This preparation is administered in the treatment of carbohydrate and fluid depletion. It is mainly used to replace water deficiency and should be given alone when there is no significant loss of electrolytes. Water depletion (dehydration) occurs when fluid loss is not matched by adequate intake, such as in coma, dysphagia, or in elderly patients who may not consume sufficient water on their own. It provides a readily metabolizable source of energy. One litre of 5% solution provides approximately 170 calories. Glucose solutions are also used in combination regimens with calcium bicarbonate and insulin for emergency management of hyperkalaemia. They are further used, after correction of hyperglycaemia, during treatment of diabetic ketoacidosis, where continuous insulin infusion is required. Dextrose may also serve as a suitable vehicle for slow intravenous infusion of various drugs.

Dextrose is a form of glucose (sugar). Dextrose 5% in water is administered intravenously to replace lost fluids and supply carbohydrates to the body. Dextrose 5% in water is used in the treatment of hypoglycaemia, insulin shock, and dehydration (fluid loss). It is also used for nutritional support in patients who are unable to eat due to illness, injury, or other medical conditions.

5% dextrose solution: The dose of dextrose infusion is variable. It is dependent on individual patient requirements. For 5% dextrose solution, the dose frequently ranges from 500 to 1000 ml. The maximum rate of infusion that will not cause glycosuria is 0.5 g/kg/hour. About 95% is retained when the rate is 0.8 g/kg/hr. The maximum rate of glucose utilization is about 800 mg per kg body weight per hour.

10% dextrose solution: Dose is variable. It depends on the clinical condition, age and body surface area of the patients and the judgment of the physician. Ordinarily, normal circulation is restored by infusing 20–30 ml/kg as rapidly as possible. The laboratory findings should be available by this time so that the physician can proceed more slowly with logically planned subsequent fluid therapy.

25% dextrose solution: The volume and rate of infusion of dextrose solution will depend upon the requirements of the individual patient and the judgment of the physician. The maximum rate at which dextrose can be infused without producing glycosuria is 0.5 g/kg/hr. The usual recommended flow rate for adult is 10–35 drops per minute infused intravenously. It should not be administered by SC or IM route. 25% dextrose solution should be infused through the largest available peripheral vein.

Oral powder:

• Adult: 10–20 gm as single dose; may repeat in 10 min if needed.
• Child: >2 yr: 10–20 gm as single dose; may repeat in 10 min if needed.
• Check infusion set and infusion solution prior to use.
• Pull moderately to tear off the protective cover of the Eurocap.
• Hold lightly the Eurocap but not the bottle body.
• Open the flow regulator fully and hold the giving set on the top white area, but not the membrane venting region.
• Insert the spike of the administration set to the Eurocap and fit the connector of the administration set firmly to the needle.
• Gradually allow the fluid to flow down to the needle tip and close.
• Remove the protective cover of the needle.
• Locate the venipuncture site and clean the site with an antiseptic solution, and then insert the needle.
• Securely tape the puncture site.
• Securely tape the wings and tubing.
• Start infusion while adjusting drip speed.

Do not take this medicine and inform your doctor if you are allergic to dextrose. Before using Dextrose 5% in Water, inform your doctor if you have diabetes, breathing problems, electrolyte imbalance, kidney or liver disease, any food or drug allergy, or if you receive regular blood transfusions.

• Severe burning, pain, or swelling around the IV site
• Warmth, redness, oozing, or bleeding at the injection site
• Fever or persistent cough
• High blood sugar, headache, difficulty concentrating, memory problems, weakness, unsteadiness, hallucinations, fainting, seizures, shallow breathing, or respiratory arrest
• Low potassium, anxiety, sweating, pale skin, severe shortness of breath, wheezing, chest pain, or fast/irregular heartbeat

FDA Pregnancy Category C. It is not known whether Dextrose 5% in Water may harm the unborn baby. Inform your doctor if you are pregnant or planning pregnancy during treatment. It is not known whether this drug passes into breast milk or may harm a nursing infant. Do not use this medication during breastfeeding without consulting your doctor.

Serum glucose levels should be carefully monitored. In diabetic patients, concurrent insulin therapy may be required. Dextrose solution must not be mixed with whole blood, as haemolysis and clumping may occur. Infusion should be stopped immediately if rigor occurs during administration for any reason. Do not use the solution if it is cloudy, contains particles, or has passed its expiry date.

Take special care with dextrose. Consult your doctor before use if you are allergic to dextrose.

To ensure safe use of Dextrose 5% in Water, inform your doctor if you have any of the following conditions:

• Diabetes
• Breathing problems
• Electrolyte imbalance (such as low potassium levels in blood)
• Kidney or liver disease
• Any food or drug allergy
• Regular blood transfusions

Intravenous fluid preparations

Store below 30°C, protect from light and moisture. Keep out of reach of children