25% w/v DEXTROSE INJECTION, USP [MEDISAL] Injection/Solution for

What is 25% w/v DEXTROSE INJECTION, USP [MEDISAL]

25% w/v DEXTROSE INJECTION USP is a sterile, non-pyrogenic solution of dextrose (anhydrous) in water for injection, presented in a 500ml polypropylene bottle. It is classified as a hypertonic intravenous (IV) infusion used primarily in clinical settings for patients requiring a concentrated source of glucose.

• Composition: Each 100 ml contains 25 grams of dextrose anhydrous, totaling 125 grams per 500 ml bottle.
• Form: Clear solution for intravenous infusion only.
• Packaging: Supplied in a durable polypropylene bottle that ensures sterility and chemical compatibility.
• Primary Indications:
  • Treatment of severe hypoglycemia
  • Supplemental caloric source in parenteral nutrition
  • Adjunctive fluid for medication dilution or delivery
• Patient Population: Adults and pediatric patients, depending on clinical judgment.

How to use 25% w/v DEXTROSE INJECTION, USP [MEDISAL]

The administration of 25% DEXTROSE INJECTION USP must be handled by trained medical personnel in a hospital or clinical setting. Due to its hypertonic nature, it requires careful monitoring to avoid complications such as phlebitis or hyperglycemia.

• Route of Administration: Intravenous infusion, ideally via a central vein to reduce venous irritation.
• Pre-infusion Checks:
  • Visually inspect the solution for clarity and absence of particulate matter.
  • Ensure the container is intact and seals are unbroken.
• Infusion Guidelines:
  • Use an infusion pump to control the rate precisely.
  • Administer slowly and monitor the patient’s glucose levels throughout the infusion.
• Monitoring Parameters:
  • Blood glucose
  • Electrolyte balance (especially sodium and potassium)
  • Fluid status to prevent overload
• Do Not Mix: Unless compatibility is established, avoid mixing with other solutions or drugs.

Mode of Action 25% w/v DEXTROSE INJECTION, USP [MEDISAL]

The pharmacological effect of dextrose (glucose) revolves around its critical role in cellular metabolism and energy production.

• Energy Source:
  • Once administered, dextrose is quickly absorbed and metabolized through glycolysis and the Krebs cycle, resulting in ATP production for energy-dependent cellular processes.
• Rapid Glucose Replacement:
  • Ideal for treating acute hypoglycemia as it elevates blood glucose levels rapidly.
• Osmotic Effect:
  • Being a hypertonic solution, it can draw fluid from the intracellular to extracellular compartments, increasing intravascular volume.
• Metabolic Substrate:
  • Supports anabolism in catabolic states and is integral in total parenteral nutrition.
• Glycogen Replenishment:
  • Excess dextrose not immediately used for energy is stored as glycogen in the liver and muscles.

25% w/v DEXTROSE INJECTION, USP [MEDISAL] Interactions 25% w/v DEXTROSE INJECTION, USP [MEDISAL]

While dextrose is largely considered inert, certain drug interactions must be taken into account during therapy.

• Insulin:
  • Concurrent insulin administration lowers blood glucose and can lead to hypoglycemia if not carefully adjusted.
• Diuretics:
  • Potassium-wasting diuretics can exacerbate electrolyte disturbances when dextrose causes insulin-mediated shifts of potassium into cells.
• Corticosteroids:
  • Can antagonize insulin and increase glucose levels, requiring dosage modifications of both insulin and dextrose.
• Phenytoin:
  • Precipitation can occur; do not co-administer in the same IV line.
• Other Incompatibilities:
  • Avoid mixing with calcium- or phosphate-containing solutions unless compatibility is confirmed.

Dosage of 25% w/v DEXTROSE INJECTION, USP [MEDISAL]

Dosing must be individualized based on clinical indication, patient size, comorbidities, and monitoring results. Overdosage or rapid administration can cause serious complications.

• Adults:
  • For hypoglycemia: 50-100 ml IV bolus may be used initially, followed by continuous infusion if needed.
  • For parenteral nutrition: Dose depends on caloric requirements—often part of a mixed formulation with amino acids and electrolytes.
• Pediatrics:
  • Dose based on weight (g/kg/day), administered under close monitoring.
• Infusion Rate:
  • Should not exceed 0.5 g/kg/hour to avoid glucose overload and osmotic diuresis.
• Special Populations:
  • Geriatric and renal/cardiac patients may require slower rates and adjusted volumes.
• Method:
  • Administer using infusion pump for accurate control.

Possible side effects of 25% w/v DEXTROSE INJECTION, USP [MEDISAL]

While generally well-tolerated when used appropriately, adverse effects can occur, especially with rapid or prolonged infusions.

• Metabolic:
  • Hyperglycemia, glycosuria, and potential for hyperosmolar states.
  • Rebound hypoglycemia, particularly if abrupt discontinuation follows prolonged infusion.
• Electrolyte Imbalance:
  • Hypokalemia due to insulin-driven intracellular shifts.
  • Hyponatremia from dilutional effects in overhydrated patients.
• Vascular Irritation:
  • Phlebitis or thrombophlebitis due to hypertonicity—central line preferred for administration.
• Fluid Overload:
  • Can lead to pulmonary edema and cardiac stress in susceptible patients.
• Allergic Reactions (Rare):
  • Urticaria, rash, or anaphylactic symptoms in hypersensitive individuals.

25% w/v DEXTROSE INJECTION, USP [MEDISAL] Contraindications 25% w/v DEXTROSE INJECTION, USP [MEDISAL]

Certain clinical conditions pose a risk when using hypertonic dextrose solutions, and its use should be avoided unless absolutely necessary under specialist supervision.

• Uncontrolled Diabetes Mellitus:
  • Risk of exacerbated hyperglycemia, ketoacidosis, or hyperosmolar coma.
• Severe Fluid Overload:
  • Use is contraindicated in patients with congestive heart failure or pulmonary edema.
• Intracranial Hemorrhage or Head Trauma:
  • Hypertonic solutions may worsen cerebral edema or elevate intracranial pressure.
• Hypersensitivity to Dextrose:
  • Though rare, hypersensitivity reactions demand immediate discontinuation.
• Anuria or Severe Renal Impairment:
  • Increased risk of fluid retention and electrolyte imbalance.

Storage of 25% w/v DEXTROSE INJECTION, USP [MEDISAL]

Maintaining proper storage conditions ensures the safety and efficacy of this intravenous solution throughout its shelf life.

• Temperature:
  • Store at 20–25°C (68–77°F). Brief excursions up to 30°C are permitted.
• Light Protection:
  • Keep in outer carton or original packaging to protect from light.
• Do Not Freeze:
  • Freezing can lead to container rupture or solution precipitation.
• Container Integrity:
  • Inspect bottle before use. Do not use if cloudy, leaking, or if the seal is compromised.
• Use Once Opened:
  • Discard any unused portion to avoid contamination risks.