Dextrose 5%/nacl 0.45% Inj, 500ml
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; Parenteral Nutrition Adjunct
Pharmacologic Class
Crystalloid Solution; Dextrose-Saline Combination
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
This is an intravenous fluid given through a vein to provide your body with water, some salt, and a small amount of sugar (dextrose) for energy. It helps keep you hydrated, maintain your body's fluid and electrolyte balance, and provides minimal 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
- Not applicable as it is an acute intravenous therapy administered in a clinical 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 individualized based on patient's fluid, electrolyte, and caloric needs. Typically 500-3000 mL/24 hours, administered at a rate determined by clinical condition and fluid balance.
Dose Range:
500 - 3000 mg
Condition-Specific Dosing:
maintenance_fluid:
Typically 1.5-3 mL/kg/hour or 1000-2500 mL/day, adjusted based on clinical assessment and laboratory values.
dehydration:
Rate and volume adjusted based on severity of dehydration and ongoing losses.
Pediatric Dosing
Neonatal:
Highly individualized based on weight, gestational age, and clinical condition. Typical maintenance rates: 60-100 mL/kg/day, adjusted for fluid balance and glucose levels.
Infant:
Highly individualized based on weight and clinical condition. Typical maintenance rates: 100-150 mL/kg/day, adjusted for fluid balance and glucose levels.
Child:
Highly individualized based on weight and clinical condition. Typical maintenance rates: 50-100 mL/kg/day, adjusted for fluid balance and glucose levels.
Adolescent:
Highly individualized based on weight and clinical condition. Similar to adult dosing, but adjusted for body surface area or weight.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor fluid and electrolyte balance closely.
Moderate:
Reduced infusion rates may be necessary to prevent fluid overload and electrolyte imbalances. Close monitoring of serum electrolytes, BUN, creatinine, and urine output is essential.
Severe:
Contraindicated in anuria. In oliguric renal failure, use with extreme caution and significantly reduced rates, if at all, to avoid fluid overload and hypernatremia/hyperglycemia. Dialysis patients require specific fluid management.
Dialysis:
Fluid and electrolyte management is highly specific to the dialysis regimen. Generally, fluid intake is restricted, and this solution may be used only under strict medical supervision for specific indications (e.g., vehicle for medications) with careful volume control.
Hepatic Impairment:
Mild:
No specific dose adjustment, but monitor for fluid retention.
Moderate:
Use with caution due to potential for fluid retention and electrolyte disturbances, especially in patients with ascites or portal hypertension.
Severe:
Use with caution; monitor for fluid overload, hyponatremia, and other electrolyte imbalances. May exacerbate ascites or peripheral edema.
Pharmacology
Mechanism of Action
Dextrose 5%/Sodium Chloride 0.45% Injection provides water, electrolytes (sodium and chloride), and calories (dextrose). Dextrose is metabolized via glycolysis, providing energy (approximately 170 kcal/L) and sparing protein. The metabolism of dextrose leaves free water, which distributes throughout the total body water, aiding in hydration. Sodium and chloride are essential electrolytes for maintaining fluid balance, osmotic pressure, and acid-base equilibrium.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous administration)
Tmax:
Not applicable (immediate distribution)
FoodEffect:
Not applicable
Distribution:
Vd:
Distributes throughout total body water (for water and electrolytes); dextrose is rapidly taken up by cells.
ProteinBinding:
Not applicable (for water, dextrose, sodium, chloride)
CnssPenetration:
Yes (water, electrolytes, and glucose cross the blood-brain barrier)
Elimination:
HalfLife:
Not applicable (components are continuously utilized or excreted)
Clearance:
Varies based on metabolic rate and renal function (for water and electrolytes)
ExcretionRoute:
Water and electrolytes primarily renal; dextrose metabolized.
Unchanged:
Not applicable (components are utilized or excreted)
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Rapid, as fluid and electrolytes distribute and dextrose is metabolized.
DurationOfAction:
Dependent on infusion rate, patient's metabolic state, and renal function.
