DEXTROSE by is a Prescription medication manufactured, distributed, or labeled by Baxter Healthcare Corporation, Bieffe Medital SA. Drug facts, warnings, and ingredients follow.
Dextrose Injection is indicated as a source of water and calories. (1)
Injection:
The most common adverse reactions are, hyperglycemia, hypersensitivity reactions, hyponatremia, infection both systemic and at the injection site, vein thrombosis or phlebitis, and electrolyte imbalance. (6)
To report SUSPECTED ADVERSE REACTIONS, contact Baxter Healthcare at 1-866-888-2472 or FDA at 1-800-FDA-1088 or www.fda.gov/medwatch.
Other Products that Affect Glycemic Control, Vasopressin or Fluid and/or Electrolyte Balance: Monitor blood glucose concentrations, fluid balance, serum electrolyte concentrations and acid-base balance. (7.1)
Pediatric Use: Increased risk of hypoglycemia/hyperglycemia; monitor serum glucose concentrations. (8.4)
See 17 for PATIENT COUNSELING INFORMATION.
Revised: 8/2019
The choice of dextrose concentration, rate and volume depends on the age, weight, clinical and metabolic conditions of the patient and concomitant therapy. Electrolyte supplementation may be indicated according to the clinical needs of the patient.
The administration rate should be governed, especially for premature infants with low birth weight, during the first few days of therapy, by the patient’s tolerance to dextrose.
Increase the infusion rate gradually as indicated by frequent monitoring of blood glucose concentrations [see Warnings and Precautions (5.1), Use in Specific Populations (8.4)].
To Open
Preparation for Administration
To Add Medication
To Add Medication Before Solution Administration
To Add Medication During Solution Administration
Storage
The use of Dextrose Injection is contraindicated in patients with:
The use of dextrose infusions in patients with impaired glucose tolerance may worsen hyperglycemia. Administration of dextrose at a rate exceeding the patient’s utilization rate may lead to hyperglycemia, coma, and death.
Hyperglycemia is associated with an increase in serum osmolality, resulting in osmotic diuresis, dehydration and electrolyte losses [see Warnings and Precautions (5.5)]. Patients with underlying CNS disease and renal impairment who receive dextrose infusions, may be at greater risk of developing hyperosmolar hyperglycemic state.
Monitor blood glucose levels and treat hyperglycemia to maintain levels within normal limits while administering Dextrose Injection. Insulin may be administered or adjusted to maintain optimal blood glucose levels during Dextrose Injection administration.
Hypersensitivity and infusion reactions, including anaphylaxis, have been reported with Dextrose Injection [see Adverse Reactions (6)]. Stop infusion immediately and treat patient accordingly if signs or symptoms of a hypersensitivity reaction develop. Appropriate therapeutic countermeasures must be instituted as clinically indicated.
Peripheral administration of 5% Dextrose Injection is generally acceptable, however, consider central vein when administering more than 5% dextrose or with an osmolarity of ≥ at least 900 mOsm/L or when there is peripheral vein irritation, phlebitis, and/or associated pain [see Dosage and Administration (2. 1)]. The infusion of hypertonic solutions into a peripheral vein may result in vein irritation, vein damage, and/or thrombosis. The primary complication of peripheral access is venous thrombophlebitis, which manifests as pain, erythema, tenderness or a palpable cord. Remove the catheter as soon as possible, if thrombophlebitis develops.
5% Dextrose Injection is an isotonic solution [see Description, Table 1 (11)]. In the body, however, glucose containing fluids can become extremely physiologically hypotonic due to rapid glucose metabolization. Monitoring of serum sodium is particularly important for hypotonic fluids.
Depending on the tonicity of the solution, the volume and rate of infusion, and depending on a patient’s underlying clinical condition and capability to metabolize glucose, intravenous administration of glucose can cause electrolyte disturbances, most importantly hypo- or hyperosmotic hyponatremia. Monitor serum sodium to minimize the risk of hyponatremia.
The risk for hyponatremia is increased in pediatric patients, elderly patients, postoperative patients, those with psychogenic polydipsia, and in patients treated with medications that increase the risk of hyponatremia (such as diuretics, certain antiepileptic and psychotropic medications). Close clinical monitoring may be warranted.
