Dextrose 5% Inj, 50ml
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
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. It provides your body with fluid and a source of energy (calories) to help with hydration and metabolism.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to follow the dosage 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 immediately to receive guidance on what to do next.
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to follow the dosage 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 immediately to receive guidance on what to do next.
Lifestyle & Tips
- This medication is administered by a healthcare professional in a clinical setting.
- No specific lifestyle modifications are required due to this medication itself, but underlying conditions requiring its use may necessitate lifestyle changes.
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, typically 50-1000 mL/hour depending on fluid and caloric needs, clinical condition, and concomitant medications. For 50ml, often used as a diluent or for specific bolus administration.
Dose Range:
50 - 1000 mg
Condition-Specific Dosing:
hypoglycemia:
25-50 mL of D50W (50% Dextrose) IV push, followed by continuous infusion of D5W or D10W as needed.
fluid_replacement:
Variable, based on hydration status and electrolyte balance. Often used as a vehicle for other medications.
Pediatric Dosing
Neonatal:
Highly individualized based on weight, gestational age, and metabolic needs. Typically 4-8 mg/kg/min of dextrose. For 5% Dextrose, infusion rates are carefully calculated.
Infant:
Highly individualized, similar to neonatal, often 4-8 mg/kg/min.
Child:
Highly individualized, often 4-8 mg/kg/min.
Adolescent:
Similar to adult dosing, individualized based on needs.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment for dextrose itself, but monitor fluid balance and electrolytes closely.
Moderate:
No specific dose adjustment for dextrose itself, but monitor fluid balance and electrolytes closely.
Severe:
No specific dose adjustment for dextrose itself, but monitor fluid balance and electrolytes closely. Risk of fluid overload is higher.
Dialysis:
Monitor fluid balance and glucose levels. Dextrose may be used to prevent hypoglycemia during dialysis or as a component of dialysate.
Hepatic Impairment:
Mild:
No specific adjustment.
Moderate:
No specific adjustment.
Severe:
No specific adjustment, but monitor glucose levels closely as hepatic glucose metabolism may be impaired.
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 to prevent ketosis and promotes protein sparing in conditions of inadequate caloric intake. As a 5% solution, it is isotonic or slightly hypotonic in the body, providing free water.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous administration)
Tmax:
Not applicable (immediate systemic availability)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Distributes throughout total body water (approximately 0.6 L/kg)
ProteinBinding:
0%
CnssPenetration:
Yes (crosses blood-brain barrier)
Elimination:
HalfLife:
Not applicable (continuously metabolized)
Clearance:
Highly variable, dependent on metabolic rate and glucose utilization.
ExcretionRoute:
Carbon dioxide (exhaled), water (renal, insensible losses)
Unchanged:
0%
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Not applicable (continuous metabolism)
DurationOfAction:
Dependent on infusion rate and metabolic needs; rapidly utilized.
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when 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.
Not all possible side effects are listed here. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when 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.
Not all possible side effects are listed here. If you have questions or concerns about side effects, discuss them with 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)
- Confusion, dizziness, or unusual sweating (signs of low blood sugar, though less common with D5W unless underlying condition)
- 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
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 particularly higher if you have kidney problems or 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 PN, consult your doctor.
When used in newborns, this medication requires careful consideration. Be sure to discuss the potential risks and benefits with your doctor.
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 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 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 PN, consult your doctor.
When used in newborns, this medication requires careful consideration. Be sure to discuss the potential risks and benefits with your doctor.
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 weigh the benefits and risks of this medication to both you and your baby.
Overdose Information
Overdose Symptoms:
- Hyperglycemia (high blood sugar): increased thirst, frequent urination, fatigue, blurred vision.
- Fluid overload: edema, shortness of breath, pulmonary congestion, elevated blood pressure.
- Electrolyte imbalances: dilutional hyponatremia (headache, nausea, confusion, seizures), hypokalemia (muscle weakness, cramps, irregular heartbeat).
What to Do:
Immediate medical attention is required. Management involves discontinuing the infusion, administering insulin for hyperglycemia, diuretics for fluid overload, and correcting electrolyte imbalances. Call 911 or your local emergency number. For non-emergencies, contact Poison Control at 1-800-222-1222.
