Dextrose

What it is and how it works

Mechanism of Action Dextrose Injection is used to supplement nutrition by providing glucose parenterally. Dextrose is oxidized to carbon dioxide and water, yielding energy.

Indications

Dextrose Injection is indicated as source of calories and fluid replenishment when mixed with amino acids or other compatible intravenous fluids for patients requiring parenteral nutrition (PN) when oral or enteral nutrition is not possible, insufficient or contraindicated. Dextrose Injection is indicated as a source of calories when mixed with amino acids or other compatible intravenous fluids for patients requiring parenteral nutrition when oral or enteral nutrition is not possible, insufficient or contraindicated.

Dosage and administration (summary)

• Pharmacy Bulk Package. Not for direct intravenous infusion. • For slow intravenous infusion only into a: o Central vein, if final dextrose concentration is greater than 5% or osmolality is greater than 900 mOsm/L approximately. o Peripheral vein, if final dextrose concentration 5% or less and osmolality is less than 900 mOsm/L approximately. • Individualize dosage based on the patient’s clinical condition, body weight, nutritional/fluid requirements, as well as additional energy given orally/enterally. • Discontinue infusion of concentrated dextrose solutions slowly.

Contraindications

The use of Dextrose Injection is contraindicated in patients: • Who are severely dehydrated as hypertonic dextrose solution can worsen the patient’s hyperosmolar state . • Known hypersensitivity to dextrose . Severe dehydration.

Warnings and precautions

• Pulmonary Embolism due to Pulmonary Vascular Precipitates : If signs of pulmonary distress occur, stop the infusion and initiate a medical evaluation. • Hyperglycemia or Hyperosmolar Hyperglycemic State : Monitor blood glucose and administer insulin as needed. • Hypersensitivity Reactions : Monitor for signs and symptoms and discontinue infusion if reactions occur. • Vein Damage and Thrombosis : Administer solutions containing more than 5% dextrose as the final concentration or solutions with an osmolarity of approximately 900 mOsm/L or greater through a central vein.

Pregnancy

Pregnancy Risk Summary Appropriate administration of Dextrose Injection during pregnancy is not expected to cause adverse developmental outcomes, including congenital malformations.

Storage and supply

Dextrose Injection 70%, USP (0.7 grams/mL) is available in a Pharmacy Bulk Package flexible plastic container for intravenous administration after appropriate dilution and is available in the following size in Table 2 below.

Source: Dextrose Monohydrate (Dextrose) — US FDA prescribing information, 2019-08-05, DailyMed. Summarised and shortened; the full label governs. Iranian registration, indications and labelling may differ.