D50 Ampule Dextrose Content
One ampule of D50 (50% dextrose solution) contains 25 grams of dextrose in a standard 50 mL ampule. 1
Standard Dosing Information
- D50 composition: 50% dextrose means 50 grams of dextrose per 100 mL, which translates to 0.5 grams per mL 2
- Standard ampule volume: The typical ampule is 50 mL, delivering 25 grams of dextrose total 1
- FDA-approved dosing for hypoglycemia: 10-25 grams (20-50 mL of 50% dextrose) is the recommended range for insulin-induced hypoglycemia 1
Clinical Context for Hypoglycemia Treatment
The traditional 25-gram D50 bolus frequently causes overcorrection and hyperglycemia, making titrated lower-concentration dextrose preferable in most situations. 3, 4
Alternative Dosing Strategies
- Titrated D10 approach: Administering 5-gram aliquots (50 mL of D10) repeated every 1-2 minutes achieves symptom resolution with fewer adverse events 3, 4
- Expected blood glucose response: D50 increases blood glucose by approximately 4 mg/dL per gram administered in critically ill patients 5
- Overcorrection risk: Traditional 25-gram D50 boluses result in post-treatment glucose levels of 169 mg/dL versus 112 mg/dL with titrated D10 3
Safety Considerations
- Adverse events: D50 administration is associated with a 4.2% adverse event rate (13/310 patients) compared to 0% with D10 (0/1057 patients) 4
- Rapid administration risks: Rapid or repeated D50 boluses have been associated with cardiac arrest and hyperkalemia 3
- Hyperglycemia rates: D50 causes hyperglycemia in 47% of cases versus 37% with D10 when used for hyperkalemia treatment 6
Practical Dosing Recommendations
For conscious patients with hypoglycemia, start with 10-15 grams (20-30 mL of D50 or 100-150 mL of D10) and reassess, rather than automatically giving the full 25-gram ampule. 3, 7
- Time to effect: D10 takes approximately 8 minutes to restore consciousness versus 4 minutes for D50, but with superior glycemic control 4
- Repeat dosing: D10 requires additional doses in 19.5% of cases versus 8.1% for D50, but this allows better titration to target glucose 4
- Symptom resolution: Both achieve >95% symptom resolution, with D10 at 95.9% and D50 at 88.8% 4