Ringer's Lactate Solution is indicated for the treatment of diarrhea, dehydration, fluid and electrolyte imbalance, diabetic coma, cholera, and as an alkalinizing agent. It is commonly used for fluid replacement after blood loss caused by trauma, surgery, or burn injuries. Ringer's Lactate is preferred because lactate metabolism in the liver helps reduce acidosis, a chemical imbalance that may occur due to severe fluid loss or kidney failure.

One liter of Ringer's Lactate Solution contains:

• Na – 127 mEq
• K – 4 mEq
• Ca – 4 mEq
• Cl – 155 mEq

Each 100 ml of Ringer's Lactate Solution contains:

• Sodium Chloride – 600 mg
• Anhydrous Sodium Lactate – 310 mg
• Potassium Chloride – 30 mg
• Calcium Chloride Dihydrate – 20 mg

Lactated Ringer's Solution contains isotonic concentrations of electrolytes in water for injection. It is used for parenteral replacement of extracellular fluid and electrolyte losses. This injection produces a metabolic alkalinizing effect. Lactate ions are eventually converted into carbon dioxide and water, a process that consumes hydrogen ions and helps reduce acidity.

Calcium chloride helps prevent or treat calcium deficiency and supports proper nerve and muscle function by regulating the excitation threshold of action potentials.

Potassium chloride is the main intracellular cation. It plays an important role in nerve impulse transmission in the heart, brain, and skeletal muscles. It also supports contraction of cardiac, skeletal, and smooth muscles, maintains normal kidney function, helps preserve acid-base balance, supports carbohydrate metabolism, and regulates gastric secretion.

Sodium chloride is the major extracellular cation. It is essential for maintaining electrolyte and fluid balance, controlling osmotic pressure, and proper water distribution by restoring sodium ions. It is also used for hydration, treatment of metabolic acidosis, priming solution in hemodialysis, treatment of hyperosmolar diabetes, and as a diluent for compatible injectable medicines.

The IV dose of Ringer's lactate solution is usually calculated by estimated fluid loss and presumed fluid deficit. For fluid resuscitation the usual rate of administration is 20 to 30 ml/kg body weight/hour. RL is not suitable for maintenance therapy (i.e., maintenance fluids) because the sodium content (130 mEq/L) is considered too low, particularly for children, and the potassium content (4 mEq/L) is too low, in view of electrolyte daily requirement. Moreover, since the lactate is converted into bicarbonate, longterm use will cause patients to become alkalotic. Ringer's lactate and other crystalloids are also used as vehicles for the IV delivery of drugs.

In a large-volume resuscitation over several hours, LRS maintains a more stable blood pH than normal saline.

No known or well-documented drug interactions have been reported with this solution.

Hypersensitivity to any component of the solution.

Adverse reactions may occur due to the solution itself or the technique of administration. These may include fever, infection at the injection site, venous thrombosis or phlebitis extending from the injection site, fluid leakage (extravasation), and hypervolemia.

Pregnancy Category C: Animal studies have shown adverse effects on the fetus, and there are no adequate and well-controlled studies in humans. However, potential benefits may justify the use of this drug in pregnant women despite possible risks.

It is not known whether this drug is excreted in human breast milk. Since many drugs are excreted in breast milk, caution should be taken when administering this solution to nursing mothers.

Intravenous infusion should be avoided in metabolic acidosis as it may be ineffective and can increase the risk of lactic acidosis, especially in severely ill patients with poor tissue perfusion and impaired liver function.

Intravenous fluid preparations