DEXTROSE 5% W/V (IV) INFUSION 500ML

Indications

Approved Uses

Plasma volume expansion in hypovolemia/shock (e.g., due to hemorrhage, trauma, surgery, burns) when a colloid is indicated.

Off-Label Uses

Priming solution for extracorporeal circuits (e.g., cardiopulmonary bypass) and acute normovolemic hemodilution (institution-dependent).

Dosage & Administration

Dosing by Condition

Hypovolemia/shock: titrate to clinical endpoints; typical adult initial dose 500 mL (30 g) and may repeat as needed. Do not exceed 20 mL/kg in the first 24 hours; if continued beyond 24 hours, limit to 10 mL/kg/day.

Initial Dose

The customary dose is 500 mL for adults. [3, 15]

Maintenance Dose

If treatment exceeds 24 hours, the daily dosage should not exceed 0.6 g/kg (10 mL/kg). [3, 15]

Maximum Dose

The total dosage for the first 24 hours must not exceed 1.2 g/kg (20 mL/kg). [3, 15]

Children's Dosage

10-20 mL/kg IV, not to exceed 20 mL/kg/day; administer under close medical supervision

Dose Adjustment Notes

Use with caution and infuse more slowly in cardiac impairment/elderly and in renal impairment; avoid use in severe renal failure with oliguria/anuria and monitor closely for fluid overload and renal function.

How to Take

For intravenous infusion only (hospital use). Inspect solution/container for leaks, particulate matter, and discoloration; use aseptic technique. Start the infusion slowly and observe closely for anaphylactoid reactions during the first 10-20 mL/first minutes, then titrate rate/volume to hemodynamic response and fluid status; use an in-line filter if required by local policy for dextran products.

How to Prepare

Ready-to-use IV solution in a 500 mL bottle; no reconstitution required. Inspect for particulate matter/leaks, use aseptic technique, and do not admix/add medications unless compatibility and stability are confirmed; administer via IV infusion per institutional policy.

Side Effects

Common Side Effects

Hypersensitivity/anaphylactoid reactions (flushing, urticaria, bronchospasm, hypotension), nausea/vomiting, fever/chills; volume overload/pulmonary edema; bleeding tendency/dilutional coagulopathy with large volumes; local infusion-site reactions can occur.

Side Effect Frequency

Common: mild hypersensitivity reactions (rash/urticaria, fever/flushing), nausea/vomiting; volume-related effects (hemodilution/edema) can occur with large volumes. Uncommon: bronchospasm/wheezing, chest tightness, mild hypotension. Rare but serious: anaphylactoid/anaphylaxis, severe hypotension/shock, coagulopathy/bleeding tendency, acute kidney injury, pulmonary edema (especially with excessive volume or predisposition).

Safety & Warnings

Contraindications

Known hypersensitivity to dextran; severe renal impairment with oliguria/anuria; severe congestive heart failure or hypervolemia/pulmonary edema; marked hemostatic defects or active uncontrolled bleeding.

Warnings & Precautions

Observe closely during initiation for hypersensitivity; ensure resuscitation readiness; monitor fluid balance/urine output and avoid overload (especially cardiac/renal disease); monitor bleeding/coagulation with large doses; obtain blood for typing/cross-match before infusion; use caution in diabetes due to dextrose component.

Age Restriction

No absolute age restriction; use in all age groups only under specialist/medical supervision (extra caution in neonates/infants).

Drug Interactions

Drug Interactions

Additive bleeding risk with anticoagulants/thrombolytics; possible increased anaphylactoid risk with ACE inhibitors; interferes with blood grouping/cross-matching-draw blood samples before infusion.

Interaction Severity

MAJOR: Anticoagulants/antiplatelets and thrombolytics (e.g., heparin, warfarin, alteplase) due to additive bleeding risk and dextran-related platelet/coagulation effects. MODERATE: ACE inhibitors (possible increased anaphylactoid reaction risk) and insulin/antidiabetics (dextrose carrier may increase glucose).

Food Interaction

No restriction

Special Populations

Children

10-20 mL/kg IV, not to exceed 20 mL/kg/day; administer under close medical supervision

Kidney Impairment

Contraindicated in oliguria/anuria; otherwise use with caution in renal impairment with reduced dose/rate and close monitoring of urine output and volume status.

Storage & Patient Advice

Preparation Instructions

Ready-to-use IV solution in a 500 mL bottle; no reconstitution required. Inspect for particulate matter/leaks, use aseptic technique, and do not admix/add medications unless compatibility and stability are confirmed; administer via IV infusion per institutional policy.

