Dextrose 5% Inj, 500ml
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 replenisher; caloric agent
Pharmacologic Class
Carbohydrate; monosaccharide
Pregnancy Category
Not formally categorized for D5W specifically; generally considered safe for fluid and caloric replacement when clinically indicated.
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 your body with fluids and calories, helping to prevent dehydration and provide energy, 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. Administer the medication as directed, which typically involves intravenous infusion 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
- Report any discomfort or pain at the injection site immediately.
- Inform your healthcare provider if you have a history of diabetes, kidney problems, or heart problems.
- Understand that this medication is given by healthcare professionals in a hospital or clinic setting.
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, individualized based on fluid and caloric needs, patient's age, weight, and clinical condition. Typically administered intravenously at rates determined by the physician, often 1.25 to 2.5 mL/kg/hour (30-60 drops/min).
Condition-Specific Dosing:
hypoglycemia:
Rapid IV bolus of higher concentration dextrose (e.g., D50W) followed by continuous infusion of D5W or D10W as needed.
fluid_replacement:
Rate adjusted to maintain hydration and electrolyte balance, typically 40-80 mL/hour for maintenance, or higher for deficit replacement.
Pediatric Dosing
Neonatal:
Highly individualized based on weight, gestational age, and metabolic needs. Typical glucose infusion rate (GIR) of 4-8 mg/kg/min. Close monitoring of blood glucose is essential.
Infant:
Highly individualized based on weight and metabolic needs. Typical glucose infusion rate (GIR) of 4-8 mg/kg/min. Close monitoring of blood glucose is essential.
Child:
Highly individualized based on weight and metabolic needs. Typical glucose infusion rate (GIR) of 4-8 mg/kg/min. Close monitoring of blood glucose is essential.
Adolescent:
Similar to adult dosing, individualized based on fluid and caloric needs, weight, and clinical condition.
Dose Adjustments
Renal Impairment:
Mild:
Monitor fluid balance and electrolytes closely. Adjust infusion rate as needed.
Moderate:
Monitor fluid balance and electrolytes closely. Adjust infusion rate as needed to prevent fluid overload.
Severe:
Use with extreme caution due to risk of fluid overload and electrolyte disturbances. Close monitoring of fluid balance, electrolytes, and renal function is critical.
Dialysis:
May be used to provide calories and free water. Fluid balance must be meticulously managed in conjunction with dialysis schedule.
Hepatic Impairment:
Mild:
No specific dose adjustment typically required, but monitor fluid and electrolyte balance.
Moderate:
No specific dose adjustment typically required, but monitor fluid and electrolyte balance, especially in patients with ascites or edema.
Severe:
No specific dose adjustment typically required, but monitor fluid and electrolyte balance, especially in patients with ascites or edema or those prone to encephalopathy.
Pharmacology
Mechanism of Action
Dextrose is a monosaccharide (glucose) that provides a source of calories and free water. It is readily metabolized by the body to produce energy, carbon dioxide, and water. It helps to prevent ketosis, reduce protein catabolism, and correct hypoglycemia. Dextrose 5% in water is isotonic in the bottle but becomes hypotonic in the body as dextrose is metabolized, providing free water.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Rapid (immediately available upon IV administration)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Distributes throughout total body water (approximately 0.6 L/kg)
ProteinBinding:
None
CnssPenetration:
Yes
Elimination:
HalfLife:
Not applicable; continuously metabolized for energy
Clearance:
Not applicable; continuously metabolized
ExcretionRoute:
Metabolized to carbon dioxide (exhaled) and water (excreted renally or utilized)
Unchanged:
0%
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Rapid (as glucose is utilized)
DurationOfAction:
Continuous as long as infusion is maintained
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 immediately or seek emergency 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. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Not all possible side effects are listed here. If you have questions or concerns about side effects, talk 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 immediately or seek emergency 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. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Not all possible side effects are listed here. If you have questions or concerns about side effects, talk 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, ankles, or feet (signs of fluid overload)
- Shortness of breath or difficulty breathing
- Unusual thirst or frequent urination (signs of high blood sugar)
- Confusion or dizziness
- Muscle weakness or cramps
- 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 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 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 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 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. 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 are a premature infant. It is crucial to consult with your doctor about this potential 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 instances, these complications can be fatal. If you have any questions or concerns, it is essential to discuss them with your doctor.
When used in newborns, this medication requires careful consideration and monitoring. Be sure to discuss the potential risks and benefits with your doctor.
If you are pregnant, planning to become pregnant, or are breast-feeding, it is essential to inform your doctor. You and your doctor will need to weigh the benefits and risks of this medication to both 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 are a premature infant. It is crucial to consult with your doctor about this potential 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 instances, these complications can be fatal. If you have any questions or concerns, it is essential to discuss them with your doctor.
When used in newborns, this medication requires careful consideration and monitoring. Be sure to discuss the potential risks and benefits with your doctor.
