1-844-764-7669 Health Care Professionals: 1 (902) 470-8161
Poisoning Information for the Public & Health Care Professionals
Last updated: 03/2023


Glucose, d-glucose

Print Monograph


Glucose, d-glucose


  • Treatment of drug related hypoglycemia
  • Concurrent treatment with high dose insulin for beta blocker or calcium channel blocker toxicity


For Hypoglycemia:

IV Direct:

     0.25 g/kg  (1 mL/kg of dextrose 25%).  Repeat as needed

For Beta Blocker and/or Calcium Channel Blocker Toxicity:

IV Direct:

      0.25 g/kg  (1 mL/kg of dextrose 25%).

Infusion: Titrate to maintain serum glucose 6-14 mmol/L

          Peripheral IV: 0.25 to 0.5 g/kg/hour (2.5 to 5 ml/kg/hour of dextrose 10%)  

          Central line: 0.25 to 0.5 g/kg/hour (1 to 2 ml/kg/hour of dextrose 25%) 

  • In the context of high dose insulin treatment for beta blocker or calcium channel blocker toxicity: dextrose infusion may need to continue for approximately 24 hours after insulin is discontinued, as rebound hypoglycaemia may occur


  • Dextrose 10% = dextrose 0.1 g/mL
  • Dextrose 25% = dextrose 0.25 g/mL


IV Direct:  To prepare dextrose 25% - use a 1:1 dilution of dextrose 50% and sterile water for injection (equal volumes of each)

Example: For a final volume of 50 mL, dilute 25 mL of dextrose 50% with 25 mL of sterile water for injection


For a central line, prepare dextrose 25% as above.

For a peripheral line, use dextrose 10%. 

If dextrose 10% is not available, dextrose 9.5% can be prepared and used in place of dextrose 10% according to the following instructions:

  • Remove 50 mL dextrose 5% from a 500 mL bag.  Add 50 mL dextrose 50%. Label bag appropriately.


  • Remove 100 mL dextrose 5% from a 1000 mL bag.  Add 100 mL dextrose 50%. Label bag appropriately.

Compatibility, Stability

  • Dextrose 50% has an acidic pH (3.5-5) and therefore specific compatibility information should be consulted when dextrose 50% is injected into an IV line containing another drug.
  • Store at room temperature. Do not use cloudy solutions.

Potential Hazards of Administration

  • Pain, phlebitis and/or thrombosis at injection site.
  • Tissue necrosis may result if extravasation occurs.
  • Hyperglycemia and glycosuria.
  • Hyperosmolar syndrome. Signs include mental confusion and loss of consciousness especially in patients with chronic uremia or carbohydrate intolerance.
  • May cause fluid or solute overload leading to fluid and electrolyte disturbances (especially phosphate and potassium), overhydration or fluid congestion.
  • May cause vitamin B complex deficiency.


  • Dextrose 25% has an osmolarity of 1263m/L. 

Azendour, H., Belyamani, L., Atmani, M., Balkhi, H., & Haimeur, C. (2010). Severe amlodipine intoxication treated by hyperinsulinemia euglycemia therapy. The Journal of Emergency Medicine, 38(1), 33.

Bailey, B., Blais, R., Gaudreault, P., Gosselin, S., & Laliberte, M. (2009). Antidotes en toxicologie d'urgence (3rd ed.). Quebec, Canada: Centre antipoison du Quebec.

Doepker, B., Healy, W., Cortez, E., & Adkins, E. J. (2014). High-dose insulin and intravenous lipid emulsion therapy for cardiogenic shock by intentional calcium-channel blocker and beta-blocker overdose: A case series. The Journal of Emergency Medicine, 46(4), 486-490.

Holger, J. S., Stellplug, S. J., Cole, J. B., Harris, C. R., & Engebretsen, K. M. (2011). High-dose insulin: A consecutive case series in toxin-induced cardiogenic shock. Clinical Toxicology (Philadelphia, Pa.), 49, 653-658.

IWK Regional Poison Centre. (2011). Beta-adrenergic antagonists (beta-blockers): A brief overview for emergency departments. Unpublished manuscript.

IWK Regional Poison Centre. (2011). Calcium channel blockers: A brief overview for emergency departments. Unpublished manuscript.

Micromedex, T. H. A. (2014). Micromedex health care systems. Retrieved from http://www.micromedexsolutions.com

Olson, K. R. (2007). Poisoning & drug overdose (Sixth ed.). New York: McGraw Hill.

Page, C. B., Hacket, L. P., & Isbister, G. K. (2009). The use of high-dose insulin-glucose euglycemia in beta-blocker overdose: A case report. Journal of Medical Toxicology, 5(3), 139.

Patel, N. P., Pugh, M. E., & Goldburg, S. (2007). Hyperinsulinemic euglycemia therapy for verapamil poisoning: A review. American Journal of Critical Care, 16, 498-503.

Phelps SJ, C. C. (2013).  Teddy bear, pediatric injectable drugs. Retrieved from http://www.pharmpress.com/product/MC_PED/pediatric-injectable-drugs

Shannon, M. W., Borron, S. W., & Burns, M. J. (2007). Haddad and Winchester's clinical management of poisoning and drug overdose (Fourth ed.). Philadelphia: Saunders Elsevier.

Smollin, C. G. (2010). Toxicology: Pearls and pitfalls in the use of antidotes. Emergency Medicine Clinic of North America, 28, 149-161.

Trissel, Lawrence, A,. (2013). Handbook on injectable drugs (17th ed.). Bethesda, Maryland: American Society of Health-System Pharmacists

Yuan, T. H., Kerns, I. W. P., & Tomaszewski. (1999). Insulin-glucose as adjunctive therapy for severe calcium channel antagonist poisoning. J Toxicol Clin Toxicol, 37, 463.