Lactated Ringers solution


Concise Prescribing Info
Indications/Uses
Replacement of fluid and electrolytes.
Dosage/Direction for Use
Adult : IV Dosage depends on the age, weight, clinical and biological conditions of the patient and concomitant therapy.
Dosage Details
Intravenous
Replacement of fluid and electrolytes
Adult: Dosage depends on the age, weight, clinical and biological conditions of the patient and concomitant therapy.
Renal Impairment
Severe: Contraindicated.
Hepatic Impairment
Severe: Contraindicated.
Incompatibility
May form precipitate with ceftriaxone and may increase coagulation risk with citrate anticoagulated/preserved blood when administered through the same administration set.
Contraindications
Severe metabolic alkalosis or acidosis, conditions associated with increased lactate levels (e.g. lactic acidosis) or impaired lactate utilisation, CHF, hyperkalaemia, hypervolaemic or overhydrated patient. Severe hepatic and renal impairment. Concomitant use with ceftriaxone in newborns (≤28 days).
Special Precautions
Patient with hypernatraemia, hyperchloraemia, hypercalcaemia or at risk of hypercalcaemia (e.g. sarcoidosis), current or history of Ca renal calculi, conditions predisposing to hyperkalaemia (e.g. adrenocortical insufficiency, acute dehydration, extensive tissue injury or burns); type 2 diabetes mellitus, respiratory alkalosis; conditions that may cause Na retention, fluid overload and oedema (e.g. preeclampsia). Not intended for the treatment of severe potassium deficiency. Mild to moderate renal and hepatic impairment.
Adverse Reactions
Significant: Fluid or solute overload resulting in overhydration, congested states (e.g. pulmonary congestion, oedema); electrolyte imbalance, acid-base imbalance, hypersensitivity reactions (e.g. urticaria, pruritus).
Cardiac disorders: Chest tightness or pain with tachycardia or bradycardia.
General disorders and administration site conditions: Febrile response, infusion site reactions (e.g. phlebitis, venous thrombosis, inflammation, rash, erythema, pruritus, pain, burning).
Respiratory, thoracic and mediastinal disorders: Cough, sneezing, nasal congestion, difficulty of breathing.
MonitoringParameters
Monitor infusion site; input and output, weight, serum electrolyte levels (e.g. Na, K, Cl, Ca, bicarbonate), acid-base balance, and osmolarity.
Drug Interactions
Risk of Na and fluid retention may be increased with corticosteroids. May increase risk of severe hyperkalaemia with K-sparing diuretics (e.g. spironolactone, amiloride), ACE inhibitors, angiotensin II receptor antagonists, tacrolimus, ciclosporin. May increase effects of digitalis which may result in serious cardiac arrhythmia. May increase risk of hypercalcaemia with thiazide diuretics, vitamin D. Renal clearance of acidic drugs (e.g. barbiturates, salicylates, lithium) may be increased due to the alkalinisation of urine while renal clearance of alkaline drugs (e.g. ephedrine, dexamphetamine) may be decreased.
Potentially Fatal: May increase risk of insoluble precipitations with ceftriaxone (particularly in neonates ≤28 days).
Action
Description: Lactated Ringer’s solution is an isotonic sterile solution containing Na chloride 6 g/L, K chloride 0.40 g/L, Ca chloride dihydrate 0.27 g/L, and Na lactate 3.17 g/L intended for restoring electrolyte imbalance and water for hydration. Additionally, its Na lactate content acts as an alkalinising agent which normalises the pH of the acid-base balance of the body.
Synonym: Hartmann’s solution; Ringer’s lactate.
Storage
Store between 20-25°C. Protect from excessive heat.
References
Anon. Ringer’s Injection (Lactated). Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 05/08/2020.

Compound Sodium Lactate Solution for Infusion BP (Baxter Healthcare Ltd.). MHRA. https://products.mhra.gov.uk/. Accessed 05/08/2020.

Lactated Ringers (B.Braun Medical Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 05/08/2020.

Disclaimer: This information is independently developed by MIMS based on Lactated Ringers solution from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
  • RL Albert David
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