D5W as a Drug Diluent

Evidence-Based Rationale

• The American College of Allergy and Clinical Immunology recommends ranitidine for anaphylaxis to be diluted in 5% dextrose to 20 mL total volume and injected IV over 5 minutes 1, 2, 3
• The American Heart Association recommends dopamine for refractory hypotension to be administered at 2-20 mcg/kg/min in 500 mL D5W 1, 2, 3
• The American College of Cardiology recommends vasopressin to be diluted in either 5% dextrose water OR normal saline (25 U/250 mL) at 0.01-0.04 U/min 1
• The American Heart Association recommends sodium bicarbonate for tricyclic antidepressant toxicity to be prepared as 150 mEq NaHCO3 per liter of D5W 4
• The American Academy of Allergy and Clinical Immunology recommends epinephrine infusions to be prepared in D5W at 1 mg in 250 mL yielding 4 mcg/mL 2, 3

Clinical Considerations

• The American Diabetes Association recommends monitoring blood glucose levels when using D5W, especially in diabetic patients 5
• The American Heart Association recommends monitoring for fluid overload in patients with cardiac or renal compromise, regardless of diluent choice 5