Acute hyponatremia can lead to acute hyponatremic encephalopathy characterized by headache, nausea, seizures, lethargy and vomiting. Patients with brain edema are at particular risk of severe, irreversible and life-threatening brain injury. Patients at increased risk for developing complications of hyponatremia, such as hyponatremic encephalopathy include pediatric patients; women, in particular, premenopausal women; patients with hypoxemia; and in patients with underlying central nervous system disease [see Use in Specific Populations (8.4, 8.5)].
Avoid Dextrose Injection in patients with or at risk for hyponatremia. If use cannot be avoided, monitor serum sodium concentrations.
Rapid correction of hyponatremia is potentially dangerous with risk of serious neurologic complications. Brain adaptations reducing risk of cerebral edema make the brain vulnerable to injury when chronic hyponatremia is too rapidly corrected, which is known as osmotic demyelination syndrome (ODS). To avoid complications, monitor serum sodium and chloride concentrations, fluid status, acid-base balance, and signs of neurologic complications.
High volume infusion must be used with close monitoring in patients with cardiac or pulmonary failure, and in patients with non-osmotic vasopressin release (including SIADH), due to the risk of hospital-acquired hyponatremia.
Electrolyte deficits, particularly in serum potassium and phosphate, may occur during prolonged use of concentrated dextrose solutions.
Depending on the volume and rate of infusion, the patient’s underlying clinical condition and capability to metabolize dextrose, intravenous administration of Dextrose Injection can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, (including hypoosmotic hyponatremia), overhydration, congested states or pulmonary edema. The risk of dilutional states is inversely proportional to the electrolyte concentrations in the administered solution. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentrations in the solution.
Avoid Dextrose Injection in patients with or at risk for fluid and/or solute overloading. If use cannot be avoided, monitor fluid balance, blood electrolyte levels, concentration of glucose, acid-base balance, correct fluid and electrolyte imbalances during prolonged parenteral therapy or whenever the condition of the patient or the rate of administration warrants such evaluation and acid-base balance as needed and especially during prolonged use. Additional monitoring is recommended for patients with water and electrolyte disturbances that could be aggravated by increased glucose, insulin administration and/or free water load. Patients at increased risk for developing hyponatremic encephalopathy include pediatric patients; elderly patients, women, in particular premenopausal women; patients with hypoxemia; and patients with underlying CNS disease [see Use in Specific Populations (8.4,8.5)].
Refeeding severely undernourished patients may result in refeeding syndrome, characterized by the intracellular shift of potassium, phosphorus, and magnesium as the patient becomes anabolic. Thiamine deficiency and fluid retention may also develop. To prevent these complications, monitor severely undernourished patients and slowly increase nutrient intake.
The following adverse reactions associated with the use of dextrose injection were identified in clinical trials or postmarketing reports. Because these reactions were reported voluntarily from a population of uncertain size, it is not always possible to estimate their frequency, reliably, or to establish a causal relationship to drug exposure.
The following clinically significant adverse reactions are described elsewhere in the labeling:
Dextrose Injection can affect glycemic control, vasopressin and fluid and/or electrolyte balance [see Warnings and Precautions (5.1, 5.4, 5.5)]. Monitor blood glucose concentrations, fluid balance, serum electrolyte concentrations and acid-base balance when using Dextrose Injection in patients treated with other substances that affect glycemic control, vasopressin or fluid and/or electrolyte balance.
Risk Summary
Appropriate administration of Dextrose Injection during pregnancy is not expected to cause adverse developmental outcomes, including congenital malformations. Animal reproduction studies have not been conducted with injectable dextrose solutions.
The estimated background risk of major birth defects and miscarriage for the indicated population is unknown. All pregnancies have a background risk of birth defect, loss, or other adverse outcomes. In the U.S. general population, the estimated background risk of major birth defects and miscarriage in clinically recognized pregnancies is 2 to 4% and 15 to 20%, respectively.
Risk Summary
There are no data on the presence of dextrose in human milk, the effects on a breastfed infant, or the effects on milk production. The lack of clinical data during lactation precludes a clear determination of the risk of Dextrose Injection to an infant during lactation; therefore, the developmental and health benefits of breastfeeding should be considered along with the mother’s clinical need for Dextrose Injection and any potential adverse effects on the breastfed infant from Dextrose Injection or from the underlying maternal condition.
