Ionosol-Mb D5w 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; Parenteral Nutrition
Pharmacologic Class
Electrolyte Solution; Carbohydrate Solution
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medication is an intravenous (IV) fluid, meaning it's given directly into your vein. It contains water, a type of sugar (dextrose), and essential salts (electrolytes) like sodium, potassium, and magnesium. It's used to help keep your body hydrated, provide some energy, and maintain the right balance of salts in your blood, especially when you can't drink enough fluids or have lost a lot of fluids.
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
- Report any discomfort at the IV site (pain, swelling, redness).
- Report any new or worsening symptoms such as swelling in your hands, feet, or ankles, difficulty breathing, unusual thirst, muscle weakness, or confusion.
- Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
Highly individualized based on patient's fluid, electrolyte, and caloric needs. Typically administered at maintenance rates (e.g., 40-100 mL/hour) or higher for replacement.
Dose Range:
40 - 200 mg
Condition-Specific Dosing:
maintenance:
Typically 40-100 mL/hour, adjusted for individual needs.
replacement:
Higher rates (e.g., 100-200 mL/hour or more) may be used for acute fluid or electrolyte deficits, guided by clinical assessment and laboratory values.
Pediatric Dosing
Neonatal:
Highly individualized, typically 60-100 mL/kg/day, adjusted for gestational age, postnatal age, and clinical condition. Close monitoring of electrolytes and glucose is crucial.
Infant:
Highly individualized, typically 100-150 mL/kg/day, adjusted for clinical condition and laboratory values.
Child:
Highly individualized, typically 60-100 mL/kg/day, adjusted for clinical condition and laboratory values.
Adolescent:
Highly individualized, similar to adult dosing, adjusted for weight and clinical condition.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor electrolytes (especially potassium, magnesium, phosphate) and fluid status closely.
Moderate:
Reduced rates and careful monitoring of electrolytes (especially potassium, magnesium, phosphate) and fluid balance are essential. May require specific electrolyte adjustments or alternative fluids.
Severe:
Contraindicated or used with extreme caution and close monitoring due to risk of fluid overload and severe electrolyte imbalances (hyperkalemia, hypermagnesemia, hyperphosphatemia). May require dialysis.
Dialysis:
Fluid and electrolyte administration must be carefully coordinated with dialysis schedule and patient's interdialytic weight gain and electrolyte levels. Often requires specific fluid formulations.
Hepatic Impairment:
Mild:
Generally no specific dose adjustment required, but monitor for fluid retention.
Moderate:
Monitor for fluid retention and electrolyte imbalances. Acetate component is metabolized by the liver, but typically not a major concern unless severe hepatic failure.
Severe:
Monitor closely for fluid retention, ascites, and electrolyte disturbances. Use with caution.
Pharmacology
Mechanism of Action
Ionosol-Mb D5W provides water, dextrose (carbohydrate source), and a balanced mixture of electrolytes (sodium, potassium, magnesium, chloride, phosphate, acetate). It helps to maintain or restore fluid and electrolyte balance, provides calories for energy, and prevents dehydration. Dextrose is metabolized to carbon dioxide and water, providing free water and energy. Acetate is metabolized to bicarbonate, contributing to the buffering capacity of the blood.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Immediate (upon completion of infusion)
FoodEffect:
Not applicable (intravenous administration)
Distribution:
Vd:
Water and electrolytes distribute throughout the total body water. Dextrose distributes throughout extracellular and intracellular fluid.
ProteinBinding:
Negligible for electrolytes and dextrose.
CnssPenetration:
Yes (water, electrolytes, and dextrose cross the blood-brain barrier)
Elimination:
HalfLife:
Variable, dependent on patient's fluid and electrolyte status, renal function, and metabolic rate.
Clearance:
Electrolytes are primarily cleared renally. Dextrose is metabolized.
ExcretionRoute:
Renal (electrolytes, water), Respiratory (CO2 from dextrose metabolism), Insensible losses (water).
Unchanged:
Electrolytes are excreted largely unchanged, though their concentrations are tightly regulated.
Pharmacodynamics
OnsetOfAction:
Immediate (upon initiation of infusion)
PeakEffect:
Rapid, as fluid and electrolytes are distributed and utilized.
DurationOfAction:
Dependent on the rate of infusion, patient's physiological needs, and ongoing losses. Effects persist as long as infusion continues and for a period thereafter until equilibrium is re-established.
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 fainting
+ Increased thirst
+ Seizures
+ Feeling extremely 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 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 fainting
+ Increased thirst
+ Seizures
+ Feeling extremely 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 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 hands, feet, ankles, or face (signs of fluid overload)
- Difficulty breathing or shortness of breath
- Rapid weight gain
- Unusual thirst or dry mouth (signs of dehydration if fluid needs are not met)
- Muscle weakness, cramps, or numbness/tingling (signs of electrolyte imbalance)
- Irregular heartbeat
- Confusion or dizziness
- Excessive urination or very little urination
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 and pharmacist identify potential interactions between this medication and other substances you are taking.
