Dextrose 5%/nacl 0.45% Inj, 250ml
It is used to give fluids to the body when more fluids and electrolytes are needed.It is used as a way to give other drugs as a shot.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Fluid and Electrolyte Replenisher; Caloric Agent
Pharmacologic Class
Hypotonic Crystalloid Solution; Carbohydrate
Pregnancy Category
Category B
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medication is an intravenous (IV) fluid given through a vein. It contains a small amount of sugar (dextrose) for energy and essential salts (sodium and chloride) to help keep your body hydrated and maintain the proper balance of fluids and electrolytes. It's commonly used when you can't drink enough fluids or need extra hydration and a small amount of calories.
How to Use This Medicine
Proper Use of This Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is administered as an infusion into a vein over a period of time. Your doctor may instruct you on how to self-administer this medication.
Before and after handling the medication, wash your hands thoroughly. Do not use the medication if the solution appears cloudy, is leaking, or contains particles. Additionally, do not use the solution if it has changed color.
To dispose of used needles and other sharp objects, use a needle/sharp disposal box. Never reuse needles or other items. When the disposal box is full, follow local regulations for proper disposal. If you have any questions or concerns, consult your doctor or pharmacist.
Storage and Disposal
Typically, this medication is administered in a hospital or doctor's office. If you need to store it at home, follow the storage instructions provided by your doctor.
Missed Dose
If you miss a dose, contact your doctor to determine the best course of action.
To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is administered as an infusion into a vein over a period of time. Your doctor may instruct you on how to self-administer this medication.
Before and after handling the medication, wash your hands thoroughly. Do not use the medication if the solution appears cloudy, is leaking, or contains particles. Additionally, do not use the solution if it has changed color.
To dispose of used needles and other sharp objects, use a needle/sharp disposal box. Never reuse needles or other items. When the disposal box is full, follow local regulations for proper disposal. If you have any questions or concerns, consult your doctor or pharmacist.
Storage and Disposal
Typically, this medication is administered in a hospital or doctor's office. If you need to store it at home, follow the storage instructions provided by your doctor.
Missed Dose
If you miss a dose, contact your doctor to determine the best course of action.
Lifestyle & Tips
- No specific lifestyle changes are required due to the medication itself. However, your underlying medical condition may necessitate specific dietary or fluid restrictions as advised by your healthcare provider.
- Report any unusual swelling, difficulty breathing, or changes in urination to your nurse or doctor immediately.
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 patient's fluid, electrolyte, and caloric needs. Typically administered at rates of 40-125 mL/hour for maintenance, or higher for rehydration.
Condition-Specific Dosing:
dehydration:
Higher rates (e.g., 100-250 mL/hour) may be used for rehydration, adjusted based on clinical response and laboratory values.
maintenance_fluid:
Lower rates (e.g., 40-80 mL/hour) for daily fluid and caloric maintenance.
Pediatric Dosing
Neonatal:
Individualized based on body weight (e.g., 60-100 mL/kg/day initially, adjusted based on clinical status and laboratory values).
Infant:
Individualized based on body weight (e.g., 100-150 mL/kg/day, adjusted based on clinical status and laboratory values).
Child:
Individualized based on body weight (e.g., 75-100 mL/kg/day, adjusted based on clinical status and laboratory values).
Adolescent:
Individualized based on body weight and clinical status, often transitioning to adult dosing guidelines.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor fluid and electrolyte balance closely.
Moderate:
Use with caution; monitor fluid and electrolyte balance closely. May require reduced rates or volumes to prevent fluid overload or electrolyte imbalances.
Severe:
Use with extreme caution; significant reduction in rate and volume may be necessary. Close monitoring of fluid status, electrolytes, and renal function is critical to prevent fluid overload and severe electrolyte disturbances.
Dialysis:
Contraindicated in anuric patients unless specifically indicated for free water deficit. Use with extreme caution and reduced volumes in patients on dialysis, as fluid and electrolyte balance are tightly controlled by dialysis.
Hepatic Impairment:
Mild:
Generally no specific adjustment.
Moderate:
Monitor fluid and electrolyte balance closely, especially if ascites or edema are present.
Severe:
Monitor fluid and electrolyte balance closely; may require reduced rates or volumes to prevent fluid overload, particularly in patients with significant ascites or peripheral edema.
Pharmacology
Mechanism of Action
Dextrose 5%/0.45% NaCl Injection provides water, calories (from dextrose), and essential electrolytes (sodium and chloride). Dextrose is metabolized via glycolysis and the Krebs cycle, providing energy and reducing protein catabolism. Sodium and chloride are crucial for maintaining fluid balance, nerve impulse transmission, muscle contraction, and acid-base balance. The 0.45% NaCl concentration makes the solution hypotonic relative to plasma, allowing for the movement of free water into intracellular and interstitial spaces after the metabolism of dextrose.