The safety profile of Dextrose Injection in pediatric patients is similar to adults.
Neonates, especially premature infants with low birth weight, are at increased risk of developing hypo- or hyperglycemia and therefore need close monitoring during treatment with intravenous glucose infusions to ensure adequate glycemic control in order to avoid potential long-term adverse effects.
Closely monitor plasma electrolyte concentrations in pediatric patients who may have impaired ability to regulate fluids and electrolytes. In very low birth weight infants, excessive or rapid administration of Dextrose Injection may result in increased serum osmolality and risk of intracerebral hemorrhage.
Children (including neonates and older children) are at increased risk of developing hyponatremia as well as for developing hyponatremic encephalopathy [see Warnings and Precautions (5.4)].
Clinical studies of Dextrose Injection did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Elderly patients are at increased risk of developing hyponatremia as well as for developing hyponatremic encephalopathy [see Warnings and Precautions (5.4)]. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy.
Dextrose is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.
An increased infusion rate of Dextrose Injection or administration of dextrose solutions can cause hyperglycemia, hyperosmolality, and adverse effects on water and electrolyte balance [see Warnings and Precautions (5.1, 5.5)].
Severe hyperglycemia and severe dilutional hyponatremia, and their complications, can be fatal. Discontinue infusion, reduce dose and institute appropriate corrective measures such as administration of exogenous insulin.
Discontinue infusion and institute appropriate corrective measures in the event of overhydration or solute overload during therapy, with particular attention to CNS, respiratory and cardiovascular systems.
If over-exposure occurs, call your Poison Control Center at 1-800-222-1222 for current information on the management of poisoning or overdosage.
Dextrose Injection, USP is sterile, non-pyrogenic solutions of Dextrose, USP in Water for Injection in a flexible plastic container for intravenous administration as a source of water and calories.
Partial-fill containers, designed to facilitate admixture when necessary, are available in 250 mL, 500 mL, and 1000 mL sizes. See Table 1 for the content and characteristics of this solution.
The solution contains no bacteriostatic, antimicrobial agent or added buffer and is intended only for use as a single-dose injection. The pH range is 4.0 (3.2 to 6.5).
Water can permeate from inside the container into the overwrap but not in amounts sufficient to affect the solution significantly.
Strength | Fill Volume | Amount of Dextrose Hydrous per Container | kcal* per Container | Osmolarity (mOsmol per liter) |
---|---|---|---|---|
|
||||
Dextrose Injection 5%, USP |
250 mL |
12.5 grams |
42.5 |
252 |
500 mL |
25 grams |
85 |
252 |
|
1000 mL |
50 grams |
170 |
252 |
Dextrose, USP is chemically designated D-glucose, monohydrate (C6H12O6 H2O), a hexose sugar freely soluble in water. The molecular weight of dextrose (D-glucose) monohydrate is 198.17. It has the following structural formula:
Water for Injection, USP is chemically designated H2O.
Dextrose is derived from corn.
VIAFLO is a flexible plastic container fabricated from a multilayer sheeting (PL-2442) composed of Polypropylene (PP), Polyamide (PA) and Polyethylene (PE). Two different administration connectors are available with VIAFLO containers. The VIAFLO dripless access container (DAC) will not drip once the spike is removed. The non-DAC VIAFLO will drip once the spike is removed from the administration port.
VIAFLO is not made with natural rubber latex, DEHP, or PVC.
Dextrose Injection, USP are clear, colorless, sterile solutions of dextrose supplied in VIAFLO dripless access containers (DAC) and non-DAC plastic containers are shown below. VIAFLO DAC will not drip once the spike is removed. VIAFLO non-DAC will drip once the spike is removed from the administration port.
Product Description |
Size |
Code |
NDC |
Dextrose Injection 5%, USP |
250 mL (DAC) 250 mL (Non-DAC) 500 mL (DAC) 500 mL (Non-DAC) 1000 mL (DAC) 1000 mL (Non-DAC) |
UE0062D UE0062 UE0063D UE0063 UE0064D UE0064 |
0338-0062-30 0338-0074-30 0338-0066-20 0338-0078-20 0338-0070-10 0338-0082-10 |
Do not remove container from the overwrap until intended for use.
Use the product immediately after mixing and the introduction of additives.
