Dextrose 50% 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
Antihypoglycemic agent, 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 50% Injection is a sugar solution given directly into a vein to quickly raise blood sugar levels. It's used in emergencies when someone's blood sugar is dangerously low (hypoglycemia) and they can't take sugar by mouth.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. Adhere to 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 for guidance on proper storage procedures.
Missing a 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. Adhere to 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 for guidance on proper storage procedures.
Missing a Dose
If you miss a dose, contact your doctor to determine the best course of action.
Lifestyle & Tips
- This medication is for acute, emergency use. Long-term management of blood sugar requires dietary control, regular exercise, and potentially other medications as prescribed by a doctor.
- Patients with diabetes should carry a source of fast-acting sugar (e.g., glucose tablets, juice) for mild to moderate hypoglycemia.
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:
25 g (50 mL of Dextrose 50% Injection) intravenously, administered slowly
Dose Range:
25 - 50 mg
Condition-Specific Dosing:
acuteHypoglycemia:
25 g (50 mL of Dextrose 50% Injection) IV push, may repeat if blood glucose remains low.
Pediatric Dosing
Neonatal:
0.25-0.5 g/kg (2-4 mL/kg of Dextrose 12.5% or 25% solution) IV slowly. Dextrose 50% is generally not recommended due to hyperosmolarity and vein irritation; if used, dilute to lower concentrations.
Infant:
0.5-1 g/kg (2-4 mL/kg of Dextrose 25% solution) IV slowly. Dextrose 50% is generally not recommended; if used, dilute to lower concentrations.
Child:
0.5-1 g/kg (1-2 mL/kg of Dextrose 50% solution) IV slowly, maximum 25 g per dose. Dextrose 50% should be diluted or administered cautiously due to hyperosmolarity.
Adolescent:
0.5-1 g/kg (1-2 mL/kg of Dextrose 50% solution) IV slowly, maximum 25 g per dose. For severe hypoglycemia, 25 g (50 mL of Dextrose 50% Injection) IV slowly.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment for acute hypoglycemia, monitor fluid and electrolyte balance.
Moderate:
No specific dose adjustment for acute hypoglycemia, monitor fluid and electrolyte balance closely.
Severe:
No specific dose adjustment for acute hypoglycemia, monitor fluid and electrolyte balance and glucose levels very closely due to potential for fluid overload and electrolyte disturbances.
Dialysis:
Administer post-dialysis if needed for hypoglycemia. Monitor glucose and electrolytes carefully.
Hepatic Impairment:
Mild:
No specific dose adjustment for acute hypoglycemia.
Moderate:
No specific dose adjustment for acute hypoglycemia.
Severe:
No specific dose adjustment for acute hypoglycemia, but monitor glucose levels closely as hepatic glucose production may be impaired.
Pharmacology
Mechanism of Action
Dextrose (D-glucose) is a monosaccharide that serves as the primary source of energy for cellular metabolism. When administered intravenously, it rapidly increases blood glucose levels, providing an immediate source of carbohydrate calories. It is metabolized to carbon dioxide and water, releasing energy.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Not applicable (IV administration, immediate effect)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.6 L/kg (distributes into total body water)
ProteinBinding:
0%
CnssPenetration:
Yes
Elimination:
HalfLife:
Highly variable, depends on metabolic rate and glucose utilization; rapidly utilized
Clearance:
Highly variable, depends on metabolic rate and renal threshold
ExcretionRoute:
Metabolized to CO2 and water; excess glucose excreted renally if renal threshold is exceeded
Unchanged:
<1% (typically, unless renal threshold is exceeded)
Pharmacodynamics
OnsetOfAction:
Immediate (within minutes for blood glucose elevation)
PeakEffect:
Within 10-15 minutes (for blood glucose elevation)
DurationOfAction:
Variable, depends on patient's metabolic state and underlying cause of hypoglycemia; typically short-lived unless continuous 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 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 may only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, 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 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 may only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, 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:
- Symptoms of persistent or recurring hypoglycemia (e.g., confusion, sweating, tremors, weakness, seizures) after administration, requiring further medical attention.
