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Kcl/d5w/nacl .15/.45% Inj, 1000ml

Manufacturer BAXTER Active Ingredient Intravenous (IV) Fluids(in truh VEE nuhs FLOO ids) Pronunciation K-C-L / D-5-W / N-A-C-L point one five / point four five percent Injection
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.
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Drug Class
Fluid, Electrolyte, and Caloric Replenisher
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Pharmacologic Class
Intravenous Solution; Electrolyte; Carbohydrate
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Pregnancy Category
Category C (due to electrolyte balance considerations, generally safe when indicated)
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FDA Approved
Jan 1970
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

This medication is an intravenous (IV) fluid given through a vein to provide your body with water, essential salts (like sodium and potassium), and a sugar (dextrose) for energy. It helps to keep your body's fluids and electrolytes balanced, especially when you can't drink enough or have lost fluids due to illness.
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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.
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Lifestyle & Tips

  • Report any discomfort or pain at the IV site immediately.
  • Inform your healthcare provider about any new or worsening symptoms, such as shortness of breath, swelling, or changes in urination.
  • Follow all instructions regarding fluid intake or restrictions if advised by your doctor.
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Available Forms & Alternatives

Available Strengths:

Dosing & Administration

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Adult Dosing

Standard Dose: Highly individualized based on patient's fluid, electrolyte, and caloric needs, clinical condition, and laboratory parameters. Typical infusion rates range from 40-125 mL/hour, but can be higher in acute situations.
Dose Range: 40 - 250 mg

Condition-Specific Dosing:

dehydration: Rate and volume adjusted to correct fluid deficit and maintain hydration.
electrolyte_imbalance: Rate and volume adjusted to correct specific electrolyte deficits (e.g., hypokalemia, hyponatremia) while avoiding overload.
caloric_support: Provides 170 calories/L from dextrose; rate adjusted based on overall nutritional needs.
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Pediatric Dosing

Neonatal: Dosing highly individualized based on weight, gestational age, fluid and electrolyte status, and caloric needs. Close monitoring is essential.
Infant: Dosing highly individualized based on weight, fluid and electrolyte status, and caloric needs. Close monitoring is essential.
Child: Dosing highly individualized based on weight, fluid and electrolyte status, and caloric needs. Close monitoring is essential.
Adolescent: Dosing highly individualized based on weight, fluid and electrolyte status, and caloric needs. Close monitoring is essential.
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor fluid and electrolyte balance closely.
Moderate: Use with caution; monitor fluid and electrolyte balance closely. May require reduced rates or volumes, especially for potassium and sodium.
Severe: Contraindicated or use with extreme caution and reduced rates/volumes due to risk of fluid overload, hyperkalemia, and hypernatremia. Close monitoring of renal function, fluid balance, and electrolytes is critical.
Dialysis: Contraindicated or use with extreme caution and reduced rates/volumes, often requiring specific formulations tailored to dialysis patients. Consult nephrology.

Hepatic Impairment:

Mild: Generally no specific adjustment, but monitor for fluid retention or electrolyte disturbances if associated with other conditions.
Moderate: Generally no specific adjustment, but monitor for fluid retention or electrolyte disturbances if associated with other conditions.
Severe: Use with caution due to potential for fluid retention (e.g., ascites) and electrolyte imbalances. Monitor fluid balance and electrolytes closely.

Pharmacology

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Mechanism of Action

This solution provides water, electrolytes (sodium, potassium, chloride), and calories (dextrose) for intravenous administration. Dextrose is readily metabolized, providing a source of energy and reducing protein catabolism. Sodium and chloride are essential for maintaining fluid and electrolyte balance, osmotic pressure, and acid-base balance. Potassium is a major intracellular cation essential for nerve impulse transmission, muscle contraction, and maintenance of intracellular tonicity.
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Pharmacokinetics

Absorption:

Bioavailability: 100% (intravenous administration)
Tmax: Immediate (components are directly introduced into systemic circulation)
FoodEffect: Not applicable

Distribution:

Vd: Distributes throughout total body water (for water, sodium, chloride) and intracellular/extracellular compartments (for potassium).
ProteinBinding: Not significant for these components.
CnssPenetration: Yes (water, electrolytes, and dextrose distribute into the CNS).

