This is a sterile, non-pyrogenic, isotonic electrolyte solution for intravenous administration, commonly known as Ringer's Lactate (RL) or Lactated Ringer's (LR) solution. It is a balanced crystalloid solution used for fluid resuscitation and maintenance. The sodium lactate component is metabolized in the liver to bicarbonate, providing a mild alkalinizing effect. It is one of the most widely used intravenous fluids in Indian clinical practice, especially in surgical, emergency, and critical care settings.
Adult: Dosage is highly individualized based on patient's condition, ongoing losses, and hemodynamic status. General guideline: For resuscitation: 1-2 liters rapidly infused (e.g., 20-30 mL/kg). For maintenance: 1.5-3 liters per day (approx. 30-40 mL/kg/day). Rate and volume must be titrated to clinical endpoints (BP, urine output, CVP).
Note: For intravenous use only. Use aseptic technique. Administer via a large-bore peripheral or central line. Do not administer simultaneously in the same intravenous line with blood or blood products due to calcium content. Compatible with most IV drugs, but physical/chemical compatibility should be checked before Y-site administration. Infusion rate is dictated by clinical need.
This solution restores intravascular and interstitial fluid volume by increasing plasma osmolarity, drawing fluid into the vascular space. It corrects electrolyte imbalances by directly supplying sodium, potassium, calcium, and chloride ions. The lactate anion serves as a bicarbonate precursor, helping to correct mild metabolic acidosis by generating alkali.
Pregnancy: Category C (US FDA). No well-controlled studies. Should be used only if clearly needed. It is frequently used during labor, delivery, and cesarean section for hydration and resuscitation. Benefits generally outweigh risks.
Driving: No effect. The patient's underlying condition requiring IV fluids is the limiting factor.
| Digoxin and other Cardiac Glycosides | Calcium in RL may potentiate the toxic effects of digoxin (arrhythmias). | Major |
| Corticosteroids (e.g., Hydrocortisone) | May enhance sodium and fluid retention, increasing risk of edema and hypertension. | Moderate |
| Potassium-Sparing Diuretics (e.g., Spironolactone) | Increased risk of severe hyperkalemia. | Major |
| IV Ceftriaxone (especially with Calcium-containing solutions) | Risk of ceftriaxone-calcium precipitation in the bloodstream (potentially fatal). Do not mix or administer within 48 hours. | Contraindicated |
| Non-depolarizing Muscle Relaxants (e.g., Vecuronium) | Calcium may antagonize neuromuscular blockade. | Moderate |
Same composition (Sodium Chloride (5.15gm) + Sodium Lactate (NA) + Potassium Chloride (0.30gm) + Calcium Chloride (0.15gm)), different brands: