Dextrose-based products

Product Options

• D5W
• D10W
• D25W
• D50W
• D5NS
• D5 1/2NS

Choosing Products

Pediatric Hypoglycemia Dextrose Chart

Category	Age	Glucose	Treatment	Initial IV Bolus	Maintenance Dose
Neonatal	<2mo	<40	D10W	2.5-5 mL/kg	6 mL/kg/h
Pediatric	2mo-8yrs	<60	D25W	2 mL/kg	D10W: 6 mL/kg/h for first 10 kg + 3 mL/kg/h for 11–20 kg + 1.5 mL/kg/h for each additional kg >20 kg
Adult	>8yrs	<70	D50W	50mL (1 amp) OR 1 mL/kg

• Consider diluting the D25W or D50W bolus, with NS 1-to-1, as those concentrations may be sclerosing to veins
• Recheck 5 minutes after dose and repeat dose if low.
• Consider glucagon IM/SQ if IV access is not readily available

Dextrose Comparison

• D50W
  • 25gm dextrose in 50mL sterile water (25g/50ml = 50% dextrose)
• D10W
  • 25gm dextrose in 250mL sterile water (25gm/250mL = 10% dextrose)
• D5W
  • 25gm dextrose in 500mL sterile water (25gm/500mL = 5% dextrose)

Rule of 50

Divide 50 by the type of dextrose solution to arrive at rate in ml/kg

• Adult (D50): 50/50 = 1 ml/kg
• Pediatric (D25): 50/25 = 2 ml/kg
• Infant (D10): 50/10 = 5 ml/kg

Indications by Condition

The following table is automatically generated from disease/condition pages across WikEM.

Indication	Dose	Context	Route	Population
Hypoglycemia	D50W 50 mL (25 g glucose) IV bolus	IV dextrose for AMS/unable to take PO	IV	Adult
Hypoglycemia	D25W 2-4 mL/kg IV; D10W 5 mL/kg IV (neonates)	IV dextrose (pediatric)	IV	Pediatric
Neonatal hypoglycemia	2-3mL/kg of D10W IV bolus, then D10W infusion at 4-6mg/kg/min	Acute neonatal hypoglycemia	IV	Pediatric
Newborn resuscitation	2-4mL/kg of D10W IV	Hypoglycemia	IV	Pediatric
Seizure (peds)	2mL/kg of D25W	Hypoglycemic seizure (glucose <50mg/dL)	IV	Pediatric
Status epilepticus (peds)	D25W 2mL/kg (max 100mL) or D10W 5mL/kg (max 250mL)	If blood glucose <60mg/dL	IV	Pediatric

See Also

• Hypoglycemia
• Non-neonatal hypoglycemia (peds)
• Neonatal hypoglycemia
• Intravenous fluids (main)