Drug Interactions
Moderate Interactions
- Corticosteroids (may increase blood glucose levels)
- Insulin (dose adjustment may be needed if dextrose is administered concurrently)
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl)
Rationale: To assess baseline fluid and electrolyte status and identify potential imbalances.
Timing: Prior to initiation of therapy
Blood Glucose
Rationale: To assess baseline glucose levels and risk of hyperglycemia or hypoglycemia.
Timing: Prior to initiation of therapy
Renal Function (BUN, Creatinine)
Rationale: To assess kidney function and risk of fluid overload.
Timing: Prior to initiation of therapy
Fluid Status (Weight, I&O, Vital Signs)
Rationale: To establish baseline hydration status.
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: >180 mg/dL (consider insulin), <70 mg/dL (consider dextrose bolus/rate increase)
Serum Electrolytes (Na, K)
Frequency: Daily or as clinically indicated, especially with large volumes or in patients with renal/cardiac dysfunction.
Target: Na: 135-145 mEq/L, K: 3.5-5.0 mEq/L
Action Threshold: Significant deviations (e.g., Na <130 or >150, K <3.0 or >5.5)
Fluid Balance (Intake & Output, Daily Weight)
Frequency: Every 8-24 hours, or more frequently if clinically unstable.
Target: Balanced I&O, stable weight
Action Threshold: Significant positive or negative fluid balance, rapid weight changes
Vital Signs (BP, HR, RR)
Frequency: Every 4-8 hours or as per institutional protocol.
Target: Within normal limits for patient
Action Threshold: Signs of fluid overload (e.g., elevated BP, crackles, dyspnea)
Symptom Monitoring
- Signs of hyperglycemia (increased thirst, urination, fatigue)
- Signs of hypoglycemia (sweating, tremors, confusion, dizziness)
- Signs of fluid overload (edema, dyspnea, crackles in lungs, elevated blood pressure, jugular venous distension)
- Signs of electrolyte imbalance (muscle weakness, cramps, irregular heartbeat, confusion, seizures)
Special Patient Groups
Pregnancy
Generally considered safe and commonly used in pregnancy for hydration and caloric support. However, careful monitoring of maternal glucose and electrolytes is essential, 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
Dextrose is a natural component of the body and is considered compatible with breastfeeding. It is unlikely to cause adverse effects in the breastfed infant.
Infant Risk:
Low risk.
Pediatric Use
Dextrose 5% is commonly used in pediatric patients. Dosing must be carefully calculated based on weight, age, and metabolic needs to avoid hyperglycemia, hypoglycemia, and fluid/electrolyte imbalances. Neonates and infants are particularly vulnerable to glucose fluctuations and fluid overload.
Geriatric Use
Use with caution in elderly patients due to increased risk of fluid overload, electrolyte imbalances, and impaired glucose tolerance. 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 hypotonic in the body as dextrose is metabolized, providing free water. This can lead to dilutional hyponatremia if large volumes are administered, especially in patients with impaired water excretion (e.g., SIADH, renal failure).
- Often used as a diluent or vehicle for IV medications due to its isotonicity and compatibility with many drugs.
- Not suitable for rapid volume expansion alone in hypovolemic shock due to its hypotonic effect after metabolism; crystalloids like normal saline or lactated Ringer's are preferred.
- Always check for particulate matter or discoloration before administration.
- Ensure proper aseptic technique during preparation and administration to prevent infection.
Alternative Therapies
- Normal Saline (0.9% Sodium Chloride) - for fluid replacement, not caloric support.
- Lactated Ringer's Solution - for fluid and electrolyte replacement.
- Oral rehydration solutions - for mild to moderate dehydration (if patient can tolerate oral intake).
- Total Parenteral Nutrition (TPN) - for comprehensive nutritional support.
- Enteral nutrition - for comprehensive nutritional support via GI tract.
Cost & Coverage
Average Cost:
$0.50 - $5.00 per 50ml bag/vial
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, 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; do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist or healthcare provider. 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 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.