This site is intended for UK healthcare professionals
Medscape UK Univadis Logo
Medscape UK Univadis Logo

Ringer's parenteral


Intravenous infusion of sodium chloride compound (Ringer's solution)

Drugs List

  • ringer's infusion
  • Therapeutic Indications


    Electrolyte imbalance (sodium and fluid depletion)
    Fluid replacement


    The rate and volume of infusion depends on the requirements of the individual patient and the judgement of the physician. Dosage should be based on the age, weight and clinical condition of the patient.


    500 ml to 3 litres in 24 hours.


    500 ml to 3 litres in 24 hours.

    Elderly patients should be treated with caution to avoid circulatory overload, especially those with cardiac or renal impairment.


    20 ml to 100 ml/kg in 24 hours.

    In children with burns, the dose is on average 3.4 ml/kg/per cent burn at 24 hours post-burn and 6.3 ml/kg/per cent burn at 48 hours.

    In severely head-injured children the dose is on average 2850 ml/square metre.


    For intravenous infusion.

    The infusion rate is usually 40 ml/kg/24 hours in adults and children older than 11 years.

    The average paediatric infusion rate is 5 ml/kg/hour but the value varies with age:
    Children aged 2 to 11 years: 2 to 4 ml/kg/hour
    Toddler: 4 to 6 ml/kg/hour
    Infant: 6 to 8 ml/kg/hour

    Infusion rate and total volume can be higher in surgery or in case of need.


    Cardiac failure
    Severe hypertension
    Severe renal impairment

    Precautions and Warnings

    Cardiopulmonary disorder
    Hypervitaminosis D
    Peripheral oedema
    History of congestive cardiac failure
    Pulmonary disease
    Pulmonary oedema
    Renal impairment

    Avoid rapid infusion rates
    Use only if the solution is clear and colourless
    Monitor serum electrolytes before and during treatment
    Examine bases of lungs for crepitations
    Monitor ECG prior to and during treatment in existing cardiac abnormalities
    Monitor fluid balance
    Monitor patients with cardiac disorders

    Pregnancy and Lactation


    Sodium chloride compound infusion (Ringer's solution) can be given during pregnancy as long as fluid and electrolyte balance is controlled.

    The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( ) or if this is unavailable at the backup site ( ).


    Sodium chloride compound infusion (Ringer's solution) can be given during breastfeeding as its use is not considered to constitute a hazard.

    Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
    Specialist advice is available from the UK Drugs in Lactation Advisory Service at

    Side Effects

    Cardiac failure
    Electrolyte disturbances
    Febrile reactions
    Local infection at injection site
    Local pain (injection site)
    Thrombophlebitis (injection site)
    Venous irritation


    It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

    The following number will direct the caller to the relevant local centre (0844) 892 0111

    Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( ) or if this is unavailable at the backup site ( ).

    Further Information

    Last Full Review Date: September 2013

    Reference Sources

    British National Formulary, 65th Edition (March - September 2013) Pharmaceutical Press, London.

    BNF for Children (2013-2014) Pharmaceutical Press, London.

    Summary of Product Characteristics: Ringer's Solution for Infusion. Baxter Healthcare Ltd. Revised February 2013.

    Summary of Product Characteristics: Ringers Solution for Injection BPC59, as Steriflex No.9 or freeflex. Fresenius Kabi Ltd. Revised August 2006.

    Summary of Product Characteristics: Ringers solution. Fresenius Kabi Ltd. Revised September 2009.

    Access the full UK drug database with a FREE Medscape UK Account
    It takes just a few minutes, and you’ll get unlimited access to information on over 11,000 UK drugs.
    Register for Free

    Already a member? Log in

    Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content

    FDB Logo

    FDB Disclaimer : FDB Multilex is intended for the use of healthcare professionals and is provided on the basis that the healthcare professionals will retain FULL and SOLE responsibility for deciding what treatment to prescribe or dispense for any particular patient or circumstance.