Isoride0.18%+4.3%

Isoride is an intravenous (IV) crystalloid solution indicated for use as a source of water, electrolytes, and calories, and to treat combined water and sodium depletion.

Established / FDA-approved uses

• Fluid and electrolyte replacement in patients with dehydration, hypovolemia, or ongoing fluid losses (e.g. vomiting, diarrhea, surgery, trauma, or shock) who cannot maintain adequate oral intake.
• Maintenance of daily water and electrolyte requirements in patients requiring parenteral fluid therapy.
• Provision of a source of calories via dextrose, useful in states of limited oral/enteral intake.

Adjunct / vehicle use

• Used as a diluent/vehicle for administration of compatible IV medications and additives, as directed by a physician or pharmacist.

Isoride is a prescription-only, hospital/clinic-administered infusion; it is not a self-administered outpatient medicine. The specific concentration (e.g. 5% dextrose with 0.9%, 0.45%, or 0.225% sodium chloride) and rate of infusion are selected by the treating physician according to the patient's clinical status.

Sodium Chloride + Dextrose is available as a sterile, non-pyrogenic solution in water for injection, in several strength combinations. Common presentations include:

• 5% Dextrose Monohydrate (5 g/100 mL) with 0.9% Sodium Chloride (0.9 g/100 mL) — e.g. D5NS
• 5% Dextrose Monohydrate with 0.45% Sodium Chloride (0.45 g/100 mL) — e.g. D5 1/2NS
• 5% Dextrose Monohydrate with 0.225% Sodium Chloride (0.225 g/100 mL) — e.g. D5 1/4NS

Supplied in single-use IV infusion containers of 250 mL, 500 mL, and 1000 mL. Contains no bacteriostatic or antimicrobial agent and no added buffer.

Isoride is a sterile intravenous crystalloid solution combining dextrose (a carbohydrate source) with sodium chloride (an electrolyte source) dissolved in water for injection. Depending on the sodium chloride concentration, the solution may be isotonic or hypotonic relative to plasma.

It is administered exclusively by the intravenous route under the supervision of trained healthcare personnel, typically in a hospital, clinic, or supervised infusion setting, and is used for fluid resuscitation, maintenance fluid therapy, and as a vehicle for compatible IV medications.

Isoride belongs to the therapeutic class of intravenous fluid and electrolyte replenishers (crystalloid solutions), used for parenteral fluid, electrolyte, and caloric replacement therapy.

Sodium Chloride + Dextrose works by combining the physiological actions of its two components:

• Sodium Chloride restores or maintains extracellular fluid volume and sodium/chloride ion concentrations, since sodium is the principal cation of extracellular fluid and controls water distribution across cell membranes.
• Dextrose is metabolized to carbon dioxide and water, yielding energy (approximately 3.4 kcal/g), and helps minimize protein and glycogen breakdown while contributing to hepatic glycogen deposition, with negligible effect on osmotic pressure once metabolized.

Following infusion, Sodium Chloride + Dextrose is distributed within the extracellular fluid compartment; sodium and chloride are handled by normal renal regulatory mechanisms, and dextrose is taken up by cells for oxidative metabolism.

Isoride is administered by continuous intravenous infusion using aseptic technique:

• Inspect the container for clarity, absence of particulate matter, and an intact seal before use; discard if the solution is cloudy, discolored, or the container is damaged or leaking.
• Use sterile equipment; prime the IV line before connecting to avoid air embolism.
• Select and prepare the venipuncture site using aseptic/antiseptic technique.
• Set and regularly verify the infusion rate as prescribed, using an infusion pump where indicated.
• Monitor the infusion site regularly for redness, swelling, pain, or leakage (signs of phlebitis or extravasation) and discontinue promptly if these occur.
• Discard any unused portion of an opened container; do not reuse partially used containers.

Clinically significant interactions with Isoride include:

• Corticosteroids/corticotropin: may cause sodium and fluid retention, increasing the risk of fluid overload and edema when co-administered.
• Lithium: concurrent sodium chloride infusion can increase renal lithium clearance and lower serum lithium concentrations, potentially reducing its therapeutic effect.
• Insulin and other glucose-lowering drugs: the dextrose component can antagonize glycemic control; blood glucose should be monitored and antidiabetic therapy adjusted as needed.
• Drugs affecting sodium/fluid balance (e.g. NSAIDs, some antihypertensives): may alter the fluid and electrolyte effects of this infusion; monitor accordingly.

Only medications and additives confirmed compatible with Isoride should be admixed, per pharmacy compatibility references.

