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, hypertonic solution of Dextrose (as monohydrate) used primarily as a source of carbohydrates in clinical settings. This solution contains 500 mg of Dextrose per mL and is packaged in a 100ml polypropylene bag intended for intravenous (IV) administration. It is typically used in situations requiring rapid energy supplementation, treatment of hypoglycemia, or as part of parenteral nutrition therapy.

• Primary Use: Emergency treatment of severe hypoglycemia, where rapid glucose administration is required.
• Supportive Therapy: Used as a carbohydrate supplement in patients unable to consume food orally or via enteral nutrition.
• Clinical Settings: Often administered in emergency rooms, intensive care units (ICUs), and during surgical interventions.
• Formulation: Does not contain bacteriostatic agents or antimicrobial preservatives; single-use only.
• Osmolarity: The hypertonic nature makes it suitable for rapid energy repletion but necessitates careful monitoring during administration.

This high-concentration glucose solution should only be administered under medical supervision, particularly in individuals with underlying metabolic or cardiovascular conditions.

How to use 50% DEXTROSE INJECTION USP [WELLPHARMA]

Proper administration of 50% Dextrose Injection is critical due to its hypertonic properties and rapid systemic effects. This medication is administered intravenously by healthcare professionals in controlled clinical environments.

• Route of Administration: Intravenous (IV) only – preferably via a central vein for large or repeated doses.
• Dosage: Must be individualized based on the patient's condition, age, weight, and clinical response. In hypoglycemia, a common initial adult dose is 25 to 50 mL of the 50% solution (12.5–25g of dextrose).
• Monitoring:
  • Regular blood glucose checks to prevent rebound hyperglycemia.
  • Serum electrolyte monitoring, especially potassium, as rapid glucose administration can induce hypokalemia.
• Preparation: The solution should be visually inspected for particulate matter and discoloration prior to administration. Do not use if the solution is cloudy or contains precipitate.
• Precautions: Avoid extravasation as it can cause local tissue necrosis due to hyperosmolarity.
• Combination Therapy: May be co-administered with other intravenous fluids under strict medical guidance.

Always follow institutional protocols and manufacturer’s instructions during preparation and administration.

Mode of Action 50% DEXTROSE INJECTION USP [WELLPHARMA]

The therapeutic effect of 50% Dextrose Injection is primarily achieved through rapid elevation of blood glucose levels. As a monosaccharide, dextrose (D-glucose) serves as the body’s most direct source of metabolic energy.

• Immediate Energy Source: After IV administration, dextrose enters the bloodstream and is quickly transported into cells via insulin-dependent and insulin-independent pathways to produce ATP (adenosine triphosphate).
• Metabolism:
  • Undergoes glycolysis to generate energy.
  • Excess glucose is stored as glycogen in the liver and muscle tissue.
• Hyperglycemia Reversal: The concentrated dextrose rapidly corrects hypoglycemia by replenishing circulating glucose levels within minutes.
• Central Nervous System (CNS) Support: The brain relies on glucose for energy. Restoring glucose levels can quickly reverse neuroglycopenic symptoms such as confusion, drowsiness, or unconsciousness.
• Insulin Dynamics: Administration may prompt endogenous insulin release, thereby influencing potassium balance and glucose uptake.

The pharmacological action is nearly instantaneous due to intravenous administration, making it effective in acute metabolic emergencies.

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

While 50% Dextrose Injection is generally considered safe in acute situations, there are several drug and physiological interactions that must be considered.

• Insulin:
  • Administered concurrently in cases of hyperkalemia, as insulin facilitates intracellular uptake of potassium.
  • May increase glucose utilization and reduce the effectiveness of dextrose if not appropriately dosed.
• Diuretics: Loop and thiazide diuretics may exacerbate electrolyte imbalances when combined with hypertonic glucose solutions.
• Corticosteroids: May increase blood glucose levels, potentially countering the hypoglycemic corrective effect of dextrose.
• Potassium Supplements: May be co-administered with caution to prevent hypokalemia, which may be induced by insulin response to glucose.
• Warfarin: Although no direct pharmacokinetic interaction is established, fluctuations in nutritional and metabolic status may indirectly affect anticoagulant response.
• Digoxin: Dextrose-induced electrolyte shifts (e.g., hypokalemia) may predispose to digoxin toxicity.

