance, signs of fluid overload or dehydration.
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, crackles) or dehydration (e.g., tachycardia, hypotension).
Symptom Monitoring
- Signs of fluid overload (e.g., dyspnea, peripheral edema, crackles, weight gain)
- Signs of electrolyte imbalance (e.g., muscle weakness, confusion, arrhythmias)
- Signs of hyperglycemia (e.g., polyuria, polydipsia, fatigue)
- Signs of hypoglycemia (e.g., sweating, tremors, confusion, dizziness)
- Local irritation or phlebitis at infusion site
Special Patient Groups
Pregnancy
Generally considered safe when clinically indicated and administered with appropriate monitoring of fluid and electrolyte balance. Dextrose is a natural component of metabolism.
Trimester-Specific Risks:
First Trimester:
No specific risks identified beyond general fluid/electrolyte management.
Second Trimester:
No specific risks identified beyond general fluid/electrolyte management.
Third Trimester:
No specific risks identified beyond general fluid/electrolyte management. Caution with excessive fluid administration to avoid fluid overload.
Lactation
Considered safe for use during lactation. Dextrose is a natural component of breast milk and maternal metabolism.
Infant Risk:
L1 (Safest) - No adverse effects expected in breastfed infants.
Pediatric Use
Dosing must be carefully calculated based on weight, age, and metabolic needs to avoid fluid overload, hyperglycemia, or hypoglycemia. Close monitoring of blood glucose and electrolytes is essential due to higher metabolic rates and smaller fluid reserves.
Geriatric Use
Administer with caution, especially in patients with cardiac or renal impairment, due to increased risk of fluid overload and electrolyte imbalances. Start with lower infusion rates and monitor fluid status, electrolytes, and glucose closely.
Clinical Information
Clinical Pearls
- Dextrose 5% in water (D5W) is isotonic in the bag but becomes physiologically hypotonic once dextrose is metabolized, providing free water.
- Primarily used for hydration and as a vehicle for administering other medications.
- Not a significant source of calories for prolonged nutritional support; higher concentrations (e.g., D10W, D50W) or total parenteral nutrition (TPN) are needed for caloric replacement.
- Always monitor blood glucose, especially in diabetic patients or those at risk for glucose intolerance.
- Risk of hyponatremia if large volumes are administered rapidly, particularly in patients with impaired free water excretion (e.g., SIADH, heart failure).
Alternative Therapies
- 0.9% Sodium Chloride (Normal Saline) for fluid replacement without caloric needs
- Lactated Ringer's Solution for fluid and electrolyte replacement
- Oral rehydration solutions for mild dehydration
- Total Parenteral Nutrition (TPN) for comprehensive nutritional support
Cost & Coverage
Average Cost:
Very low (e.g., $1-$5) per 25ml vial/bag
Generic Available:
Yes
Insurance Coverage:
Tier 1 (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, do not share your medication with others, and never take someone else's medication. 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; do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional. 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 have additional patient information leaflets, so it is a good idea to check with your pharmacist. 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 it happened, as this will aid in providing appropriate care.