Pharmacokinetics
Absorption:
Bioavailability:
100% (Intravenous administration)
Tmax:
Immediate (upon infusion)
FoodEffect:
Not applicable (intravenous administration)
Distribution:
Vd:
Distributes throughout the total body water (intracellular and extracellular compartments).
ProteinBinding:
Not applicable (dextrose, sodium, chloride do not bind significantly to plasma proteins)
CnssPenetration:
Yes (water, glucose, and electrolytes readily cross the blood-brain barrier)
Elimination:
HalfLife:
Variable, dependent on patient's metabolic rate, fluid status, and renal function.
Clearance:
Water and electrolytes are primarily cleared renally. Dextrose is metabolized and eliminated as CO2 and water.
ExcretionRoute:
Renal (water, sodium, chloride); Respiratory (CO2 from dextrose metabolism).
Unchanged:
Variable (water, sodium, chloride); Dextrose is fully metabolized.
Pharmacodynamics
OnsetOfAction:
Immediate (upon initiation of infusion)
PeakEffect:
Minutes to hours, depending on infusion rate and patient's physiological response.
DurationOfAction:
Dependent on infusion rate, patient's metabolic rate, and renal function; effects persist as long as infusion continues and for a period thereafter as fluid and electrolytes are balanced.
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
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
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
Swelling, warmth, numbness, color changes, or pain in a leg or arm
Chest pain or pressure
Fever
Shortness of breath
Sudden weight gain
Swelling in the arms or legs
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people experience no side effects or only mild ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Irritation or swelling at the injection site
* Pain at the injection site
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact 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
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
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
Swelling, warmth, numbness, color changes, or pain in a leg or arm
Chest pain or pressure
Fever
Shortness of breath
Sudden weight gain
Swelling in the arms or legs
Other Possible Side Effects
Like all medications, this drug can cause side effects. While many people experience no side effects or only mild ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Irritation or swelling at the injection site
* Pain at the injection site
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns, contact 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 (edema)
- Difficulty breathing or shortness of breath
- Rapid weight gain
- Confusion or unusual drowsiness
- Excessive thirst or frequent urination (signs of high blood sugar)
- Headache, nausea, or vomiting (signs of electrolyte imbalance)
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 as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor identify potential interactions between this medication and other substances.
* Any existing health problems, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor. By sharing this information with your doctor and pharmacist, you can help prevent potential interactions and ensure the safe use of this medication.
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 as a result of the allergy.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor identify potential interactions between this medication and other substances.
* Any existing health problems, as they may affect the safety and efficacy of this medication.
To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Never start, stop, or adjust the dosage of any medication without first consulting your doctor. By sharing this information with your doctor and pharmacist, you can help prevent potential interactions and ensure the safe use of this medication.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.
If your medication contains potassium, consult your doctor before using any salt substitutes or products that also contain potassium.
If your medication contains dextrose and you have diabetes (high blood sugar), discuss this with your doctor to ensure safe management of your condition.
Regular blood tests will be necessary as directed by your doctor. Be sure to follow their instructions and discuss any concerns or questions you may have.
When administering this medication to newborns, exercise caution due to a potentially higher risk of side effects in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to discuss the benefits and risks of this medication with your doctor to make an informed decision about its use.
If your medication contains potassium, consult your doctor before using any salt substitutes or products that also contain potassium.
If your medication contains dextrose and you have diabetes (high blood sugar), discuss this with your doctor to ensure safe management of your condition.
Regular blood tests will be necessary as directed by your doctor. Be sure to follow their instructions and discuss any concerns or questions you may have.
When administering this medication to newborns, exercise caution due to a potentially higher risk of side effects in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to discuss the benefits and risks of this medication with your doctor to make an informed decision about its use.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., pulmonary edema, peripheral edema, hypertension)
- Electrolyte imbalances (e.g., hypernatremia, hyponatremia, hyperchloremia)
- Hyperglycemia (high blood sugar)
- Cerebral edema (in severe hyponatremia)
What to Do:
Immediate cessation of infusion. Management is supportive and includes administering diuretics for fluid overload, correcting electrolyte imbalances, and administering insulin for hyperglycemia. Seek immediate medical attention or call 1-800-222-1222 (Poison Control).
Drug Interactions
Monitoring
Baseline Monitoring
Serum Electrolytes (Sodium, Potassium, Chloride, Bicarbonate)
Rationale: To establish baseline electrolyte status and identify pre-existing imbalances.
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.
Blood Glucose
Rationale: To establish baseline glucose levels, especially in diabetic patients or those at risk of hyperglycemia.
Timing: Prior to initiation of therapy.
Fluid Status (Intake/Output, Vital Signs, Body Weight)
Rationale: To assess hydration status and guide initial fluid volume and rate.
Timing: Prior to initiation of therapy.
Routine Monitoring
Serum Electrolytes (Sodium, Potassium, Chloride)
Frequency: Daily or more frequently as clinically indicated (e.g., every 4-6 hours in critically ill patients).
