Dextrose 70% Inj, 2000ml
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
Caloric agent; Fluid and electrolyte replacement
Pharmacologic Class
Carbohydrate; Monosaccharide
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Dextrose 70% Injection is a concentrated sugar solution given through a vein, usually a large vein in the chest (central line). It provides energy (calories) to your body when you cannot eat or absorb enough food, or when your body needs extra sugar. It's often part of a complete nutrition mixture called TPN.
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 to receive guidance on the next steps to take.
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 to receive guidance on the next steps to take.
Lifestyle & Tips
- This medication is administered intravenously, typically in a hospital or clinical setting. No specific lifestyle modifications are required by the patient related to its administration, but underlying conditions requiring its use may necessitate dietary or activity adjustments.
- Patients receiving this infusion will have their blood sugar levels closely monitored.
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 caloric needs, metabolic state, and glucose tolerance. Typically administered as part of a Total Parenteral Nutrition (TPN) regimen via central venous access. Glucose infusion rates commonly range from 4 to 7 mg/kg/min (equivalent to 5.76 to 10.08 g/kg/day). For 70% Dextrose, this would be a component of the total fluid volume.
Dose Range:
4 - 7 mg
Condition-Specific Dosing:
TPN:
Glucose infusion rate (GIR) 4-7 mg/kg/min, adjusted to maintain blood glucose within target range (e.g., 110-150 mg/dL).
Hypoglycemia (severe):
Not typically used as a bolus for acute hypoglycemia due to high concentration; 50% Dextrose is more common. If used, it would be diluted or administered very slowly with extreme caution.
Hyperkalemia:
Often given with insulin to drive potassium intracellularly. Dextrose 70% may be used as part of a continuous infusion to prevent hypoglycemia from insulin, but specific bolus doses for hyperkalemia are usually 50% Dextrose.
Pediatric Dosing
Neonatal:
Glucose infusion rate (GIR) 4-8 mg/kg/min, adjusted based on blood glucose levels and metabolic needs. Close monitoring is essential.
Infant:
Glucose infusion rate (GIR) 3-5 mg/kg/min, adjusted based on blood glucose levels and metabolic needs.
Child:
Glucose infusion rate (GIR) 3-5 mg/kg/min, adjusted based on blood glucose levels and metabolic needs.
Adolescent:
Glucose infusion rate (GIR) 4-7 mg/kg/min, adjusted based on blood glucose levels and metabolic needs.
Dose Adjustments
Renal Impairment:
Mild:
No specific dose adjustment, but monitor blood glucose and fluid balance closely.
Moderate:
No specific dose adjustment, but monitor blood glucose, fluid balance, and electrolytes (especially potassium, phosphate) closely. May require lower glucose infusion rates if glucose intolerance develops.
Severe:
No specific dose adjustment, but monitor blood glucose, fluid balance, and electrolytes very closely. May require lower glucose infusion rates. Risk of fluid overload and electrolyte imbalances is higher.
Dialysis:
Monitor blood glucose and fluid balance closely. Dextrose may be removed during dialysis, requiring adjustments to infusion rates. Electrolyte management is critical.
Hepatic Impairment:
Mild:
No specific dose adjustment, but monitor blood glucose and liver function tests (LFTs) closely.
Moderate:
No specific dose adjustment, but monitor blood glucose and LFTs closely. May have impaired glucose tolerance, requiring lower glucose infusion rates or concomitant insulin.
Severe:
No specific dose adjustment, but monitor blood glucose and LFTs very closely. Significant risk of impaired glucose tolerance and metabolic complications. May require lower glucose infusion rates and careful insulin management.
Pharmacology
Mechanism of Action
Dextrose is a monosaccharide (glucose) that serves as the primary energy source for cellular metabolism. When administered intravenously, it provides calories, helps maintain fluid balance, and can raise blood glucose levels. It is metabolized via glycolysis and the Krebs cycle to produce ATP, carbon dioxide, and water.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous administration)
Tmax:
Rapid (immediate distribution upon infusion)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.6 L/kg (distributes throughout total body water)
ProteinBinding:
None
CnssPenetration:
Yes (glucose readily crosses the blood-brain barrier)
Elimination:
HalfLife:
Highly variable, depends on metabolic rate and glucose utilization (typically very short, minutes)
Clearance:
Metabolic clearance (rate of glucose utilization)
ExcretionRoute:
Metabolized to carbon dioxide (exhaled) and water (excreted renally or utilized)
Unchanged:
Less than 1% (under normal conditions)
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Rapid (within minutes of infusion initiation or rate change)
DurationOfAction:
Dependent on infusion rate and patient's metabolic demand; effects cease rapidly upon discontinuation of infusion.
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 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.
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 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.
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 high blood sugar (hyperglycemia): increased thirst, increased urination, blurred vision, fatigue, confusion.