If you are pregnant, planning to become pregnant, or are breast-feeding, it is essential to inform your doctor. You and your doctor will need to weigh the benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Hyperglycemia (high blood sugar): polyuria, polydipsia, fatigue, blurred vision, nausea, vomiting, dehydration
- Fluid overload: edema, pulmonary congestion, dyspnea, hypertension, heart failure
- Electrolyte disturbances: hyponatremia (due to free water), hypokalemia (due to insulin release)
What to Do:
Discontinue infusion, administer insulin for hyperglycemia, administer diuretics for fluid overload, correct electrolyte imbalances. Call 1-800-222-1222 (Poison Control) for specific guidance if needed, though overdose is typically managed by the treating medical team.
Drug Interactions
Major Interactions
Moderate Interactions
- Diuretics (especially loop diuretics, can alter fluid and electrolyte balance, requiring careful monitoring)
- Other IV fluids containing electrolytes (risk of electrolyte imbalance if not carefully calculated)
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl)
Rationale: To assess baseline electrolyte status and guide fluid therapy.
Timing: Prior to initiation of therapy
Blood Glucose
Rationale: To assess baseline glucose levels and identify pre-existing hyperglycemia or hypoglycemia.
Timing: Prior to initiation of therapy
Renal Function (BUN, Creatinine)
Rationale: To assess kidney function, which impacts fluid and electrolyte excretion.
Timing: Prior to initiation of therapy
Fluid Status (Weight, Edema, Vital Signs)
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 as clinically indicated (e.g., daily or less frequently once stable)
Target: 70-180 mg/dL (or per institutional protocol)
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, or more frequently if clinically unstable
Target: Within normal limits (e.g., Na 135-145 mEq/L, K 3.5-5.0 mEq/L)
Action Threshold: Significant deviations from normal range requiring intervention (e.g., hyponatremia, hypokalemia)
Fluid Balance (Intake and Output)
Frequency: Every 4-8 hours or continuously
Target: Balanced or appropriate for clinical condition
Action Threshold: Significant positive or negative fluid balance, indicating fluid overload or dehydration
Vital Signs (BP, HR, RR)
Frequency: Every 4-8 hours or as per institutional protocol
Target: Within patient's normal range
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., peripheral edema, pulmonary crackles, dyspnea, weight gain)
- Signs of hyperglycemia (e.g., polyuria, polydipsia, fatigue, blurred vision)
- Signs of electrolyte imbalance (e.g., muscle weakness, cramps, confusion, arrhythmias)
- Signs of infusion site reactions (e.g., pain, redness, swelling, phlebitis)
Special Patient Groups
Pregnancy
Generally considered safe for use in pregnancy for fluid and caloric replacement when clinically indicated. Close monitoring of maternal glucose levels is important, especially in diabetic or gestational diabetic patients.
Trimester-Specific Risks:
First Trimester:
No known specific risks.
Second Trimester:
No known specific risks.
Third Trimester:
No known specific risks, but careful monitoring of fluid balance and glucose is important, especially near term.
Lactation
Considered safe for use during lactation. Dextrose is a natural component of the body and is not expected to harm the breastfed infant.
Infant Risk:
Low risk; compatible with breastfeeding.
Pediatric Use
Requires careful monitoring of fluid balance, electrolyte levels, and blood glucose due to higher metabolic rates and smaller fluid compartments. Neonates and infants are particularly susceptible to hyperglycemia and hypoglycemia, and precise glucose infusion rates (GIR) are crucial.
Geriatric Use
Increased risk of fluid overload, electrolyte imbalances (especially hyponatremia), and hyperglycemia due to age-related changes in renal function, cardiac reserve, and glucose metabolism. Close monitoring of fluid status, electrolytes, and blood glucose is essential.
Clinical Information
Clinical Pearls
- Dextrose 5% in water (D5W) is isotonic in the bag but becomes physiologically hypotonic as dextrose is rapidly metabolized, providing free water.
- It is primarily used for fluid replacement and to provide minimal calories (170 calories per 500mL). It is not a significant source of nutrition.
- D5W is often used as a diluent for other intravenous medications.
- Careful monitoring of blood glucose is essential, especially in diabetic patients or those at risk of hyperglycemia.
- Risk of hyponatremia exists, particularly in pediatric patients, post-operative patients, or those with SIADH, due to the free water load.
- Not suitable for rapid volume expansion alone; other isotonic solutions (e.g., Normal Saline, Lactated Ringer's) are preferred for this purpose.
Alternative Therapies
- 0.9% Sodium Chloride (Normal Saline) - for isotonic fluid replacement
- Lactated Ringer's Solution - for isotonic fluid and electrolyte replacement
- Other intravenous fluids based on specific patient needs (e.g., balanced salt solutions, colloids)
- Oral rehydration solutions (for mild dehydration, if tolerated)
Cost & Coverage
Average Cost:
$5 - $20 per 500ml bag
Generic Available:
Yes
Insurance Coverage:
Tier 1 (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 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 otherwise, do not flush medications down the toilet or pour 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.