Target: Physiological normal ranges (e.g., Na 135-145 mEq/L, K 3.5-5.0 mEq/L, Cl 98-106 mEq/L).
Action Threshold: Significant deviations from normal ranges, or clinical signs of imbalance (e.g., confusion, weakness, arrhythmias).
Blood Glucose
Frequency: Every 4-6 hours initially, then daily once stable, or as clinically indicated.
Target: 70-180 mg/dL (target may vary based on patient condition).
Action Threshold: Persistent hyperglycemia (>180 mg/dL) or hypoglycemia (<70 mg/dL).
Fluid Status (Intake/Output, Vital Signs, Body Weight)
Frequency: Every 4-8 hours for I&O, daily for weight, continuous for vital signs.
Target: Balanced I&O, stable weight, normal vital signs.
Action Threshold: Significant positive or negative fluid balance, rapid weight changes, signs of fluid overload (e.g., dyspnea, edema) or dehydration (e.g., hypotension, tachycardia).
Symptom Monitoring
- Signs of fluid overload (e.g., peripheral edema, pulmonary crackles, dyspnea, rapid weight gain, elevated blood pressure)
- Signs of electrolyte imbalance (e.g., muscle weakness, cramps, confusion, lethargy, arrhythmias, seizures)
- Signs of hyperglycemia (e.g., polyuria, polydipsia, blurred vision, fatigue)
- Signs of hyponatremia (e.g., headache, nausea, vomiting, lethargy, seizures, coma)
Special Patient Groups
Pregnancy
Generally considered safe and often used for hydration and caloric support during pregnancy. The components (water, dextrose, sodium, chloride) are essential nutrients. Pregnancy Category B.
Trimester-Specific Risks:
First Trimester:
No known specific risks.
Second Trimester:
No known specific risks.
Third Trimester:
No known specific risks.
Lactation
Compatible with breastfeeding. The components are naturally present in breast milk or are essential nutrients, and are not expected to cause adverse effects in the breastfed infant.
Infant Risk:
L1 (Safest).
Pediatric Use
Used widely in pediatric patients. Dosing must be carefully calculated based on body weight, age, and clinical status to avoid fluid overload, electrolyte imbalances (especially hyponatremia), and hypo/hyperglycemia. Close monitoring of fluid status, electrolytes, and blood glucose is essential.
Geriatric Use
Use with caution in elderly patients due to increased susceptibility to fluid overload, electrolyte imbalances, and pre-existing renal or cardiac comorbidities. Close monitoring of fluid status, electrolytes, and renal function is recommended.
Clinical Information
Clinical Pearls
- Dextrose 5%/0.45% NaCl is a hypotonic solution after dextrose metabolism, providing free water to both intracellular and extracellular compartments.
- It is commonly used as a maintenance fluid to meet daily fluid and minimal caloric needs, or for rehydration in mild to moderate dehydration.
- Always monitor fluid intake and output, vital signs, serum electrolytes, and blood glucose closely to prevent complications such as fluid overload, hyponatremia, or hyperglycemia.
- Not a complete nutritional solution; provides only minimal calories (approx. 170 kcal/L).
- Exercise caution in patients at risk for fluid overload (e.g., heart failure, renal impairment) or hyponatremia (e.g., SIADH, post-operative patients, children).
Alternative Therapies
- Oral rehydration solutions (for mild to moderate dehydration in conscious patients)
- Other IV fluid types depending on specific needs (e.g., colloids for significant volume expansion, parenteral nutrition for complete nutritional support)
- Specific electrolyte replacement solutions (e.g., potassium chloride, magnesium sulfate) if severe deficiencies exist.
Cost & Coverage
Average Cost:
$5 - $20 per 250ml bag
Generic Available:
Yes
Insurance Coverage:
Typically covered by most insurance plans as a medical supply or part of hospital/clinic services.
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, do not share your prescription medications with others, and never take someone else's medications. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion or exposure.
Proper disposal of unused or expired medications is crucial. Do not flush medications down the toilet or pour them down the drain unless specifically instructed to do so by a healthcare professional or the medication's instructions. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities have drug take-back programs that provide a safe and environmentally friendly way to dispose of unwanted medications.
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, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide critical information, including the name of the medication, the amount taken, and the time it was taken, to ensure prompt and effective treatment.
To ensure safe use, do not share your prescription medications with others, and never take someone else's medications. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion or exposure.
Proper disposal of unused or expired medications is crucial. Do not flush medications down the toilet or pour them down the drain unless specifically instructed to do so by a healthcare professional or the medication's instructions. If you are unsure about the correct disposal method, consult your pharmacist for guidance. Many communities have drug take-back programs that provide a safe and environmentally friendly way to dispose of unwanted medications.
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, do not hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. Be prepared to provide critical information, including the name of the medication, the amount taken, and the time it was taken, to ensure prompt and effective treatment.