Lactated ringer's (Intravenous)

Lactated Ringer's injection is used to replace lost water and electrolytes in patients who have low blood volume or low blood pressure. It is also used to raise the pH level of the body.

This medicine should only be given by your doctor or under their supervision.

It is very important that your doctor checks 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.

In deciding to use a medicine, you and your doctor will need to weigh the risks against the benefits. Consider the following before using this medicine:

Allergies

Inform your doctor if you have ever had any unusual or allergic reactions to this medicine or any other medicines. Also, tell your healthcare professional about any other allergies, such as to foods, dyes, preservatives, or animals. For over-the-counter products, read the label or package ingredients carefully.

Pediatric

There have not been appropriate studies on how Lactated Ringer's injection affects children. However, there are no specific pediatric problems expected that would limit its usefulness in children. Do not exceed the recommended doses, and the patient should be closely monitored during treatment. Safety and effectiveness have not been established.

Geriatric

Studies so far have not shown any specific problems in elderly patients that would limit the usefulness of Lactated Ringer's injection. However, older patients are more likely to have electrolyte imbalances and age-related issues with the liver, kidneys, or heart, which may require caution and possible dose adjustments for patients taking this medicine.

Breast Feeding

There are no adequate studies in women to determine the risk to infants when using this medicine during breastfeeding. Weigh the potential benefits against the possible risks before taking this medicine while breastfeeding.

Interactions with Medicines

Some medicines should not be used together at all, while others may be used together even if an interaction could happen. In these cases, your doctor may adjust the dose or take other precautions. It is very important that your healthcare professional knows if you are taking any of the medicines listed below while you are receiving this medicine. The following interactions have been chosen based on their potential importance 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 may 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 necessary in some situations. If both medicines are prescribed together, your doctor may adjust the dose or frequency of use for one or both 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 increase the 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 adjust the dose or frequency of use for one or both medicines.

• Chlorothiazide
• Delafloxacin
• Licorice
• Strontium Ranelate

Interactions with Food/Tobacco/Alcohol

Some medicines should not be used around the time of eating food or certain types of food due to potential interactions. Using alcohol or tobacco with some medicines may also cause interactions. Discuss with your healthcare professional about using your medicine with food, alcohol, or tobacco.

Other Medical Problems

Having other medical issues may affect the use of this medicine. Make sure to inform your doctor about 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 (e.g., lactic acidosis), severe—Use is not recommended.

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

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

• Extensive burns or
• Congestive heart failure or
• Acute dehydration or
• Severe kidney disease or
• Extensive tissue injury—Use with caution. Increased risk for more side effects.

• Severe liver disease—Use with caution. This medicine may not increase the pH level in this condition due to decreased lactate metabolism.

Along with its necessary effects, a medicine can cause some unwanted effects. Not all of these side effects may happen, but if they do, they may need medical attention.

Check with your doctor or nurse right away 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 happen that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Your health care professional may also 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 happen 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.

Available Dosage Forms:

• Solution

Therapeutic Class: Parenteral Electrolyte Combination

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.