Pronunciation:

KAL-see-um KLOR-ide, poe-TAS-ee-um KLOR-ide, SOE-dee-um KLOR-ide, SOE-dee-um LAK-tate

Dosage Forms:

• Solution

Classifications:

Therapeutic—

Parenteral Electrolyte Combination

Uses of This Medicine:

Lactated Ringer's injection is used to replace water and electrolyte loss in patients with low blood volume or low blood pressure. It is also used as an alkalinizing agent, which increases the pH level of the body.

This medicine is to be given only by or under the supervision of your doctor.

Before Using This Medicine:

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For this medicine, the following should be considered:

Allergies—

Tell your doctor if you have ever had any unusual or allergic reaction to this medicine or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Children—

Appropriate studies on the relationship of age to the effects of Lactated Ringer's injection have not been performed in the pediatric population. However, pediatric-specific problems that would limit the usefulness of this medicine in children are not expected. Recommended doses should not be exceeded, and the patient should be carefully monitored during treatment. Safety and efficacy have not been established.

Older adults—

Appropriate studies performed to date have not demonstrated geriatric-specific problems that would limit the usefulness of Lactated Ringer's injection in the elderly. However, elderly patients are more likely to have electrolyte imbalance and age-related liver, kidney, or heart problems, which may require caution and an adjustment in the dose for patients receiving this medicine.

Breast-feeding—

There are no adequate studies in women for determining infant risk when using this medication during breastfeeding. Weigh the potential benefits against the potential risks before taking this medication while breastfeeding.

Other medicines—

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are receiving this medicine, it is especially important that your healthcare professional know if you are taking any of the medicines listed below. The following interactions have been selected on the basis of their potential significance and are not necessarily all-inclusive.

Using this medicine with any of the following medicines is not recommended. Your doctor may decide not to treat you with this medication or change some of the other medicines you take.

• Eplerenone

Using this medicine with any of the following medicines is usually not recommended, but may be required in some cases. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Alacepril
• Amiloride
• Baloxavir Marboxil
• Benazepril
• Bictegravir
• Canrenoate
• Captopril
• Cilazapril
• Delapril
• Digoxin
• Eltrombopag
• Erdafitinib
• Fosinopril
• Imidapril
• Indomethacin
• Lisinopril
• Moexipril
• Pentopril
• Perindopril
• Quinapril
• Raltegravir
• Ramipril
• Sparsentan
• Spirapril
• Spironolactone
• Temocapril
• Trandolapril
• Triamterene
• Zofenopril

Using this medicine with any of the following medicines may cause an increased risk of certain side effects, but using both drugs may be the best treatment for you. If both medicines are prescribed together, your doctor may change the dose or how often you use one or both of the medicines.

• Chlorothiazide
• Delafloxacin
• Licorice
• Strontium Ranelate

Other interactions—

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other medical problems—

The presence of other medical problems may affect the use of this medicine. Make sure you tell your doctor if you have any other medical problems, especially:

• Alkalosis (high pH levels in the blood) or
• Diabetes or
• Hypercalcemia (high calcium level in the blood) or
• Hypokalemia (low potassium levels in the blood) or
• Kidney stones, or history of or
• Metabolic acidosis (eg, lactic acidosis), severe—Use is not recommended.

• Allergy to sodium lactate—Should not be used in patients with this condition.

• Brain or nerve problems (eg, swelling in the brain) or
• Heart problems or
• Hypoxemia (low oxygen levels in the blood) or
• Lung problems or
• Psychogenic polydypsia (increased water intake without being thirsty) or
• Surgery, recent or
• Syndrome of inappropriate antidiuretic hormone secretion (SIADH)—Use with caution. May increase risk for hyponatremia, which may lead to encephalopathy.

• Burns, extensive or
• Congestive heart failure or
• Dehydration, acute or
• Kidney disease, severe or
• Tissue injury, extensive—Use with caution. Increased risk for more side effects.