Missed Dose

Not applicable in usual practice-administered and titrated in a monitored clinical setting; if an ordered infusion is interrupted, clinicians should reassess volume status and restart/adjust per hemodynamic goals.

Stopping the Medicine

Administered and discontinued by healthcare professionals; stop infusion immediately if hypersensitivity, respiratory compromise, hypotension, or circulatory overload occurs.

Overdose

Overdose manifests as volume/circulatory overload (pulmonary edema/CHF), hemodilution and coagulopathy/bleeding, and electrolyte/glucose disturbances; management is stop infusion and provide supportive care (e.g., oxygen/ventilation, diuretics) and correct coagulopathy as needed.

Patient Counseling

Given IV in hospital by professionals; report immediately any itching, rash/hives, wheeze, chest tightness, dizziness, or swelling during infusion (possible severe allergy). Inform staff about prior reactions to dextran, bleeding disorders/anticoagulant use, and heart/kidney disease; diabetics should expect glucose monitoring because the solution contains dextrose.

Monitoring Requirements

Monitor closely for hypersensitivity during the first minutes/initial 10-20 mL; monitor blood pressure/heart rate, oxygenation/respiratory status, urine output, fluid balance, and labs as indicated (hematocrit/hemoglobin; coagulation parameters with large volumes; electrolytes and blood glucose given the dextrose carrier).

Pharmacology

Mechanism of Action

Dextran 70 is a high-molecular-weight glucose polymer colloid that increases intravascular oncotic pressure and expands plasma volume; dextrose 5% serves as the carrier and provides free water/calories after metabolism.

Onset of Action

Within minutes of starting the infusion.

Duration of Effect

Approximately 3-6 hours of plasma volume expansion (may vary with dose and capillary leak).

Half-Life

Dextran 70: biphasic intravascular persistence-an initial distribution/clearance phase of a few hours followed by a prolonged terminal phase that can extend for days (reported terminal half-life ~2-3 days). Dextrose: effectively minutes (rapid cellular uptake/metabolism).

Bioavailability

100% (intravenous administration).

Metabolism

Dextran 70: partially metabolized slowly by dextranases (primarily in the reticuloendothelial system/liver/spleen) to smaller oligosaccharides and ultimately glucose; a significant fraction is excreted unchanged in urine depending on molecular size. Dextrose: metabolized via normal carbohydrate pathways (glycolysis/oxidation) to CO2 and water (and glycogen/fat storage as applicable).

Excretion

Dextran 70: primarily renal elimination-lower-molecular-weight fractions are excreted unchanged in urine (a substantial proportion within 24 hours); remaining higher-molecular-weight fraction is slowly metabolized and ultimately eliminated mainly via the kidneys. Dextrose: metabolized to CO2 and water (not excreted unchanged except if hyperglycemia exceeds renal threshold causing glucosuria).

Protein Binding

Dextran 70: not meaningfully protein-bound (circulates largely as free polymer; may interfere with some laboratory assays/crossmatching but not via classic protein binding). Dextrose: negligible/none.

Product Information

Available Dosage Forms

Solution for intravenous infusion (bottle), 500 mL.

Composition per Dose

Each 500 mL bottle: Dextran 70 30 g (6% w/v) + Dextrose (anhydrous) 25 g (5% w/v) in water for injection

Generic Availability

Yes

OTC Alternatives

No OTC alternative

Primary Use

Intravenous plasma volume expander used to treat and prevent hypovolemia and shock, and to improve microcirculation

Legal Disclaimer - Al Mujtama Pharmacy

The product information provided is derived from verified pharmaceutical references and is intended for general health education only. It is not a substitute for professional medical advice, diagnosis, or treatment.

Al Mujtama Pharmacy assumes no legal or medical liability for:

• Any therapeutic decision made based on the information displayed without consulting a licensed physician or pharmacist
• Any discrepancy between the information provided and the product's package insert or SFDA guidelines
• Any misuse of medication resulting from personal interpretation of the content displayed

Important notice: Drug formulations and instructions may vary between production batches. Always rely on the leaflet included inside the product packaging you have, and consult your pharmacist or physician before starting, adjusting, or discontinuing any medication.

By using this content, you acknowledge that you have read this disclaimer and agree that Al Mujtama Pharmacy bears no liability arising from reliance on this information as a substitute for direct medical consultation.

Your health is a trust - always consult your doctor first.