- Symptoms of hyperglycemia (e.g., excessive thirst, frequent urination, blurred vision) if blood sugar rises too high.
- Signs of fluid overload (e.g., difficulty breathing, swelling in legs/ankles).
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
Please note that this is not an exhaustive list of all potential interactions between this medication and other health issues.
To ensure your safety, it is crucial to discuss all of your:
Prescription and over-the-counter (OTC) medications
Natural products
Vitamins
Health problems
with your doctor and pharmacist. This will help determine whether it is safe to take this medication in conjunction with your other 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 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
Please note that this is not an exhaustive list of all potential interactions between this medication and other health issues.
To ensure your safety, it is crucial to discuss all of your:
Prescription and over-the-counter (OTC) medications
Natural products
Vitamins
Health problems
with your doctor and pharmacist. This will help determine whether it is safe to take this medication in conjunction with your other 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. 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. Your doctor will need to closely monitor you for any potential complications.
In some cases, this medication may be mixed with parenteral nutrition (PN). However, PN has been associated with serious side effects, 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 risks, be sure to discuss them with your doctor.
When used in newborns, this medication requires careful monitoring. Your doctor will need to assess the potential benefits and risks of using this medication in this age group.
If you are pregnant, planning to become pregnant, or are breast-feeding, it is crucial to inform your doctor. You and your doctor will need to discuss the potential benefits and risks of using this medication during this time to 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. Your doctor will need to closely monitor you for any potential complications.
In some cases, this medication may be mixed with parenteral nutrition (PN). However, PN has been associated with serious side effects, 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 risks, be sure to discuss them with your doctor.
When used in newborns, this medication requires careful monitoring. Your doctor will need to assess the potential benefits and risks of using this medication in this age group.
If you are pregnant, planning to become pregnant, or are breast-feeding, it is crucial to inform your doctor. You and your doctor will need to discuss the potential benefits and risks of using this medication during this time to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Severe hyperglycemia (very high blood sugar)
- Osmotic diuresis (excessive urination leading to dehydration)
- Hyperosmolar hyperglycemic state (HHS)
- Fluid overload (pulmonary edema, peripheral edema)
- Electrolyte imbalances (e.g., hypokalemia, hypophosphatemia, hypomagnesemia)
- Cerebral edema (rare, especially in children or with rapid correction of chronic hypoglycemia)
What to Do:
Immediate medical attention is required. Management involves stopping dextrose administration, administering insulin if indicated, correcting fluid and electrolyte imbalances, and supportive care. Call 911 or Poison Control at 1-800-222-1222.
Drug Interactions
Moderate Interactions
- Insulin (pharmacodynamic antagonism, requires dose adjustment)
- Oral hypoglycemic agents (pharmacodynamic antagonism, requires dose adjustment)
- Corticosteroids (may increase glucose requirements)
- Diuretics (e.g., thiazides, loop diuretics - may alter electrolyte balance, especially potassium and magnesium, requiring careful monitoring)
Monitoring
Baseline Monitoring
Blood Glucose
Rationale: To confirm hypoglycemia and establish baseline for treatment effectiveness.
Timing: Prior to administration
Electrolytes (Potassium, Phosphate, Magnesium)
Rationale: To assess baseline status and anticipate potential shifts during glucose administration (e.g., hypokalemia, hypophosphatemia, hypomagnesemia due to intracellular shift with insulin release).
Timing: Prior to administration, especially in malnourished or alcoholic patients
Routine Monitoring
Blood Glucose
Frequency: Every 15-30 minutes initially, then hourly or as clinically indicated
Target: 70-180 mg/dL (or as per institutional protocol for target glucose)
Action Threshold: If blood glucose remains <70 mg/dL, consider repeat dose; if >180 mg/dL, consider reducing infusion rate (if on continuous infusion) or alternative management.
