• Basic Info
• Clinical Info

Uses

Parenteral Nutrition and Hydration

Used as a parenteral source of calories and water for parenteral nutrition and hydration.

Hypertonic dextrose injections (concentration >5%) are used to provide adequate calories in a minimal volume of water.

May be admixed with amino acids injections or other compatible IV fluids to provide parenteral nutrition.

Hypoglycemia

10–25% dextrose injections used in neonates and infants to restore blood glucose concentrations in the treatment of acute symptomatic hypoglycemia.

50% dextrose injections used in adults and children to restore blood glucose concentrations in the treatment of hypoglycemia resulting from insulin excess or other causes.

Used orally for the management of hypoglycemia in conscious diabetics.

Dosage and Administration

Administration

Administer orally, by slow IV injection, or slow IV infusion.

Concentrated dextrose solutions should not be administered by sub-Q or IM injection.

Oral Administration

Administer orally as a gel or a chewable tablet for the management of acute symptomatic hypoglycemia in conscious patients who are able to swallow.

To administer gel, squeeze appropriate dose from tube into mouth and swallow.

IV Administration

Administer hypertonic dextrose solutions (e.g., >5%) slowly; rapid administration may produce substantial hyperglycemia and hyperosmolar syndrome. (See Hyperglycemia and Hyperosmolar Syndrome under Cautions.)

It is preferable to administer hypertonic dextrose solutions via an IV catheter placed into a large central vein, and only after appropriate admixture or dilution.

Hypertonic dextrose solutions may be administered slowly via a large peripheral vein, preferably through a small bore needle. If possible, alternate the injection site daily.

Ensure that the needle (or catheter) is within the vein lumen and avoid extravasation. (See Infusion Site Reactions under Cautions.)

Administer concentrated dextrose solutions (≥10%) only after appropriate dilution, except in the emergency treatment of severe hypoglycemia.

Rate of Administration

Usually, administer by IV infusion at a rate of 0.5 g/kg per hour. Approximately 95% of dextrose is retained when infused at a rate of 0.8 g/kg per hour. (See Prescribing Limits under Dosage and Administration.)

For hypoglycemia in children and adults, administer 50% dextrose injection slowly (e.g., 3 mL/minute).

For hypoglycemia in neonates and infants, administer 10–25% dextrose injection slowly.

Dosage

Each 1 gram of hydrous dextrose provides approximately 3.4 calories.

Dextrose gel contains 40% glucose; each dose (1.3 ounces) provides 15 g of carbohydrates and 60 calories.

Each chewable tablet provides 5 g of carbohydrates and 20 calories; each dose (3 tablets) provides 15 g of carbohydrates.

Determine dosage based on the age, weight, clinical condition, fluid and electrolyte balance, glucose concentration, and acid-base balance of the patient.

Pediatric Patients

Select dosage and infusion rate with caution in pediatric patients, especially in neonates and low-birthweight infants.

Parenteral Nutrition and Hydration

IV

Calculate dosage based on patient’s weight, clinical condition, and laboratory results.

Hypoglycemia

Oral

Gel: 15 g. Repeat dose after 15 minutes, if necessary.

Chewable tablet: 15 g (3 tablets). Repeat dose after 10–20 minutes, if necessary.

Some clinicians recommend consideration of an additional dose if hypoglycemic symptoms are still present and a blood glucose increase of ≥20 mg/dL is not achieved within 20 minutes.

IV

Neonates and infants: 250–500 mg/kg as a single dose (1–2 mL of 25% dextrose injection) in neonates. In severe cases or in older infants, higher or repeated single doses up to a maximum 10–12 mL of 25% dextrose injection may be required. Subsequently, if required, administer 10% dextrose injection by continuous IV infusion to stabilize blood glucose concentrations. Alternatively, 2 mL/kg of 10–25% dextrose injection in neonates and infants.

Children: 20–50 mL of 50% dextrose injection administered slowly (e.g., 3 mL/minute). In severe cases, repeated doses and supportive therapy may required.

Adults

Parenteral Nutrition and Hydration

IV

Calculate dosage based on age, weight, clinical condition, fluid and electrolyte balance, and acid-base balance of the patient.

Hypoglycemia

Oral

Gel: 15 g. Repeat dose after 15 minutes, if necessary.

Chewable tablet: 15 g (3 tablets). Repeat dose after 10–20 minutes, if necessary.

Some clinicians recommend consideration of an additional dose if hypoglycemic symptoms are still present and a blood glucose increase of ≥20 mg/dL is not achieved within 20 minutes.

IV

20–50 mL of 50% dextrose injection administered slowly (e.g., 3 mL/minute). In severe cases, repeated doses and supportive therapy may be required.

When patients do not respond to or tolerate dextrose, consider the use of other drugs (e.g., glucagon, corticosteroids, epinephrine).

Prescribing Limits

Pediatric Patients

Parenteral Nutrition and Hydration

IV

Children: Maximum infusion rate without producing glycosuria: 0.5 g/kg per hour. Maximum infusion rate 0.8 g/kg per hour.

Hypoglycemia

IV

Neonates and infants: Maximum 10–12 mL of 25% dextrose injection in severe cases or in older infants.

Children: Maximum infusion rate without producing glycosuria: 0.5 g/kg per hour. Maximum infusion rate 0.8 g/kg per hour.

Adults

Parenteral Nutrition and Hydration

IV

Maximum infusion rate without producing glycosuria: 0.5 g/kg per hour. Maximum infusion rate 0.8 g/kg per hour.

Hypoglycemia

IV

Maximum infusion rate without producing glycosuria: 0.5 g/kg per hour. Maximum infusion rate 0.8 g/kg per hour.

Special Populations

No specific dosage recommendations for special populations.

Last Updated: August 01, 2008