Lactated Ringer's Injection should be administered with particular caution, if at all, to patients with alkalosis or at risk for alkalosis. Lactated Ringer's Injection should be administered with particular caution, if at all, to patients with hyperkalemia or conditions predisposing to hyperkalemia (such as severe renal impairment or adrenocortical insufficiency, acute dehydration, or extensive tissue injury or burns) and in patients with cardiac disease. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentrations of the injections.Ĭlinical evaluation and periodic laboratory determinations may be necessary to monitor changes in fluid balance, electrolyte concentrations, and acid base balance during prolonged parenteral therapy or whenever the condition of the patient or the rate of administration warrants such evaluation. The risk of dilutional states is inversely proportional to the electrolyte concentrations of the injections. Hypersensitivity reactions are reported more frequently during pregnancy.ĭepending on the volume and the rate of infusion, the intravenous administration of Lactated Ringer's Injection can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration, congested states, pulmonary edema or acid-base imbalance. Appropriate therapeutic countermeasures must be instituted as clinically indicated. The infusion must be stopped immediately if any signs or symptoms of a suspected hypersensitivity reaction develop. Lactated Ringer's Injection should not be administered simultaneously with citrate anticoagulated/preserved blood through the same administration set because of the likelihood of coagulation. Lactated Ringer's Injection is not for use for the treatment of lactic acidosis or severe metabolic acidosis. WARNINGS:Īlthough Lactated Ringer's Injection has a potassium concentration similar to the concentration in plasma, it is insufficient to produce a useful effect in case of severe potassium deficiency; therefore, it should not be used for this purpose. Lactated Ringer's Injection is contraindicated in patients with a known hypersensitivity to sodium lactate. If the same infusion line is used for sequential administration, the line must be thoroughly flushed between infusions with a compatible fluid. In patients older than 28 days (including adults), ceftriaxone must not be administered simultaneously with intravenous calcium-containing solutions, including Lactated Ringer's Injection, through the same infusion line (e.g., via Y-connector). CONTRAINDICATIONS:Īs for other calcium-containing infusion solutions, concomitant administration of ceftriaxone and Lactated Ringer's Injection is contraindicated in newborns (≤ 28 days of age), even if separate infusion lines are used (risk of fatal ceftriaxone-calcium salt precipitation in the neonate's bloodstream). Lactated Ringer's Injection is indicated as a source of water and electrolytes or as an alkalinizing agent. Related/similar drugs Plasma-Lyte 148, Normosol-R INDICATIONS AND USAGE: Lactate ions are metabolized ultimately to carbon dioxide and water, which requires the consumption of hydrogen cations. Lactated Ringer's Injection produces a metabolic alkalinizing effect. It is capable of inducing diuresis depending on the clinical condition of the patient. Lactated Ringer's Injection has value as a source of water and electrolytes. The suitability of the container material has been confirmed by tests in animals according to USP biological tests for plastic containers. Solutions in contact with the flexible container can leach out certain of the container's chemical components in very small amounts within the expiration period. The amount of water that can permeate from inside the container into the overwrap is insufficient to affect the solution significantly. The flexible container is fabricated from a specially formulated non-plasticized, film containing polypropylene and thermoplastic elastomers ( free flex ® bag).
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