Elimination:

HalfLife: Not applicable for continuous infusion; components are continuously utilized or excreted.
Clearance: Dextrose is cleared by cellular metabolism. Sodium, potassium, and chloride are primarily excreted by the kidneys.
ExcretionRoute: Renal (electrolytes), Metabolic (dextrose)
Unchanged: Not applicable for dextrose; electrolytes are excreted unchanged.
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Pharmacodynamics

OnsetOfAction: Immediate
PeakEffect: Continuous during infusion
DurationOfAction: As long as infusion is maintained and components are utilized/excreted.

Safety & Warnings

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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

This is not an exhaustive list of possible side effects. If you have questions or concerns, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
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Seek Immediate Medical Attention If You Experience:

  • Shortness of breath or difficulty breathing
  • Swelling in your ankles, feet, or hands
  • Rapid weight gain
  • Increased thirst or dry mouth
  • Muscle weakness or cramps
  • Irregular heartbeat
  • Confusion or dizziness
  • Headache
  • Nausea or vomiting
  • Pain, redness, or swelling at the IV site
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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 assess potential interactions between this medication and other substances you are taking.
* 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. Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor.
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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.

If your medication contains dextrose and you have diabetes (high blood sugar), discuss this with your doctor to ensure safe management of your condition.

Regular blood tests will be necessary as directed by your doctor. Be sure to follow their instructions and discuss any concerns or questions you may have.

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. They will help you weigh the benefits and risks of this medication to both you and your baby, ensuring an informed decision.
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Overdose Information

Overdose Symptoms:

  • Fluid overload (e.g., pulmonary edema, peripheral edema, hypertension, heart failure)
  • Severe hyperkalemia (e.g., muscle weakness, paralysis, cardiac arrhythmias, cardiac arrest)
  • Severe hypernatremia (e.g., thirst, lethargy, confusion, seizures, coma)
  • Hyperglycemia (e.g., polyuria, polydipsia, dehydration, diabetic ketoacidosis in susceptible patients)

What to Do:

Immediate medical attention is required. Management involves discontinuing the infusion, administering diuretics for fluid overload, administering insulin and glucose for hyperkalemia, and other supportive measures as indicated by specific electrolyte imbalances. Call 911 or Poison Control (1-800-222-1222).

Drug Interactions

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Contraindicated Interactions

  • Patients with known hypersensitivity to any component (e.g., corn products for dextrose).
  • Patients with severe hyperkalemia.
  • Patients with severe hypernatremia.
  • Patients with severe fluid overload or pulmonary edema.
  • Patients with anuria or severe oliguria (unless on dialysis).
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Major Interactions

  • Drugs that increase potassium levels (e.g., ACE inhibitors, ARBs, potassium-sparing diuretics, NSAIDs, cyclosporine, tacrolimus) - increased risk of hyperkalemia.
  • Corticosteroids or other sodium-retaining drugs - increased risk of hypernatremia and fluid retention.
  • Insulin (large doses) - may cause rapid shift of potassium into cells, leading to hypokalemia (though dextrose in solution may counteract this to some extent).
  • Digoxin - potassium imbalances (hypo- or hyperkalemia) can alter digoxin toxicity.
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Moderate Interactions

  • Diuretics (loop or thiazide) - may alter sodium and potassium balance, requiring careful monitoring.
  • Lithium - sodium levels can affect lithium excretion; changes in sodium intake/administration may alter lithium levels.
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Minor Interactions

  • None commonly cited for direct interaction with this specific IV fluid combination, but general caution with any medication affecting fluid or electrolyte balance.

Monitoring

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Baseline Monitoring

Serum Electrolytes (Na, K, Cl)

Rationale: To establish baseline electrolyte status and identify pre-existing imbalances.

Timing: Prior to initiation of therapy

Renal Function (BUN, Creatinine)

Rationale: To assess kidney's ability to excrete electrolytes and fluid.

Timing: Prior to initiation of therapy

Fluid Status (Weight, I&O, Vital Signs)

Rationale: To assess hydration status and risk of fluid overload.

Timing: Prior to initiation of therapy

Blood Glucose

Rationale: To establish baseline glucose level, especially in diabetic patients.

Timing: Prior to initiation of therapy

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Routine Monitoring

Serum Electrolytes (Na, K, Cl)

Frequency: Every 4-24 hours, depending on clinical status and infusion rate

Target: Sodium: 135-145 mEq/L; Potassium: 3.5-5.0 mEq/L; Chloride: 98-106 mEq/L

Action Threshold: Values outside normal range, especially critical values (e.g., K < 3.0 or > 5.5 mEq/L, Na < 130 or > 150 mEq/L) require immediate intervention.