Store between 20ºC to 25°C (68º F to 77°F). [See USP controlled room temperature.]
Do not freeze.
Inform patients, caregivers, or home healthcare providers of the following risks of Dextrose Injection:
Hyperglycemia and hyperosmolar hyperglycemic state [see Warnings and Precautions (5.1)]
Hypersensitivity reactions [see Warnings and Precautions (5.2)]
Vein damage and thrombosis [see Warnings and Precautions (5.3)]
Hyponatremia [see Warnings and Precautions (5.4)]
Electrolyte imbalance and fluid overload [see Warnings and Precautions (5.5)]
Refeeding syndrome [see Warnings and Precautions (5.6)]
Manufactured by, Packed by, Distributed by:
Baxter Healthcare Corporation
Deerfield, IL 60015 USA
SA-30-02-493
Baxter and Viaflo are trademarks of Baxter International Inc.
Baxter
Viaflo
5% Dextrose
Injection USP
UE0062D
0338-0062-30
250 mL
Sterile non pyrogenic
Single dose container
pH 4.0 (3.2-6.5)
Osmolarity 252 mOsm/L (calc)
Each 100 mL contains 5 g Dextrose Hydrous USP Additives may be incompatible
Consult with pharmacist if available when introducing additives Use aseptic
technique Mix thoroughly Do not store Dosage intravenously as directed by a
physician See directions Cautions Squeeze and inspect inner bag which maintains
product sterility Discard if leaks are found Must not be used in series connections
Do not administer simultaneously with blood Do not use unless solution is clear
Rx Only Store unit in moisture barrier overwrap at room temperature (25°C/77°F)
until ready to use Avoid excessive heat See insert VIAFLO is not made from natural
rubber latex, DEHP, or PVC
Baxter and Viaflo are trademarks of Baxter International Inc.
For product information
1-800-933-0303
Baxter Healthcare Corporation
Deerfield IL 60015 USA
Made in Spain
BAR CODE
Lot
UN-
Expiry
50
100
150
200
Baxter
Viaflo
5% Dextrose
Injection USP
UE0062
0338-0074-30
250 mL
Sterile non pyrogenic
Single dose container
pH 4.0 (3.2-6.5)
Osmolarity 252 mOsm/L (calc)
Each 100 mL contains 5 g Dextrose Hydrous USP Additives may be incompatible
Consult with pharmacist if available when introducing additives Use aseptic
technique Mix thoroughly Do not store Dosage intravenously as directed by a
physician See directions Cautions Squeeze and inspect inner bag which maintains
product sterility Discard if leaks are found Must not be used in series connections
Do not administer simultaneously with blood Do not use unless solution is clear
Rx Only Store unit in moisture barrier overwrap at room temperature (25°C/77°F)
until ready to use Avoid excessive heat See insert VIAFLO is not made from natural
rubber latex, DEHP, or PVC
Baxter and Viaflo are trademarks of Baxter International Inc.
For product information
1-800-933-0303
Baxter Healthcare Corporation
Deerfield IL 60015 USA
Made in Spain
BAR CODE
Lot
UN-
Expiry
50
100
150
200
Baxter
Viaflo
5% Dextrose
Injection USP
UE0063D
0338-0066-20
500 mL
Sterile non pyrogenic
Single dose container
pH 4.0 (3.2-6.5)
Osmolarity 252 mOsm/L (calc)
Each 100 mL contains 5 g Dextrose Hydrous USP Additives may be incompatible
Consult with pharmacist if available when introducing additives Use aseptic
technique Mix thoroughly Do not store Dosage intravenously as directed by a
physician See directions Cautions Squeeze and inspect inner bag which maintains
product sterility Discard if leaks are found Must not be used in series connections
Do not administer simultaneously with blood Do not use unless solution is clear
Rx Only Store unit in moisture barrier overwrap at room temperature (25°C/77°F)
until ready to use Avoid excessive heat See insert VIAFLO is not made from natural
rubber latex, DEHP, or PVC
Baxter and Viaflo are trademarks of Baxter International Inc.
