Ringer Lactate

What it is and how it works

Ringer’s lactate (Hartmann’s solution) contains sodium, potassium, calcium and chloride in concentrations close to those of plasma, plus lactate, which is metabolised mainly in the liver to bicarbonate. It replaces extracellular fluid and electrolytes and has a mild alkalinising effect.

Indications

Replacement of extracellular fluid and electrolyte losses (e.g. haemorrhage, burns, surgery, dehydration); fluid resuscitation; maintenance fluid in mild metabolic acidosis (not lactic acidosis).

Dosage and administration (summary)

Given by intravenous infusion; volume and rate are individualised according to age, weight, clinical condition, fluid balance and electrolytes.

Contraindications

Fluid overload, hyperkalaemia, hypercalcaemia, severe lactic acidosis or severe hepatic impairment (impaired lactate metabolism), and metabolic or respiratory alkalosis; concurrent ceftriaxone infusion in neonates.

Warnings and precautions

Monitor fluid balance and electrolytes; use with caution in heart failure, renal impairment and conditions with oedema. Because of its calcium content it must not be given through the same line as blood or ceftriaxone, and it is not suitable for treating severe hyperkalaemia; it is slightly hypotonic and should be used cautiously in raised intracranial pressure.

Pregnancy

May be used in pregnancy, including during labour, with fluid balance monitoring.

Storage and supply

Store below 25 °C; do not freeze; use only if the solution is clear and the container undamaged.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.