Electrolytes (Potassium, Phosphate, Magnesium)
Frequency: Every 4-6 hours or as clinically indicated, especially with continuous infusions or in high-risk patients
Target: Normal physiological ranges
Action Threshold: Supplementation may be required if levels drop below normal range.
Fluid Balance (Intake/Output, Edema)
Frequency: Every 4-8 hours or as clinically indicated
Target: Balanced fluid status
Action Threshold: Signs of fluid overload (e.g., pulmonary edema) require immediate intervention.
Symptom Monitoring
- Resolution of hypoglycemic symptoms (e.g., confusion, tremor, sweating, weakness, seizures)
- Signs of hyperglycemia (e.g., polyuria, polydipsia, blurred vision)
- Signs of fluid overload (e.g., dyspnea, crackles, peripheral edema)
- Signs of phlebitis or extravasation at injection site
Special Patient Groups
Pregnancy
Dextrose is generally considered safe and necessary for the treatment of acute, severe hypoglycemia in pregnant women. Untreated severe hypoglycemia poses a greater risk to both mother and fetus than the administration of dextrose. However, prolonged or excessive administration should be avoided due to potential for fetal hyperglycemia and hyperinsulinemia.
Trimester-Specific Risks:
First Trimester:
Generally safe for acute use; untreated hypoglycemia is a greater risk.
Second Trimester:
Generally safe for acute use; untreated hypoglycemia is a greater risk.
Third Trimester:
Generally safe for acute use; untreated hypoglycemia is a greater risk. Monitor for fetal hyperglycemia if prolonged high-dose infusions are used.
Lactation
Dextrose is a natural component of breast milk. Acute administration for hypoglycemia is unlikely to pose a significant risk to the breastfed infant. Monitor the infant for any unusual symptoms, though unlikely.
Infant Risk:
Low risk
Pediatric Use
Dextrose 50% is hyperosmolar and can cause vein irritation, phlebitis, and extravasation, especially in neonates and infants. Lower concentrations (D10W, D12.5W, D25W) are generally preferred and safer for pediatric patients. Dosing is weight-based (g/kg). Careful monitoring of blood glucose and electrolytes is crucial due to higher metabolic rates and smaller fluid compartments.
Geriatric Use
Elderly patients may be more susceptible to fluid overload, electrolyte imbalances, and hyperglycemia. Use with caution and monitor fluid status, electrolytes, and blood glucose closely. Lower initial doses or slower administration rates may be considered.
Clinical Information
Clinical Pearls
- Dextrose 50% is highly hypertonic (2525 mOsm/L) and should be administered into a large vein to minimize the risk of phlebitis and extravasation. Avoid small peripheral veins.
- Always confirm hypoglycemia with a blood glucose measurement before administering Dextrose 50% if possible, unless the patient is seizing or unconscious and hypoglycemia is strongly suspected.
- After initial bolus, consider a continuous dextrose infusion (e.g., D10W) if the underlying cause of hypoglycemia is ongoing (e.g., sulfonylurea overdose, insulinoma) to prevent recurrence.
- Monitor for electrolyte shifts, particularly hypokalemia, hypophosphatemia, and hypomagnesemia, as glucose administration can drive these electrolytes intracellularly, especially in malnourished or alcoholic patients.
- Extravasation of Dextrose 50% can cause severe tissue necrosis. If extravasation occurs, stop infusion immediately, aspirate residual drug, and consider hyaluronidase injection.
Alternative Therapies
- Oral glucose (for conscious patients with mild-moderate hypoglycemia)
- Glucagon (intramuscular or subcutaneous, for unconscious patients where IV access is difficult or delayed)
- Other intravenous dextrose concentrations (e.g., D10W, D25W for continuous infusions or pediatric use)
Cost & Coverage
Average Cost:
$5 - $20 per 50 mL 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 promptly. 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 to do so by a healthcare professional, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the proper 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.