- Symptoms of low blood sugar (hypoglycemia): sweating, shakiness, dizziness, confusion, rapid heartbeat, extreme hunger.
- Symptoms at the IV site: pain, redness, swelling, warmth, or leakage around the catheter site (especially if administered peripherally, which is not recommended for 70% dextrose).
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.
Certain health conditions, including:
+ Bleeding in the brain or spine
+ Severe dehydration
+ Severe liver problems
+ Difficulty passing urine
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor.
To ensure safe treatment, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Natural products and vitamins you are using
* Any health problems you have
Before making any changes to your medication regimen, including starting, stopping, or adjusting the dose of any drug, consult with your doctor to confirm it is safe to do so.
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.
Certain health conditions, including:
+ Bleeding in the brain or spine
+ Severe dehydration
+ Severe liver problems
+ Difficulty passing urine
This list is not exhaustive, and it is crucial to discuss all your health problems and medications with your doctor.
To ensure safe treatment, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter medications you are taking
Natural products and vitamins you are using
* Any health problems you have
Before making any changes to your medication regimen, including starting, stopping, or adjusting the dose of any drug, consult with your doctor to confirm it is safe to do so.
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 higher if you have kidney problems or are a premature infant. Your doctor will need to monitor you closely to minimize this risk.
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 PN, discuss them with your doctor.
When used in newborns, this medication requires careful monitoring. Your doctor will need to weigh the benefits and risks of treatment in this age group.
If you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor. They will help you discuss the potential benefits and risks of this medication to both you and your baby, and determine the best course of treatment.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is higher if you have kidney problems or are a premature infant. Your doctor will need to monitor you closely to minimize this risk.
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 PN, discuss them with your doctor.
When used in newborns, this medication requires careful monitoring. Your doctor will need to weigh the benefits and risks of treatment in this age group.
If you are pregnant, planning to become pregnant, or are breast-feeding, inform your doctor. They will help you discuss the potential benefits and risks of this medication to both you and your baby, and determine the best course of treatment.
Overdose Information
Overdose Symptoms:
- Severe hyperglycemia (very high blood sugar)
- Osmotic diuresis (excessive urination leading to dehydration)
- Electrolyte imbalances (e.g., hypokalemia, hypophosphatemia)
- Fluid overload (edema, shortness of breath, heart failure)
- Hyperosmolar hyperglycemic state (HHS) in severe cases
What to Do:
Immediate medical attention is required. Management involves stopping or reducing the infusion rate, administering insulin to lower blood glucose, correcting fluid and electrolyte imbalances, and supportive care. Call 1-800-222-1222 (Poison Control) or seek emergency medical help.
Drug Interactions
Major Interactions
Moderate Interactions
- Diuretics (e.g., loop diuretics, thiazide diuretics: can affect fluid and electrolyte balance, requiring careful monitoring when co-administering dextrose solutions)
- Certain antibiotics (e.g., ampicillin, erythromycin, tetracycline): Incompatibility issues when mixed directly in the same IV line or bag due to pH or precipitation.
- Electrolyte supplements (e.g., potassium phosphate): Must be carefully balanced in TPN solutions to avoid precipitation with calcium.
Monitoring
Baseline Monitoring
Blood Glucose
Rationale: To establish baseline metabolic state and guide initial infusion rate.
Timing: Prior to initiation of infusion
Serum Electrolytes (Na, K, Cl, HCO3, Mg, PO4, Ca)
Rationale: To assess baseline electrolyte status, especially important for TPN components.
Timing: Prior to initiation of infusion
Renal Function (BUN, Creatinine)
Rationale: To assess kidney function, which impacts fluid and electrolyte balance.
Timing: Prior to initiation of infusion
Liver Function Tests (ALT, AST, Alk Phos, Bilirubin)
Rationale: To assess baseline liver function, especially important for prolonged TPN.
Timing: Prior to initiation of infusion
Fluid Status (Weight, I&O)
Rationale: To establish baseline hydration status and guide fluid management.