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
Signs of fluid and electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or passing out
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or change in the amount of urine produced
+ Dry mouth
+ Dry eyes
+ Severe upset stomach or vomiting
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
Swelling, warmth, numbness, change of color, 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 may not experience any side effects or only minor 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 guidance:
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, 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, 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
Signs of fluid and electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or passing out
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or change in the amount of urine produced
+ Dry mouth
+ Dry eyes
+ Severe upset stomach or vomiting
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
Swelling, warmth, numbness, change of color, 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 may not experience any side effects or only minor 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 guidance:
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, 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
- Confusion or dizziness
- Muscle weakness or cramps
- Headache
- Nausea or vomiting
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 this medication may interact with certain conditions.
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.
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 this medication may interact with certain conditions.
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.
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.
For medications containing dextrose, if you have diabetes (high blood sugar), discuss this with your doctor to ensure safe use.
Regular blood tests are crucial while taking this medication. Follow your doctor's instructions regarding the frequency and timing of these tests, and discuss the results with your doctor.
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, notify your doctor. It is crucial to discuss the benefits and risks of this medication to both you and your baby to make an informed decision.
If your medication contains potassium, consult your doctor before using any salt substitutes or products that also contain potassium.
For medications containing dextrose, if you have diabetes (high blood sugar), discuss this with your doctor to ensure safe use.
Regular blood tests are crucial while taking this medication. Follow your doctor's instructions regarding the frequency and timing of these tests, and discuss the results with your doctor.
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, notify your doctor. It is crucial to discuss the benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., peripheral edema, pulmonary congestion, elevated blood pressure)
- Electrolyte imbalances (e.g., hypernatremia, hyponatremia, hyperchloremia)
- Hyperglycemia (high blood sugar)
- Acidosis (due to excessive chloride or rapid dextrose metabolism)
- Cerebral edema (in severe hyponatremia)
What to Do:
Discontinue infusion immediately. Administer diuretics to manage fluid overload. Correct electrolyte imbalances as needed. Administer insulin if hyperglycemia is severe. Provide supportive care. Call 1-800-222-1222 for poison control if at home.
Drug Interactions
Contraindicated Interactions
- Patients with known allergy to corn or corn products (due to dextrose source)
- Patients with anuria or severe oliguria (risk of fluid overload)
- Patients with severe fluid overload or pulmonary edema
- Patients with uncompensated diabetes mellitus (risk of severe hyperglycemia)
Major Interactions
- Corticosteroids (may cause sodium and fluid retention, increasing risk of fluid overload and electrolyte imbalance)
- Drugs causing sodium retention (e.g., NSAIDs, some antihypertensives) - increased risk of fluid overload
- Insulin (exogenous insulin will affect glucose utilization and may require adjustment of infusion rate)
Moderate Interactions
- Diuretics (can alter fluid and electrolyte balance, requiring careful monitoring and adjustment of infusion)
- Drugs that increase ADH secretion (e.g., desmopressin, carbamazepine, SSRIs) - increased risk of hyponatremia due to free water retention
- Lithium (renal clearance of lithium may be affected by changes in sodium balance)
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl)
Rationale: To establish baseline electrolyte status and guide initial fluid therapy.
Timing: Prior to initiation of therapy
Renal Function (BUN, Creatinine)
Rationale: To assess kidney's ability to excrete fluid and electrolytes.
Timing: Prior to initiation of therapy
Blood Glucose
Rationale: To assess baseline glucose metabolism and identify hyperglycemia/hypoglycemia risk.
Timing: Prior to initiation of therapy
Fluid Status (BP, HR, Urine Output, Edema, Lung Sounds)
Rationale: To assess hydration status and risk of fluid overload.
Timing: Prior to initiation of therapy
Routine Monitoring
Fluid Balance (Intake/Output)
Frequency: Every 4-8 hours or as clinically indicated
Target: Positive or negative balance as per clinical goal
Action Threshold: Significant positive balance (e.g., >1-2 L/24h) or negative balance (e.g., >1-2 L/24h) without clinical indication; rapid weight changes.
