Dextrose 50% Injection Ftv 25x50ml
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 Nutrient Replenisher
Pharmacologic Class
Carbohydrate; Monosaccharide
Pregnancy Category
C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Dextrose is a type of sugar (glucose) that your body uses for energy. This injection is given directly into your vein to quickly raise your blood sugar if it gets too low (hypoglycemia), which can be dangerous. It helps restore your body's energy levels.
How to Use This Medicine
To use this medication correctly, follow your doctor's instructions and carefully read all accompanying information. Take this medication exactly as directed, and adhere to all guidelines provided. This drug is administered intravenously 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.
If you miss a dose, contact your doctor immediately 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.
If you miss a dose, contact your doctor immediately to receive guidance on the next steps to take.
Lifestyle & Tips
- Maintain regular meal times and snack schedules if prone to hypoglycemia.
- Monitor blood glucose levels as advised by your healthcare provider.
- Always carry a source of fast-acting sugar (e.g., glucose tablets, juice) if you have diabetes or are at risk for hypoglycemia.
- Inform your healthcare provider about all medications you are taking, especially insulin or other diabetes medications.
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 50% solution) IV push, may repeat if necessary
Dose Range:
10 - 50 mg
Condition-Specific Dosing:
hypoglycemia:
25 g IV push, may repeat once or twice if blood glucose remains low or drops
Pediatric Dosing
Neonatal:
Not typically recommended for routine use; if used for severe hypoglycemia, 0.2-0.5 g/kg/dose (1-2.5 mL/kg of 20% solution or 2-5 mL/kg of 10% solution) IV. 50% dextrose is too hypertonic for neonates.
Infant:
0.5-1 g/kg/dose (2-4 mL/kg of 25% solution or 5-10 mL/kg of 10% solution) IV. Max 25 g/dose. 50% dextrose is generally diluted or used in smaller volumes for older children.
Child:
0.5-1 g/kg/dose (2-4 mL/kg of 25% solution or 5-10 mL/kg of 10% solution) IV. Max 25 g/dose. 50% dextrose is generally diluted or used in smaller volumes for older children.
Adolescent:
25 g (50 mL of 50% solution) IV push, similar to adult dosing for hypoglycemia.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment; monitor fluid and electrolyte balance.
Moderate:
No specific dose adjustment; monitor fluid and electrolyte balance closely.
Severe:
No specific dose adjustment; monitor fluid and electrolyte balance and blood glucose closely due to potential for fluid overload and electrolyte shifts.
Dialysis:
No specific dose adjustment; monitor blood glucose and fluid status carefully. Dextrose is dialyzable.
Hepatic Impairment:
Mild:
No specific dose adjustment; monitor blood glucose.
Moderate:
No specific dose adjustment; monitor blood glucose closely as hepatic dysfunction can impair glucose regulation.
Severe:
No specific dose adjustment; monitor blood glucose closely as hepatic dysfunction can impair glucose regulation and glycogenolysis.
Pharmacology
Mechanism of Action
Dextrose is a monosaccharide (glucose) that serves as the primary energy source for cellular metabolism. When administered intravenously, it rapidly increases blood glucose levels, reversing hypoglycemia and providing calories. It is readily utilized by tissues for energy or converted to glycogen for storage in the liver and muscles, or to fat.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Not applicable (IV administration, immediate effect)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.6 L/kg (total body water)
ProteinBinding:
0%
CnssPenetration:
Yes
Elimination:
HalfLife:
Variable, depends on metabolic rate and glucose utilization (rapidly consumed)
Clearance:
Rapid, dependent on cellular uptake and metabolism
ExcretionRoute:
Primarily metabolized to CO2 and H2O; minimal renal excretion of unchanged glucose unless blood glucose levels exceed renal threshold
Unchanged:
<1% (typically, unless hyperglycemic)
Pharmacodynamics
OnsetOfAction:
Immediate (within minutes for hypoglycemia reversal)
PeakEffect:
Within minutes
DurationOfAction:
Short, dependent on patient's metabolic state and underlying cause of hypoglycemia
Safety & Warnings
Side Effects
Serious Side Effects: Seek Medical Attention Immediately
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 medical help right away:
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 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 or seek medical help right away:
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 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:
- Symptoms of hypoglycemia (low blood sugar): shakiness, sweating, confusion, dizziness, hunger, rapid heartbeat, blurred vision, anxiety, irritability, headache, seizures, loss of consciousness.
- Symptoms of hyperglycemia (high blood sugar, if too much dextrose is given or in diabetic patients): increased thirst, frequent urination, fatigue, blurred vision, nausea, dry mouth.
- Symptoms of fluid overload: shortness of breath, swelling in ankles/feet, rapid weight gain.
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 if you are a premature infant. It is crucial to discuss this potential risk with your doctor.
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 about these risks, 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 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 if you are a premature infant. It is crucial to discuss this potential risk with your doctor.
