50% DEXTROSE INJECTION USP [WELLPHARMA] Infusion/Solution for

What is 50% DEXTROSE INJECTION USP [WELLPHARMA]

50% DEXTROSE INJECTION USP [WELLPHARMA] is a sterile, non-pyrogenic solution containing dextrose monohydrate intended for intravenous administration. It is a highly concentrated carbohydrate solution used in emergency and clinical settings for various therapeutic purposes.

• Composition: Each 100 mL contains 50 g of Dextrose (as monohydrate), equivalent to 500 mg/mL.
• Primary Use: It is used for the immediate treatment of hypoglycemia (low blood sugar) and to provide a rapid source of calories and fluids in patients with nutritional deficiencies or metabolic stress.
• Clinical Settings: Often used in intensive care units, emergency rooms, and surgical recovery environments.
• Type of Solution: Hypertonic solution – should be administered with care due to its high osmolality.
• Energy Source: Acts as a direct and fast-acting source of glucose, which is vital for cellular metabolism and organ function.

50% Dextrose Injection is not intended for long-term use due to the risk of vein irritation and potential fluid/electrolyte imbalances. It must be administered under the supervision of healthcare professionals.

How to use 50% DEXTROSE INJECTION USP [WELLPHARMA]

This medication must be administered intravenously by a healthcare provider, and its use should be guided by the patient’s clinical condition and glucose levels.

• Administration Route: Intravenous (IV) injection or infusion.
• Patient Monitoring: Blood glucose levels must be monitored before, during, and after administration.
• Dosage Individualization: The volume and rate of administration should be tailored to the individual’s glucose requirement, fluid status, and underlying condition.
• Use in Hypoglycemia: Typically administered as a rapid IV bolus in cases of acute symptomatic hypoglycemia.
• Dilution Warning: Not recommended to dilute unless under specific medical guidance; dilution reduces the osmolarity, which may reduce vein irritation but also diminishes rapid glucose delivery.

For emergency situations, such as insulin overdose or unconscious diabetic patients, 25–50 mL of 50% dextrose may be administered intravenously. Care should be taken to avoid extravasation, as the hypertonic solution can cause tissue damage.

Mode of Action 50% DEXTROSE INJECTION USP [WELLPHARMA]

The pharmacological effect of 50% dextrose is primarily metabolic, providing a quick and concentrated source of glucose, the body’s primary energy substrate.

• Glucose Utilization: After IV administration, dextrose enters the bloodstream and is rapidly absorbed by cells to be used in glycolysis for ATP production.
• Reversal of Hypoglycemia: Provides an immediate increase in blood glucose levels, which reverses the symptoms of hypoglycemia such as confusion, dizziness, and unconsciousness.
• Energy Provision: Supplies essential calories in a compact volume, useful in patients who cannot eat or are under metabolic stress.
• Liver Storage: Some of the dextrose is stored as glycogen in the liver for future energy needs.

The action is fast, often within minutes of administration, particularly when given as an IV bolus. The liver also plays a key role in maintaining glucose homeostasis once the immediate hypoglycemic crisis is resolved.

50% DEXTROSE INJECTION USP [WELLPHARMA] Interactions 50% DEXTROSE INJECTION USP [WELLPHARMA]

Drug interactions with 50% Dextrose Injection are relatively rare but can be clinically significant, especially in critically ill patients or when combined with other intravenous treatments.

• Insulin: Co-administration can cause severe hypoglycemia if not monitored closely.
• Diuretics (e.g., furosemide): May exacerbate fluid shifts or cause imbalances in serum electrolytes when combined with dextrose infusions.
• Corticosteroids: May elevate blood glucose levels, potentially counteracting the glucose-lowering intent of dextrose in some scenarios.
• Phenytoin: Dextrose solutions may reduce the efficacy of phenytoin due to reduced solubility or changes in plasma protein binding.
• Electrolyte Imbalances: Combining dextrose with potassium or calcium infusions can require close monitoring to avoid hypo/hyperkalemia or other derangements.

Care must be taken with patients on tight glycemic control protocols or those receiving total parenteral nutrition (TPN), as dextrose may disrupt intended metabolic targets.

Dosage of 50% DEXTROSE INJECTION USP [WELLPHARMA]

The dosage of 50% dextrose is individualized based on clinical indications, patient weight, and severity of hypoglycemia or energy deficit.

• Adults (Hypoglycemia): 25 to 50 mL (12.5 to 25 g of dextrose) administered as a slow IV bolus.
• Pediatric Use: Typically avoided due to the high concentration; if necessary, diluted solutions (e.g., 10% or 25%) are preferred.
• Continuous Infusion: Not routinely used due to the high concentration and risk of vein irritation or thrombophlebitis.
• Repeat Dosing: May be repeated based on blood glucose levels and symptoms, but ongoing monitoring is essential.

Always ensure that the IV line is patent before administration, as extravasation may lead to severe local tissue injury.

Possible side effects of 50% DEXTROSE INJECTION USP [WELLPHARMA]

While effective, 50% dextrose injection may cause side effects, especially if administered inappropriately or repeatedly.

• Local Reactions: Pain, thrombophlebitis, tissue necrosis at the injection site due to extravasation.
• Metabolic Effects: Hyperglycemia, osmotic diuresis, and electrolyte disturbances (especially hyponatremia or hypokalemia).
• Rebound Hypoglycemia: Particularly in insulin-treated patients if dextrose is cleared faster than anticipated.
• Allergic Reactions: Rare, but hypersensitivity or rash may occur in sensitive individuals.
• Lactic Acidosis: Possible in patients with impaired glucose metabolism (e.g., sepsis, shock).

Close monitoring of glucose and electrolytes is crucial to minimize these risks, especially in patients receiving multiple IV medications or with underlying metabolic disorders.

50% DEXTROSE INJECTION USP [WELLPHARMA] Contraindications 50% DEXTROSE INJECTION USP [WELLPHARMA]

There are specific situations where the use of 50% dextrose is contraindicated due to its hypertonicity and metabolic impact.

• Hyperglycemia: Not to be used in patients with already elevated blood glucose levels.
• Intracranial or Intraspinal Hemorrhage: High glucose levels can worsen cerebral edema and outcomes.
• Anuria or Severe Renal Impairment: Risk of fluid overload and osmotic stress.
• Dehydration without Electrolyte Replacement: Can exacerbate water loss and lead to hyperosmolar states.
• Allergy to Corn Products: Dextrose is often derived from corn; hypersensitivity must be considered.

Use with caution in diabetic patients and those with heart failure, as rapid volume and glucose shifts can precipitate acute complications.

Storage of 50% DEXTROSE INJECTION USP [WELLPHARMA]

Proper storage ensures the stability, sterility, and effectiveness of the solution.

• Temperature: Store at controlled room temperature, preferably between 15°C and 30°C (59°F–86°F).
• Light Protection: Protect from excessive heat and direct sunlight.
• Packaging Integrity: Do not use if the container is damaged, discolored, or shows signs of leakage or crystallization.
• Single-Use: Once opened, any unused portion should be discarded to avoid contamination.
• Avoid Freezing: Freezing can compromise the solution's integrity and concentration.

Always check the expiration date before use. Solutions that appear cloudy, contain particulates, or have changed color should not be administered.