Timing: Prior to initiation of infusion
Routine Monitoring
Blood Glucose
Frequency: Every 4-6 hours initially, then daily once stable
Target: 110-150 mg/dL (or per institutional protocol)
Action Threshold: Below 70 mg/dL (hypoglycemia) or above 180-200 mg/dL (hyperglycemia)
Serum Electrolytes (Na, K, Cl, HCO3)
Frequency: Daily initially, then 2-3 times per week once stable
Target: Normal physiological ranges
Action Threshold: Significant deviations from normal range
Serum Magnesium, Phosphate, Calcium
Frequency: Daily initially, then 2-3 times per week once stable
Target: Normal physiological ranges
Action Threshold: Significant deviations from normal range
Renal Function (BUN, Creatinine)
Frequency: 2-3 times per week
Target: Normal physiological ranges
Action Threshold: Significant increase indicating renal impairment
Liver Function Tests (ALT, AST, Alk Phos, Bilirubin)
Frequency: Weekly or bi-weekly for prolonged infusions
Target: Normal physiological ranges
Action Threshold: Significant elevation indicating liver dysfunction
Fluid Balance (Intake/Output, Daily Weight)
Frequency: Daily
Target: Stable weight, balanced I&O
Action Threshold: Significant weight gain/loss, positive/negative fluid balance
Triglycerides (if lipids co-administered)
Frequency: Weekly or bi-weekly
Target: <400 mg/dL
Action Threshold: >400 mg/dL
Symptom Monitoring
- Signs of hyperglycemia (polyuria, polydipsia, blurred vision, fatigue, confusion, nausea, vomiting)
- Signs of hypoglycemia (sweating, tremor, palpitations, anxiety, hunger, confusion, dizziness, weakness, seizures, loss of consciousness)
- Signs of fluid overload (edema, dyspnea, crackles, elevated blood pressure)
- Signs of phlebitis/infiltration at IV site (pain, redness, swelling, warmth, streaking)
Special Patient Groups
Pregnancy
Category C. Dextrose is a natural component of human metabolism. However, high concentrations or rapid infusions can cause hyperglycemia and osmotic diuresis, potentially affecting both mother and fetus. Use with caution, and monitor maternal and fetal glucose levels closely. Benefits must outweigh potential risks.
Trimester-Specific Risks:
First Trimester:
Risk of hyperglycemia and metabolic disturbances, which could theoretically impact early fetal development if not managed.
Second Trimester:
Risk of hyperglycemia and metabolic disturbances, requiring careful monitoring.
Third Trimester:
Risk of hyperglycemia and metabolic disturbances, potential for fetal hyperglycemia and subsequent neonatal hypoglycemia if maternal glucose is not well controlled.
Lactation
Dextrose is compatible with breastfeeding. It is a natural component of breast milk. No adverse effects on the infant are expected when administered to the mother in therapeutic doses.
Infant Risk:
Low risk
Pediatric Use
Requires very careful monitoring of glucose infusion rates (GIR), blood glucose levels, and fluid balance due to higher metabolic rates, smaller fluid volumes, and immature metabolic pathways in neonates and infants. Risk of hyperglycemia, hypoglycemia, and fluid/electrolyte imbalances is higher. Central venous access is almost always required for 70% dextrose.
Geriatric Use
Monitor closely for fluid overload, electrolyte imbalances, and glucose intolerance. Elderly patients may have reduced renal or cardiac function, increasing the risk of complications. Start with lower infusion rates and titrate carefully.
Clinical Information
Clinical Pearls
- Dextrose 70% is a highly hypertonic solution (approx. 3535 mOsm/L) and MUST be administered via a central venous catheter to prevent severe phlebitis, thrombosis, and tissue necrosis.
- This concentration is primarily used as a component of Total Parenteral Nutrition (TPN) to provide significant caloric support.
- Always monitor blood glucose levels frequently, especially when initiating or adjusting infusion rates. Insulin is often required concomitantly to manage hyperglycemia.
- Careful monitoring of fluid balance, electrolytes (Na, K, Mg, PO4, Ca), and renal/hepatic function is crucial, particularly during prolonged infusions.
- Abrupt discontinuation of high-rate dextrose infusions can lead to rebound hypoglycemia; rates should be tapered gradually or replaced with a lower concentration dextrose infusion (e.g., D10W) if TPN is stopped suddenly.
Alternative Therapies
- Lipid emulsions (provide calories and essential fatty acids, often co-administered with dextrose in TPN)
- Amino acid solutions (provide protein for tissue repair and synthesis, co-administered in TPN)
- Oral or enteral nutrition (preferred route for nutrient delivery when feasible)
Cost & Coverage
Average Cost:
Varies widely by supplier, volume, and specific formulation (e.g., pre-mixed TPN vs. bulk solution). Generally inexpensive per liter. per 2000ml bag
Generic Available:
Yes
Insurance Coverage:
Generally covered by most insurance plans as a necessary medical supply/medication when prescribed.
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety and the safety of others, never share your medication with anyone, and do not take medication prescribed to someone else.
Store all medications in a secure location, out of the 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 or pharmacist, do not flush medications down the toilet or drain. 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; check with your pharmacist for more information. If you have any questions or concerns about your medication, it is crucial to 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 detailed information about the medication, including the amount taken and the time of ingestion, to ensure you receive appropriate care.
Store all medications in a secure location, out of the 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 or pharmacist, do not flush medications down the toilet or drain. 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; check with your pharmacist for more information. If you have any questions or concerns about your medication, it is crucial to 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 detailed information about the medication, including the amount taken and the time of ingestion, to ensure you receive appropriate care.