• Liver disease, severe—Use with caution. This medicine may not increase the pH level in this condition due to a decrease in the metabolism of lactate.

Proper Use of This Medicine:

A nurse or other trained health professional will give you this medicine in a medical facility. It is given through a needle placed into one of your veins.

Precautions While Using This Medicine:

It is very important that your doctor check you closely to make sure that this medicine is working properly. Blood and urine tests are needed to check for unwanted effects.

Children 28 days of age or younger (neonates) should not receive this medicine together with ceftriaxone. Patients older than 28 days of age should not receive this medicine together with ceftriaxone in the same infusion line.

This medicine may cause serious allergic reactions, including anaphylaxis, which can be life-threatening and requires immediate medical attention. Tell your doctor right away if you have a rash, itching, hoarseness, trouble breathing, trouble swallowing, or any swelling of your hands, face, or mouth after receiving this medicine.

This medicine may cause hyponatremia (low sodium level in the blood), which can lead to acute hyponatremic encephalopathy. Check with your doctor right away if you have loss of consciousness, confusion, seizures, decreased urine output, dizziness, fast or irregular heartbeat, headache, increased thirst, muscle pain or cramps, trouble breathing, swelling of the face, ankles, or hands, or unusual tiredness or weakness.

This medicine may cause fluid overload and overhydration, which can lead to pulmonary congestion (fluid in the lungs) and swelling. Talk with your doctor right away if you have a decrease in the amount of urine output, noisy, rattling breathing, trouble with breathing, swelling of the fingers, hands, feet, or lower legs, troubled breathing at rest, or weight gain.

Lactated Ringer's injection may increase your risk of having hyperkalemia (high potassium level in the blood). Check with your doctor right away if you have stomach pain, confusion, irregular heartbeat, numbness or tingling in the hands, feet, or lips, difficulty with breathing, or weakness or heaviness of the legs.

This medicine may cause changes in the pH level of the blood, which may be life-threatening and require immediate medical attention. Talk to your doctor if you have any concerns.

This medicine may cause hypercalcemia (high calcium level in the blood). Talk with your doctor right away if you have stomach pain, confusion, depression, dry mouth, headache, incoherent speech, increased urination, loss of appetite, metallic taste in the mouth, muscle weakness, or unusual tiredness.

This medicine may affect your blood sugar levels. Check with your doctor right away if you have increased thirst or increased urination. If you notice a change in the results of your urine or blood sugar tests, or if you have any questions, talk with your doctor.

Do not take other medicines unless they have been discussed with your doctor. This includes prescription or nonprescription (over-the-counter [OTC]) medicines and herbal or vitamin supplements.

Side Effects of This Medicine:

Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.

Check with your doctor or nurse immediately if any of the following side effects occur:

Incidence not known

Agitation

back pain

bluish color of the skin

blurred vision

burning, crawling, itching, numbness, prickling, "pins and needles", or tingling feeling

chest pain, discomfort, or tightness

confusion

cough

decreased heart rate

decreased urine output

difficulty breathing

dizziness, faintness, or lightheadedness when getting up suddenly from a lying or sitting position

drowsiness

fast, pounding, or irregular heartbeat or pulse

fever

headache

increased thirst

irritability

large, hive-like swelling on the face, eyelids, lips, tongue, throat, hands, legs, feet, or genitals

loss of consciousness

mood or mental changes

muscle pain or cramps

nausea

nervousness

noisy breathing

numbness of the mouth

paleness, pain, or redness at the injection site

rapid breathing

seeing, hearing, or feeling things that are not there

seizures

stiff neck

stomach pain

sweating

unusual tiredness or weakness

vomiting

weakness or heaviness of the legs

weight gain

Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:

Incidence not known

Feeling of warmth

loss of or change in taste

redness of the face, neck, arms, and occasionally, upper chest

sneezing

swelling, rash, itching, or burning at the infusion site

throat irritation

Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.

Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.