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IV glucose solution (hypoglycaemia treatment) Pregnancy: Safe in obstetric hypoglycaemia or neonatal use.

Dextrose 10% IV

Brand names: Glucose 10% Infusion

Adult dose

Dose: Severe hypoglycaemia: 75–150 mL of 10% dextrose IV (75 mmol glucose) or 50 mL of 50% dextrose
Route: IV (peripheral vein for 10%; central preferred for >20%)
Frequency: Bolus, then repeat blood glucose check at 15 minutes
Max: Repeat as needed until BG >4.0 mmol/L
Severe hypoglycaemia (unconscious): 10% dextrose 150–200 mL IV over 15 min. Or 50 mL 50% dextrose IV. Maintain glucose ≥6 mmol/L post-treatment. Follow with oral carbohydrate. 10% dextrose preferred in unconscious (50% can cause tissue necrosis if extravasation and is viscous).

Paediatric dose

Dose: 2 mL/kg
Route: IV
Frequency: Bolus; repeat as needed
Max: 200 mL per dose
Neonatal hypoglycaemia: 2–4 mL/kg 10% dextrose IV over 5 min, then maintenance infusion. Paediatric hypoglycaemia: 2 mL/kg 10% dextrose (0.2 g/kg). Max 500 mL/kg/day maintenance. NEVER give >10% dextrose in peripheral IV in neonates (osmotic damage).

Dose adjustments

Renal

No specific adjustment; monitor glucose closely.

Hepatic

Hepatic failure may cause refractory hypoglycaemia — higher glucose infusion rates.

Paediatric weight-based calculator

Neonatal hypoglycaemia: 2–4 mL/kg 10% dextrose IV over 5 min, then maintenance infusion. Paediatric hypoglycaemia: 2 mL/kg 10% dextrose (0.2 g/kg). Max 500 mL/kg/day maintenance. NEVER give >10% dextrose in peripheral IV in neonates (osmotic damage).

Clinical pearls

  • Give thiamine BEFORE glucose in alcohol-dependent or malnourished patients
  • 10% dextrose preferred over 50% (safer peripherally, less risk of hyperosmolar damage)
  • Glucose-insulin infusion for hyperkalaemia: 50 mL of 50% dextrose + 10 units soluble insulin over 15–30 min (shifts K+ intracellularly)
  • Monitor glucose 15–30 min post-treatment — ensure sustained correction
  • Neonatal hypoglycaemia: breastfeeding first if mild; IV if BG <2.0 or symptomatic

Contraindications

  • Hypertonic solutions (>10%) in peripheral veins in neonates
  • Thiamine deficiency without thiamine cover (give thiamine first)

Side effects

  • Hyperglycaemia (excessive dose)
  • Tissue necrosis (extravasation of 50% dextrose)
  • Phlebitis (hypertonic solutions)
  • Fluid overload

Interactions

  • Insulin — co-infusion for hyperkalaemia treatment (glucose + insulin protocol)

Monitoring

  • Blood glucose every 15–30 min
  • Fluid balance
  • IV site (extravasation risk)

Reference: BNFc; BNF; JBDS Guidelines; NICE NG3 Neonatal Hypoglycaemia; BNFc. Verify against your local formulary and the latest BNF before prescribing.

Related

Curated clinical cross-links plus same-class fallbacks.

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