For product information
1-800-933-0303
Baxter Healthcare Corporation
Deerfield IL 60015 USA
Made in Spain
BAR CODE
Lot
UN-35-03-406
Expiry
50
100
150
200
250
300
350
400
450
Baxter
Viaflo
5% Dextrose
Injection USP
UE0063
0338-0078-20
500 mL
Sterile non pyrogenic
Single dose container
pH 4.0 (3.2-6.5)
Osmolarity 252 mOsm/L (calc)
Each 100 mL contains 5 g Dextrose Hydrous USP Additives may be incompatible
Consult with pharmacist if available when introducing additives Use aseptic
technique Mix thoroughly Do not store Dosage intravenously as directed by a
physician See directions Cautions Squeeze and inspect inner bag which maintains
product sterility Discard if leaks are found Must not be used in series connections
Do not administer simultaneously with blood Do not use unless solution is clear Rx
Only Store unit in moisture barrier overwrap at room temperature (25°C/77°F) until
ready to use Avoid excessive heat See insert VIAFLO is not made from natural
rubber latex, DEHP, or PVC
Baxter and Viaflo are trademarks of Baxter International Inc.
For product information
1-800-933-0303
Baxter Healthcare Corporation
Deerfield IL 60015 USA
Made in Spain
BAR CODE
Lot
UN-35-03-405
Expiry
50
100
150
200
250
300
350
400
450
Baxter
Viaflo
5% Dextrose
Injection USP
UE0064D
0338-0070-10
1000 mL
Sterile non pyrogenic
Single dose container
pH 4.0 (3.2-6.5)
Osmolarity 252 mOsm/L (calc)
Each 100 mL contains 5 g Dextrose Hydrous USP Additives may be incompatible
Consult with pharmacist if available when introducing additives Use aseptic
technique Mix thoroughly Do not store Dosage intravenously as directed by a
physician See directions Cautions Squeeze and inspect inner bag which maintains
product sterility Discard if leaks are found Must not be used in series connections
Do not administer simultaneously with blood Do not use unless solution is clear
Rx Only Store unit in moisture barrier overwrap at room temperature (25°C/77°F)
until ready to use Avoid excessive heat See insert VIAFLO is not made from natural
rubber latex, DEHP, or PVC
Baxter and Viaflo are trademarks of Baxter International Inc.
For product information
1-800-933-0303
Baxter Healthcare Corporation
Deerfield IL 60015 USA
Made in Spain
BAR CODE
Lot
UN-
Expiry
100
200
300
400
500
600
700
800
900
Baxter
Viaflo
5% Dextrose
Injection USP
UE0064
0338-0082-10
1000 mL
Sterile non pyrogenic
Single dose container
pH 4.0 (3.2-6.5)
Osmolarity 252 mOsm/L (calc)
Each 100 mL contains 5 g Dextrose Hydrous USP Additives may be incompatible
Consult with pharmacist if available when introducing additives Use aseptic
technique Mix thoroughly Do not store Dosage intravenously as directed by a
physician See directions Cautions Squeeze and inspect inner bag which maintains
product sterility Discard if leaks are found Must not be used in series connections
Do not administer simultaneously with blood Do not use unless solution is clear
Rx Only Store unit in moisture barrier overwrap at room temperature (25°C/77°F)
until ready to use Avoid excessive heat See insert VIAFLO is not made from natural
rubber latex, DEHP, or PVC
Baxter and Viaflo are trademarks of Baxter International Inc.
For product information
1-800-933-0303
Baxter Healthcare Corporation
Deerfield IL 60015 USA
Made in Spain
BAR CODE
Lot
UN-
Expiry
100
200
300
400
500
600
700
800
900
DEXTROSE
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Labeler - Baxter Healthcare Corporation (005083209) |
Establishment | |||
Name | Address | ID/FEI | Business Operations |
---|---|---|---|
Bieffe Medital SA | 464755693 | ANALYSIS(0338-0062, 0338-0074, 0338-0066, 0338-0078, 0338-0070, 0338-0082) , MANUFACTURE(0338-0062, 0338-0074, 0338-0066, 0338-0078, 0338-0070, 0338-0082) , LABEL(0338-0062, 0338-0074, 0338-0066, 0338-0078, 0338-0070, 0338-0082) , PACK(0338-0062, 0338-0074, 0338-0066, 0338-0078, 0338-0070, 0338-0082) , STERILIZE(0338-0062, 0338-0074, 0338-0066, 0338-0078, 0338-0070, 0338-0082) |