* Any health problems you have, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current 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 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 and pharmacist identify potential interactions between this medication and other substances you are taking.
* Any health problems you have, as this medication may interact with certain conditions.
To ensure your safety, it is crucial to verify that it is safe to take this medication with all your current 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.
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 as directed by your doctor. Be sure to discuss your test 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 for 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 as directed by your doctor. Be sure to discuss your test 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 for both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Fluid overload (pulmonary edema, peripheral edema, hypertension, heart failure)
- Severe electrolyte imbalances (e.g., hyperkalemia, hypermagnesemia, hypernatremia, hyponatremia)
- Hyperglycemia (high blood sugar)
- Metabolic alkalosis (due to acetate metabolism)
What to Do:
Overdose requires immediate medical attention. Management involves discontinuing the infusion, administering diuretics to remove excess fluid, correcting specific electrolyte imbalances (e.g., insulin for hyperglycemia, calcium gluconate for hyperkalemia/hypermagnesemia), and potentially dialysis in severe cases. Call 911 or your local emergency number immediately. For non-emergencies, contact Poison Control at 1-800-222-1222.
Drug Interactions
Major Interactions
- Drugs that increase potassium levels (e.g., ACE inhibitors, ARBs, potassium-sparing diuretics, cyclosporine, tacrolimus) due to risk of hyperkalemia with the potassium content in Ionosol-Mb.
- Corticosteroids (e.g., prednisone, hydrocortisone) due to increased risk of sodium and fluid retention, potentially leading to fluid overload and edema.
- Drugs that increase magnesium levels (e.g., magnesium-containing antacids/laxatives, other magnesium supplements) in patients with renal impairment, due to magnesium content.
Moderate Interactions
- Diuretics (e.g., loop diuretics, thiazide diuretics) can alter electrolyte balance, requiring careful monitoring and adjustment of fluid and electrolyte administration.
- Insulin: Dextrose content may require adjustment of insulin dosage in diabetic patients.
- Digoxin: Electrolyte imbalances (especially hypokalemia, though this fluid contains potassium) can increase digoxin toxicity. Hyperkalemia can reduce digoxin effects.
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl, Mg, Phosphate)
Rationale: To establish baseline electrolyte status and identify pre-existing imbalances before initiating fluid therapy.
Timing: Prior to initiation of infusion
Renal Function (BUN, Creatinine)
Rationale: To assess kidney's ability to excrete fluid and electrolytes, which impacts dosing and risk of accumulation.
Timing: Prior to initiation of infusion
Fluid Status (Vital Signs, I&O, Physical Exam)
Rationale: To assess hydration status and guide initial fluid rate and volume.
Timing: Prior to initiation of infusion
Blood Glucose
Rationale: To assess baseline glucose levels, especially important due to dextrose content, particularly in diabetic patients.
Timing: Prior to initiation of infusion
Routine Monitoring
Serum Electrolytes (Na, K, Cl, Mg, Phosphate)
Frequency: Every 6-24 hours, or more frequently as clinically indicated (e.g., in critical illness, significant fluid shifts, or renal impairment).
Target: Within normal physiological limits (e.g., K 3.5-5.0 mEq/L, Na 135-145 mEq/L)
Action Threshold: Values outside normal range, or rapid changes, requiring immediate intervention (e.g., adjusting infusion rate, adding specific electrolyte supplements, changing fluid type).
Fluid Balance (Intake and Output, Daily Weight)
Frequency: Every 4-8 hours for I&O; daily for weight.
Target: Balanced I&O, stable weight (or appropriate weight change for clinical goal).
Action Threshold: Significant positive or negative fluid balance, or rapid weight changes, indicating fluid overload or dehydration.
Blood Glucose
Frequency: Every 4-6 hours, or as per hospital protocol for patients receiving dextrose-containing fluids, especially in diabetic or critically ill patients.
Target: Typically 80-180 mg/dL (individualized based on patient condition).
Action Threshold: Hypoglycemia (<70 mg/dL) or hyperglycemia (>180-200 mg/dL) requiring intervention (e.g., insulin, adjusting dextrose rate).
Vital Signs (BP, HR, RR, Temp)
Frequency: Every 4 hours, or more frequently as clinically indicated.
Target: Within patient's normal range.
Action Threshold: Changes indicative of fluid overload (e.g., elevated BP, tachycardia, tachypnea) or dehydration (e.g., hypotension, tachycardia).