Adverse effects associated with Isoride infusion include:

• Infusion-site reactions: pain, redness, phlebitis, thrombosis, or extravasation.
• Febrile response, local infection at the injection site.
• Hyperglycemia and, with excessive/rapid infusion, hypervolemia or fluid overload.
• Electrolyte disturbances (e.g. hyponatremia, hypernatremia) depending on concentration used and clinical context.

Infusion should be discontinued and the patient re-evaluated if any adverse reaction occurs.

Pregnancy: Isoride should be used in pregnancy only if clearly needed and the potential benefit justifies the potential risk, under close medical supervision; appropriate use for fluid/electrolyte support is not expected to cause harm, but administration and rate must be individualized and monitored, particularly to avoid fluid overload or hyperglycemia.

Lactation: There is limited data on the effect of Isoride on breastfed infants; a physician should weigh the clinical need for the infusion against any potential risk before use in breastfeeding mothers.

Fluid overload: Excessive or too-rapid administration of Isoride can cause fluid and solute overload, resulting in overhydration, congestive states, or pulmonary edema; use with particular caution in patients with congestive heart failure, severe renal impairment, or pre-eclampsia, and monitor fluid balance closely.

Hyperglycemia: The dextrose component can raise blood glucose; monitor levels closely in diabetic patients and others at risk, and administer insulin if directed by the physician.

Electrolyte imbalance: Monitor serum sodium and other electrolytes, particularly with prolonged infusion or in patients with renal impairment, to avoid hyponatremia or hypernatremia.

Administration: Isoride must be administered only by, or under direct supervision of, trained healthcare personnel with the rate and volume determined by a physician; it is not intended for self-administration. Monitor the infusion site for phlebitis or extravasation.

See Contraindications for hypersensitivity and uncontrolled hyperglycemia.

Overdosage or excessively rapid infusion of Isoride can cause water intoxication/fluid overload (with symptoms such as swelling, shortness of breath, or pulmonary edema), electrolyte disturbances, and hyperglycemia. If overdose or an adverse reaction is suspected, stop the infusion immediately and seek immediate medical attention; contact emergency services or a poison control center. Management is supportive and directed by the treating physician, and may include fluid restriction, diuretics, correction of electrolyte imbalance, or insulin for hyperglycemia, as clinically indicated.

Store at room temperature (below 30°C), protected from light and freezing. Do not use if the container is damaged or leaking, or if the solution is cloudy, discolored, or contains visible particles. For single use only; discard any unused portion. Keep out of reach of children.

Renal impairment: Use Isoride with caution and reduced infusion rates; close monitoring of fluid balance and electrolytes is required due to reduced ability to excrete excess water, sodium, and glucose.

Hepatic impairment: Use with caution; monitor glucose and fluid status closely.

Elderly: More susceptible to fluid overload and hyponatremia; use conservative infusion rates and closer monitoring.

Diabetic patients: Increased risk of hyperglycemia from the dextrose component; monitor blood glucose and adjust insulin/antidiabetic therapy as needed.

Neonates and infants: See Pediatric Uses.

Duration of Isoride infusion is determined by the treating physician based on the patient's clinical condition, ongoing fluid and electrolyte requirements, and response to therapy — ranging from a single short infusion to continuous multi-day therapy in hospitalized patients — with regular reassessment of fluid balance and laboratory parameters to decide when to taper or discontinue.

Intravenous fluid and electrolyte replenisher; crystalloid solution; parenteral caloric/fluid therapy agent.

In Sodium Chloride + Dextrose, sodium chloride supplies sodium and chloride ions to restore or maintain extracellular fluid volume and normal osmotic/electrolyte balance, since sodium governs water distribution across cell membranes and is largely confined to the extracellular compartment. Dextrose is taken up by cells and metabolized via glycolysis/oxidative pathways to carbon dioxide and water, supplying calories, sparing endogenous protein and glycogen stores, and supporting hepatic glycogen deposition.

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Isoride is used in pediatric patients, including neonates, for fluid, electrolyte, and caloric support when oral/enteral intake is inadequate, with volume and rate individualized by weight or body-surface-area and prescribed by a pediatrician.

Neonates and young infants are at increased risk of hyperglycemia, hypoglycemia (on discontinuation), and hyponatremia, and require particularly close monitoring of blood glucose, serum electrolytes, and fluid balance during and after infusion. Safety and efficacy of specific concentrations and rates should be individualized under pediatric specialist supervision, and formal dosing outside general fluid-therapy guidelines has not been separately established for all pediatric subgroups.