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  • Glucose 10%
    / Lapidot


    Active Ingredient

    Status in Israel
    RX

    Presentation and Status in Health Basket

    Presentation Basket Yarpa Pharmasoft

    Solution for Infusion

    500 ml

    not in the basket chart 42915

    Dosage

    The dosage is to be adjusted according to the individual glucose and fluid requirements.
    Dosage for adults, the elderly and adolescents from 15 year of age:
    The maximum daily dose is 40 ml per kg body weight (BW), corresponding to 4 g of glucose per kg BW.
    Note: In the presence of metabolic disorders (e.g. postoperatively or after injuries, hypoxia, organ insufficiencies), the oxidative metabolism of glucose may be impaired. In such situations the glucose intake should be limited to 2 – 4 g/kg BW/day. The blood glucose level should not exceed 6.1 mmol/l (110 mg/100 ml).
    The maximum infusion rate is 2.5 ml per kg BW per hour, corresponding to 0.25 g of glucose per kg BW per hour. The maximum drop rate is 0.8 drops per kg BW per minute.
    Thus for a patient weighing 70 kg the maximum infusion rate is approx. 175 ml/hour (corresponding maximum drop rate 58 drops/min), resulting in a glucose intake of 17.5 g/hour.
    Dosage for Paediatric patients:
    The daily dose is limited by the maximum fluid intake:
    1st day of life: 50-70 ml per kg BW
    2nd day of life: 70-90 ml per kg BW
    3rd day of life: 80 – 100 ml per kg BW
    4th day of life: 100 – 120 ml per kg BW
    From 5th day of life: 100 – 130 ml per kg BW
    1st year: 100 – 140 ml per kg BW
    2st year: 80 – 120 ml per kg BW
    3rd–5th year: 80 – 100 ml per kg BW
    6th–10th year: 60 – 80 ml per kg BW
    11th–14th year: 50-70 ml per kg BW
    The corresponding glucose amounts are below the maximum recommended glucose doses for the respective age groups.
    If the solution is used as vehicle solution, a volume should be chosen that yields the desired concentration of the medicament to be dissolved or diluted.
    Method of administration: Intravenous infusion. The solution can be administered peripherally.
    If 10 % w/v Glucose Intravenous Infusion is used as vehicle solution the possibility of peripheral infusion depends on the characteristics of the mixture prepared.


    Indications

    Carbohydrate infusion therapy:
    – Hypoglycemic situations
    – Hypertonic dehydration
    – Hypertonic electrolyte disturbances
    Vehicle solution for supplementary medication.


    Contra-Indications

    – Hyperglycaemia, not responding to insulin doses of up to 6 units insulin/hour
    – Decompensated diabetes mellitus, diabetic coma
    – Untreated diabetes insipidus
    – Acute states of shock and collapse
    – Intracranial or spinal haemorrhage
    – Metabolic acidosis
    – Renal failure (oligo- or anuria) in absence of renal replacement therapy
    – Hyperhydration
    – Pulmonary oedema
    – Acute cardiac failure


    Special Precautions

    Administration of glucose solutions is not recommended after acute ischaemic strokes as hyperglycaemia was reported to worsen ischaemic brain damage and impair recovery.
    This solution should be used with caution in patients with hypervolemia, renal insufficiency and impending or manifest cardiac decompensation.
    The solution should also be administered with caution to patients with increased serum osmolarity.
    Disorders of fluid and electrolyte balance like hypotonic dehydration or pathologically low levels of serum electrolytes, must be corrected prior to administration of Glucose 10 % w/v solution for infusion.
    Special attention must be paid to hypokalaemia. Then supplementation of potassium is absolutely mandatory.
    Unstable metabolism (e.g. postoperatively or after injuries, hypoxia, organ insufficiencies) impairs oxidative metabolism of glucose and may lead to metabolic acidosis.
    States of hyperglycaemia should be adequetely monitored and treated with insulin. The application of insulin causes additional shifts of potassium into the cells and may therefore cause or increase hypokalaemia.
    See prescribing information for full details.


    Side Effects

    Provided the product is used in accordance with the directions given, undesirable effects are not to be expected.
    The following side effects, which are not directly related to the product but to the conditions of administration, underlying disorders or accompanying treatment, may occur:
    Metabolism and nutrition disorders:
    – Hypokalemia may be related to insulin therapy. In addition, hypokalaemia,
    hypomagnesaemia and hypophosphataemia may be caused by refeeding with glucose especially in malnourished patients.
    – Abrupt discontinuation and/or insulin application may cause rebound hypoglycemia, especially in patients with glucose tolerance disorders.
    Vascular disorders:
    Thrombophlebitis may be caused by osmolarities above 800 mmol/l. The osmolarity of the added medication should be kept in mind.


    Drug interactions

    None stated.


    Pregnancy and Lactation

    For 10 % w/v glucose solutions for infusion no controlled clinical data on exposed pregnancies are available. Animal studies do not indicate direct or indirect harmful effects with respect to pregnancy, embryonal/foetal development, parturition or postnatal development.
    Yet caution should be exercised when prescribing to pregnant or nursing women and careful monitoring of blood glucose is necessary.


    Overdose

    Symptoms: Overdose may cause hyperglycaemia, glucosuria, serum hyperosmolarity, possibly leading to hyperosmotic and hyperglycaemic coma, further hyperhydration and electrolyte disorders.
    Emergency treatment, antidotes: The disorders mentioned above can be corrected by reduction of the glucose intake, administration of insulin and/or appropriate supplementation of electrolytes.


    Manufacturer
    B. Braun Melsungen AG
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