Symptom Monitoring
- Signs of fluid overload (e.g., peripheral edema, pulmonary crackles, dyspnea, jugular venous distension, weight gain)
- Signs of dehydration (e.g., dry mucous membranes, decreased skin turgor, thirst, decreased urine output, hypotension, tachycardia, weight loss)
- Symptoms of electrolyte imbalance (e.g., muscle weakness, cramps, paresthesias, arrhythmias, confusion, lethargy, seizures)
- Signs of hyperglycemia (e.g., polyuria, polydipsia, fatigue)
- Signs of hypoglycemia (e.g., sweating, tremors, hunger, confusion, dizziness)
Special Patient Groups
Pregnancy
Generally considered safe and often used to maintain hydration and electrolyte balance during pregnancy, labor, and delivery. The benefits of maintaining maternal fluid and electrolyte balance typically outweigh any potential risks.
Trimester-Specific Risks:
First Trimester:
No known specific risks. Used as needed for hydration.
Second Trimester:
No known specific risks. Used as needed for hydration.
Third Trimester:
No known specific risks. Commonly used during labor and delivery for hydration and to provide energy.
Lactation
Considered safe for use during lactation. The components (water, electrolytes, dextrose) are naturally present in breast milk or are essential nutrients. No adverse effects on the breastfed infant are expected.
Infant Risk:
Low risk (L1)
Pediatric Use
Pediatric patients, especially neonates and infants, have a higher proportion of total body water and immature renal function, making them more susceptible to fluid overload and electrolyte imbalances. Dosing must be precisely calculated based on weight, age, and clinical condition. Close monitoring of fluid balance, electrolytes, and blood glucose is critical to prevent complications like hyponatremia, hyperkalemia, and hyperglycemia.
Geriatric Use
Geriatric patients may have decreased renal function, reduced thirst sensation, and pre-existing cardiovascular conditions, increasing their susceptibility to fluid overload, electrolyte imbalances, and dehydration. Careful assessment of fluid status, renal function, and cardiac reserve is necessary. Slower infusion rates and meticulous monitoring are often required.
Clinical Information
Clinical Pearls
- Always individualize fluid and electrolyte therapy based on the patient's clinical status, laboratory values, and ongoing losses.
- Avoid rapid infusion rates, especially in patients at risk for fluid overload (e.g., heart failure, renal impairment).
- Monitor serum electrolytes, blood glucose, and fluid balance (I&O, daily weights) frequently, particularly in critically ill patients or those with significant fluid shifts.
- Be aware of the potassium content in Ionosol-Mb and potential for hyperkalemia, especially when co-administered with potassium-sparing drugs or in patients with renal dysfunction.
- The dextrose content provides calories but may require insulin adjustment in diabetic patients or close glucose monitoring in all patients to prevent hyperglycemia.
- Acetate in the solution is metabolized to bicarbonate, which can help correct metabolic acidosis but may contribute to metabolic alkalosis if over-administered.
Alternative Therapies
- 0.9% Sodium Chloride (Normal Saline) - for volume expansion, but less balanced electrolytes and no dextrose.
- Lactated Ringer's Solution (LR) - for volume expansion and electrolyte replacement, but no dextrose.
- Dextrose 5% in Water (D5W) - for free water and calories, but no electrolytes.
- Oral Rehydration Solutions (ORS) - for mild to moderate dehydration in conscious patients.
Cost & Coverage
Average Cost:
Price varies widely by manufacturer, volume, and contract. Typically low cost per bag. per 250ml bag
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Preferred Generic) or covered under medical benefit for inpatient/outpatient administration.
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 your safety and the safety of others, never share your medication with anyone, and do not take medication that has been prescribed to someone else.
All medications should be stored in a secure location, out of the reach of children and pets, to prevent accidental ingestion. When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless specifically instructed to do so by a healthcare professional or the medication's packaging. If you are unsure about the proper disposal method, consult with your pharmacist, who can provide guidance on safe disposal practices or inform you about potential drug take-back programs in your area.
Some medications may come with an additional patient information leaflet, so it is a good idea to check with your pharmacist to see if this is the case. If you have any questions or concerns about your medication, do not hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider for assistance.
In the event of a suspected overdose, it is crucial to seek immediate medical attention or contact your local poison control center. When reporting the incident, be prepared to provide as much information as possible, including the name of the medication, the amount taken, and the time it was taken, to ensure you receive the most effective treatment.
All medications should be stored in a secure location, out of the reach of children and pets, to prevent accidental ingestion. When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless specifically instructed to do so by a healthcare professional or the medication's packaging. If you are unsure about the proper disposal method, consult with your pharmacist, who can provide guidance on safe disposal practices or inform you about potential drug take-back programs in your area.
Some medications may come with an additional patient information leaflet, so it is a good idea to check with your pharmacist to see if this is the case. If you have any questions or concerns about your medication, do not hesitate to reach out to your doctor, nurse, pharmacist, or other healthcare provider for assistance.
In the event of a suspected overdose, it is crucial to seek immediate medical attention or contact your local poison control center. When reporting the incident, be prepared to provide as much information as possible, including the name of the medication, the amount taken, and the time it was taken, to ensure you receive the most effective treatment.