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 about these risks, 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 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)
- Osmotic diuresis (excessive urination leading to dehydration)
- Electrolyte imbalances (e.g., hypokalemia, hyponatremia)
- Fluid overload (e.g., pulmonary edema, peripheral edema)
- Cerebral edema (especially in children or with rapid correction of chronic hypoglycemia)
- Coma, seizures
What to Do:
Stop the infusion immediately. Administer insulin if needed to lower blood glucose. Correct fluid and electrolyte imbalances. Provide supportive care. In case of suspected overdose, call emergency services or Poison Control at 1-800-222-1222.
Drug Interactions
Moderate Interactions
- Insulin (antagonistic effect on blood glucose)
- Thiazide diuretics (may increase blood glucose)
- Loop diuretics (may increase blood glucose)
- Corticosteroids (may increase blood glucose)
Monitoring
Baseline Monitoring
Blood Glucose
Rationale: To confirm hypoglycemia and establish baseline for treatment effectiveness.
Timing: Prior to administration
Electrolytes (Na, K)
Rationale: To assess baseline electrolyte status, especially if fluid shifts or imbalances are anticipated.
Timing: Prior to administration (if clinically indicated)
Routine Monitoring
Blood Glucose
Frequency: Every 15-30 minutes initially, then hourly until stable, or as clinically indicated.
Target: 70-180 mg/dL (or as per institutional protocol)
Action Threshold: If blood glucose remains low (<70 mg/dL) or drops again, repeat dose or initiate continuous infusion. If blood glucose becomes excessively high (>200 mg/dL), consider insulin or reducing dextrose administration.
Electrolytes (Potassium, Sodium)
Frequency: As clinically indicated, especially with large or repeated doses, or in patients with renal/cardiac dysfunction.
Target: Normal physiological ranges
Action Threshold: Correct imbalances as needed (e.g., potassium supplementation for hypokalemia).
Fluid Balance (Intake & Output, signs of fluid overload)
Frequency: Continuously during administration, especially with large volumes or in patients at risk for fluid overload.
Target: Euvolemic state
Action Threshold: Reduce rate or administer diuretics if signs of fluid overload (e.g., dyspnea, crackles, edema) occur.
Symptom Monitoring
- Mental status (alertness, confusion, disorientation)
- Level of consciousness
- Seizure activity
- Signs of fluid overload (e.g., dyspnea, crackles, peripheral edema)
- Signs of phlebitis or extravasation at injection site
Special Patient Groups
Pregnancy
Generally considered safe and often used for emergency treatment of severe maternal hypoglycemia. Close monitoring of maternal and fetal glucose levels is recommended.
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. Dextrose is a natural component of breast milk and is not expected to cause adverse effects in the infant.
Infant Risk:
L1 (Safest)
Pediatric Use
Use with caution, especially in neonates and infants, due to increased risk of hyperglycemia, osmotic diuresis, and cerebral edema. Lower concentrations (e.g., 10%, 25%) or diluted 50% dextrose are generally preferred. Close monitoring of blood glucose and fluid status is crucial.
Geriatric Use
No specific dose adjustment needed, but monitor closely for fluid overload and electrolyte imbalances, particularly in patients with pre-existing cardiac, renal, or diabetic comorbidities. May be more susceptible to fluid shifts.
Clinical Information
Clinical Pearls
- Dextrose 50% is highly hypertonic (approx. 2525 mOsm/L) and should ideally be administered into a large peripheral vein or central line to minimize vein irritation, phlebitis, and extravasation injury.
- Rapid administration of D50W for chronic hypoglycemia (e.g., in alcoholics or malnourished patients) can lead to osmotic demyelination syndrome (central pontine myelinolysis). Correct chronic hypoglycemia gradually.
- Always confirm hypoglycemia with a blood glucose reading before administering D50W, if possible, to avoid unnecessary hyperglycemia.
- Consider the underlying cause of hypoglycemia and treat it appropriately (e.g., administer glucagon if due to insulin overdose and IV access is difficult, or provide sustained carbohydrate intake).
- Monitor for rebound hypoglycemia after administration, especially if the underlying cause is not resolved or if the patient is on insulin or oral hypoglycemic agents.
- Ensure patent IV access before administration; extravasation can cause tissue necrosis due to hypertonicity.
Alternative Therapies
- Oral glucose (e.g., glucose tablets, sugary drinks, candy) for conscious patients with mild to moderate hypoglycemia.
- Glucagon injection (intramuscular, subcutaneous, or intravenous) for severe hypoglycemia, especially when IV access is difficult or unavailable.
- Continuous intravenous dextrose infusion (e.g., D10W) for ongoing glucose support after initial bolus.
Cost & Coverage
Average Cost:
Low cost (typically <$10 per 50mL vial) per 50mL vial
Generic Available:
Yes
Insurance Coverage:
Covered by most insurance plans as it is a generic, essential medication.
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 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 guidance. 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 quantity, and the time of ingestion to ensure prompt and effective treatment.