Lactated Ringer Injection has value as a source of water and electrolytes. It is capable of inducing diuresis depending on the clinical condition of the patient.

Lactated Ringer Injection produces a metabolic alkalinizing effect. Lactate ions are metabolized ultimately to carbon dioxide and water, which requires the consumption of hydrogen cations.

 

Lactated Ringer Injection is indicated as a source of water and electrolytes or as an alkalinizing agent.

 

None known.

 

- Lactated Ringer Injection should be used with great care, if at all, in patients with congestive heart failure, severe renal insufficiency, hyperkalemia and in clinical states in which there exists edema with sodium retention or potassium retention.

- Lactated Ringer Injection should be used with great care in patients with metabolic or respiratory alkalosis.

- Lactated Ringer Injection should not be administered simultaneously with blood through the same administration set because of the likelihood of coagulation.

- The intravenous administration of Lactated Ringer Injection can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration, congested states, or pulmonary edema. The risk of dilutional states is inversely proportional to the electrolyte concentrations of the injections. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentrations of the injections.

- Lactated Ringer Injection is not for use in the treatment of lactic acidosis.

- Caution must be exercised in the administration of Lactated Ringer Injection to patients receiving corticosteroids or corticotrophin.

- To minimize the risk of possible incompatibilities arising from mixing this solution with other additives that may be prescribed the final in fusate should be inspected for cloudiness or precipitation immediately after mixing prior to administration and periodically during administration .  

- Clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid base balance during prolonged parenteral therapy.

Pregnancy use: Lactated Ringer Injection should be given to a pregnant woman only if clearly needed.

Pediatric use: Safety and effectiveness of Lactated Ringer Injection in pediatric patients have not been established by adequate and well controlled trials, however, the use of electrolyte solutions in the pediatric population is referenced in the medical literature.

Geriatric use: Dose selection for an elderly patient should be cautious, reflecting the greater frequency of decreased hepatic, renal, or cardiac function.

 

Allergic reactions or anaphylactoid symptoms such as localized or generalized urticaria and pruritis; periorbital, facial, and/or laryngeal edema; coughing, sneezing, and/or difficulty with breathing have been reported during administration of Lactated Ringer’s.

The reporting frequency of these signs and symptoms is higher in women during pregnancy.

Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia.

If an adverse reaction does occur, discontinue the infusion, evaluate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary.

 

As directed by a physician. Dosage is dependent upon the age, weight and clinical condition of the patient as well as laboratory determinations.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.

The  injections  are intended for intravenous administration using sterile equipment.

Additives may be incompatible. Those additives known to be incompatible should not be used.

Mix thoroughly when additives have been introduced.

Do not store solutions containing additives.

 

Plastic container contains 250 - 500 mL of sterile solution:

Composition (g/L)				Osmolarity (mOsmol/L)
Sodium Chloride	Sodium lactate	Potassium Chloride	Calsium Chloride
6	3.1	0.3	0.2	273

 

Ionic Composition (mEq/L)					Caloric Content (kcal/L)
Sodium	Potassium	Calsium	Chloride	Lactate
130	4	2.7	109	28	9

 

Store at room temperature 25°C.