Fluid Balance (Intake & Output, Daily Weight)

Frequency: Every 8-24 hours (I&O), Daily (Weight)

Target: Balanced I&O, stable weight or desired change.

Action Threshold: Significant positive or negative fluid balance, rapid weight gain/loss, or signs of fluid overload/dehydration.

Blood Glucose

Frequency: Every 4-6 hours, especially in diabetic or critically ill patients

Target: 70-180 mg/dL (target may vary based on patient condition)

Action Threshold: Hypoglycemia (<70 mg/dL) or hyperglycemia (>180-200 mg/dL).

Vital Signs (BP, HR, RR, Temp)

Frequency: Every 4-8 hours or more frequently as clinically indicated

Target: Within patient's normal limits

Action Threshold: Changes indicative of fluid overload (e.g., elevated BP, crackles) or dehydration (e.g., tachycardia, hypotension).

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Symptom Monitoring

  • Signs of fluid overload (e.g., dyspnea, crackles, peripheral edema, jugular venous distension)
  • Signs of hyperkalemia (e.g., muscle weakness, paresthesias, cardiac arrhythmias)
  • Signs of hypokalemia (e.g., muscle weakness, cramps, fatigue, cardiac arrhythmias)
  • Signs of hypernatremia (e.g., thirst, lethargy, confusion, seizures)
  • Signs of hyponatremia (e.g., headache, nausea, confusion, seizures)
  • Signs of hyperglycemia (e.g., polyuria, polydipsia, fatigue)
  • Signs of hypoglycemia (e.g., sweating, tremors, dizziness, confusion)
  • Local site reactions (e.g., pain, redness, swelling at infusion site)

Special Patient Groups

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Pregnancy

Generally considered safe when clinically indicated for fluid and electrolyte replacement. Close monitoring of fluid and electrolyte balance is crucial to avoid complications for both mother and fetus.

Trimester-Specific Risks:

First Trimester: No specific risks identified beyond general fluid/electrolyte management.
Second Trimester: No specific risks identified beyond general fluid/electrolyte management.
Third Trimester: No specific risks identified beyond general fluid/electrolyte management. Careful monitoring for fluid overload, especially in pre-eclampsia.
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Lactation

Components are endogenous and generally considered compatible with breastfeeding when administered appropriately. No known adverse effects on the breastfed infant.

Infant Risk: Low
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Pediatric Use

Use with extreme caution and precise calculation of fluid and electrolyte needs based on weight, age, and clinical condition. Pediatric patients are more susceptible to fluid overload, electrolyte imbalances (especially hyponatremia and hyperkalemia), and glucose abnormalities. Frequent monitoring of fluid balance, electrolytes, and blood glucose is essential.

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Geriatric Use

Use with caution due to increased risk of fluid overload, electrolyte imbalances (especially hypernatremia and hyperkalemia due to age-related decline in renal function), and cardiovascular compromise. Start with lower infusion rates and monitor fluid status, electrolytes, and renal function closely.

Clinical Information

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Clinical Pearls

  • Always verify the correct solution, concentration, and infusion rate before administration to prevent medication errors.
  • Assess patient's fluid status (skin turgor, mucous membranes, I&O, daily weight, vital signs) and electrolyte levels frequently.
  • Be vigilant for signs of fluid overload (e.g., crackles, dyspnea, edema) or electrolyte imbalances (e.g., cardiac arrhythmias, muscle weakness).
  • Ensure adequate renal function before administering potassium-containing solutions to prevent hyperkalemia.
  • Avoid rapid infusion, especially in patients at risk for fluid overload or electrolyte shifts.
  • This solution provides minimal calories; consider additional nutritional support for prolonged therapy.
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Alternative Therapies

  • Oral rehydration solutions (for mild dehydration/electrolyte imbalance)
  • Specific electrolyte supplements (e.g., oral potassium chloride for hypokalemia)
  • Total Parenteral Nutrition (TPN) for comprehensive nutritional support.
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Cost & Coverage

Average Cost: $5 - $20 per 1000mL bag
Generic Available: Yes
Insurance Coverage: Tier 1 (Preferred Generic) or covered under medical benefit for inpatient/outpatient administration.
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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; do not flush them down the toilet or pour them down the drain unless instructed to do so by your pharmacist or healthcare provider. For guidance on 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, 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 quantity, and the time of ingestion to facilitate prompt and effective treatment.