Serum Electrolytes (Na, K, Cl)
Frequency: Daily or more frequently if clinically indicated (e.g., every 6-12 hours in critically ill patients)
Target: Na: 135-145 mEq/L; K: 3.5-5.0 mEq/L; Cl: 98-106 mEq/L
Action Threshold: Significant deviations from normal range (e.g., Na <130 or >150 mEq/L, K <3.0 or >5.5 mEq/L)
Blood Glucose
Frequency: Every 4-6 hours initially, then daily once stable, or as per hospital protocol for IV fluids
Target: 70-180 mg/dL (or as per institutional target)
Action Threshold: Persistent hyperglycemia (>180 mg/dL) or hypoglycemia (<70 mg/dL)
Vital Signs (BP, HR, RR)
Frequency: Every 4-8 hours or as clinically indicated
Target: Within patient's normal range
Action Threshold: Significant changes indicating fluid overload (e.g., increasing BP, HR, RR) or dehydration (e.g., decreasing BP, increasing HR)
Symptom Monitoring
- Peripheral edema (swelling in extremities)
- Pulmonary congestion (shortness of breath, crackles on lung auscultation)
- Headache, confusion, altered mental status (signs of hyponatremia or fluid overload)
- Excessive thirst, dry mucous membranes (signs of dehydration or hypernatremia)
- Muscle weakness, cramps, arrhythmias (signs of electrolyte imbalance)
- Nausea, vomiting
- Polyuria or oliguria
Special Patient Groups
Pregnancy
Generally considered safe for use during pregnancy when clinically indicated for fluid and electrolyte replacement or hydration. Careful monitoring of fluid and electrolyte balance is crucial to prevent complications for both mother and fetus. Category C.
Trimester-Specific Risks:
First Trimester:
No specific increased risks identified beyond general fluid/electrolyte management.
Second Trimester:
No specific increased risks identified beyond general fluid/electrolyte management.
Third Trimester:
No specific increased risks identified beyond general fluid/electrolyte management. Monitor for fluid overload, especially in pre-eclamptic patients.
Lactation
Compatible with breastfeeding. The components (water, dextrose, sodium, chloride) are naturally present in breast milk and are essential for infant nutrition. Use when clinically indicated and monitor maternal fluid and electrolyte balance.
Infant Risk:
L1 (Safest - compatible with breastfeeding)
Pediatric Use
Dosing is highly individualized based on weight, age, and clinical condition. Pediatric patients, especially neonates and infants, are at higher risk for fluid overload, electrolyte imbalances (e.g., hyponatremia), and glucose abnormalities. Careful monitoring of fluid intake/output, weight, serum electrolytes, and blood glucose is crucial.
Geriatric Use
Use with caution in elderly patients due to increased risk of fluid overload, electrolyte imbalances, and underlying renal, cardiac, or hepatic comorbidities. Slower infusion rates and meticulous monitoring of fluid status, vital signs, and laboratory parameters are often required.
Clinical Information
Clinical Pearls
- D5/0.45% NaCl is a common maintenance fluid, providing free water, some electrolytes, and minimal calories. It is not suitable for significant caloric replacement or treatment of severe dehydration alone.
- The dextrose component is rapidly metabolized, leaving free water. This can contribute to hyponatremia if not carefully monitored, especially in patients with impaired ADH regulation (e.g., post-operative patients, SIADH).
- Always assess patient's fluid status, electrolyte balance, and glucose levels before and during administration. Adjust infusion rate based on clinical response and laboratory findings.
- Not recommended for initial resuscitation in hypovolemic shock due to its hypotonicity after dextrose metabolism, which can lead to fluid shifting into the intracellular space.
- Consider alternative solutions (e.g., 0.9% NaCl, Lactated Ringer's) for volume expansion or specific electrolyte deficits.
Alternative Therapies
- Oral rehydration solutions (for mild to moderate dehydration in patients who can tolerate oral intake)
- Other intravenous crystalloids (e.g., balanced salt solutions) or colloids (e.g., albumin) depending on specific fluid, electrolyte, and oncotic pressure needs.
- Parenteral nutrition (for significant caloric and nutritional support).
Cost & Coverage
Average Cost:
$5 - $20 per 500ml bag
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (typically covered as part of hospital/clinic care or medical benefit)
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 guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed to 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, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the correct disposal method, consult your pharmacist for advice. Many communities offer 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 call 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 happened, as this will aid in providing appropriate treatment.