Patients should be monitored closely for blood glucose and electrolyte changes when any of these drugs are co-administered with high-concentration dextrose infusions.

Dosage of 50% DEXTROSE INJECTION USP [WELLPHARMA]

Dosage should be individualized based on clinical context, severity of hypoglycemia, and patient characteristics. The following are general dosage guidelines:

• Adults:
  • Initial dose: 25–50 mL (12.5–25 g of dextrose) via slow IV push over 1–3 minutes in cases of severe hypoglycemia.
  • Repeat doses may be administered depending on response and glucose monitoring.
• Children:
  • 0.5–1 g/kg IV push (1–2 mL/kg of 50% solution), diluted to a 25% or lower concentration when appropriate.
• Neonates and Infants:
  • 10% Dextrose solutions are generally preferred. Use of 50% Dextrose is not recommended due to risk of venous irritation and rebound hypoglycemia.
• Geriatric Patients:
  • Begin with lower doses and titrate carefully. Consider underlying renal and cardiac function.
• Max Dose: Determined by blood glucose levels and metabolic status. Excessive dosing can lead to osmotic diuresis and hyperglycemia.

Always monitor capillary or serum glucose levels during and after administration to guide further treatment.

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

Though generally well tolerated in emergencies, 50% Dextrose Injection may cause several side effects, especially if administered improperly or in sensitive patients.

• Common Side Effects:
  • Irritation or thrombophlebitis at the injection site
  • Hyperglycemia
  • Electrolyte imbalances, particularly hypokalemia
• Less Common/Serious Reactions:
  • Rebound hypoglycemia (especially if insulin secretion is stimulated)
  • Fluid overload or pulmonary edema in patients with renal or cardiac dysfunction
  • Phlebitis or vein inflammation
  • Local tissue necrosis if extravasation occurs
• Hypersensitivity Reactions:
  • Rare; may include rash, urticaria, or anaphylactoid reactions

Immediate medical attention is warranted if signs of extravasation, allergic reaction, or significant metabolic disturbances occur.

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

This product should not be used in the following conditions due to potential risk of harm or lack of benefit:

• Hyperglycemia or Diabetic Coma (Uncontrolled): Dextrose can significantly worsen blood glucose levels.
• Intracranial or Intraspinal Hemorrhage: High dextrose concentrations may increase osmotic load and intracranial pressure.
• Severe Hypokalemia (Untreated): May worsen due to insulin-mediated intracellular shift of potassium.
• Anuria or Severe Renal Impairment: Risk of fluid overload and poor clearance of dextrose.
• Delirium Tremens in Dehydrated Patients: Risk of cerebral edema or severe electrolyte shifts.
• Known Allergy to Corn or Corn Products: As dextrose is typically derived from corn starch.

Use with caution in patients with congestive heart failure, pulmonary edema, or known glucose intolerance.

Storage of 50% DEXTROSE INJECTION USP [WELLPHARMA]

Proper storage is essential to maintain the sterility and stability of 50% Dextrose Injection.

• Temperature: Store between 15°C to 25°C (59°F to 77°F). Avoid excessive heat or freezing.
• Light Exposure: Store in the original packaging to protect from light. Exposure may lead to discoloration or degradation.
• Shelf Life: Refer to the expiration date printed on the bag. Do not use beyond this date.
• Single-Use Only: Discard any unused portion. Do not reuse or re-sterilize the container.
• Visual Inspection: Check for particulate matter or discoloration prior to administration. Do not use if cloudy or if there is evidence of contamination.
• Container Integrity: Use only if the container and seal are intact. Damaged or leaking bags must be discarded.

Follow institutional and manufacturer guidelines for safe storage and disposal of used or expired bags.