Drugs List

Therapeutic Indications

Uses

Coma - diabetic
Correction of fluid and electrolyte loss
Metabolic acidosis - mild to moderate

Administration

For intravenous infusion.

The infusion rate is usually 40ml/kg/24 hours in adults.

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

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

Contraindications

Neonates under 1 month
Cardiac arrhythmias
Decompensated cardiac failure
Hypervolaemia
Metabolic alkalosis
Severe hepatic impairment
Severe renal impairment

Precautions and Warnings

Burns
Children aged 1 to 6 months
Elderly
Peripheral oedema
Adrenal insufficiency
Cardiac disorder
Cardiac failure
Dehydration
Diabetes insipidus
Eclampsia
Hepatic impairment
Hypercalcaemia
Hyperchloraemia
Hyperkalaemia
Hypernatraemia
Hypertension
Pre-eclampsia
Pulmonary oedema
Renal impairment

Not all available brands are licensed for all indications
Potassium deficient patients should receive potassium supplements
Avoid rapid infusion rates
Use only if the solution is clear and colourless
Monitor acid-base balance
Monitor blood glucose
Monitor ECG prior to and during treatment in existing cardiac abnormalities
Monitor fluid balance
Monitor patients with cardiac disorders
Monitor serum electrolytes
Discontinue if allergic reaction occurs
Discontinue if lactic acidosis is suspected

The manufacturer recommends that sodium lactate compound is contraindicated in severe metabolic acidosis. Some sources suggest that sodium lactate is no longer used in metabolic acidosis because of the risk of producing lactic acidosis, particularly in seriously ill patients with poor tissue perfusion or impaired hepatic function.

Pregnancy and Lactation

Pregnancy

Sodium lactate compound infusion can be given during pregnancy but should be used with caution in toxaemia of pregnancy.

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 ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Sodium lactate compound infusion 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 https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Allergic reaction
Anaphylactic reaction
Anaphylactoid reaction
Angioedema
Anxiety
Bradycardia
Breathing difficulties
Bronchospasm
Chest pain
Chest tightness
Cough
Electrolyte disturbances
Erythema
Flushing
Headache
Hyperkalaemia
Hypervolaemia
Hypoesthesia
Hypotension
Nasal congestion
Nausea
Numbness
Panic attack
Paraesthesia
Pruritus
Pyrexia
Quincke's oedema
Rash
Sneezing
Swelling
Tachycardia
Taste disturbances
Throat irritation
Thrombophlebitis (injection site)
Urticaria
Venous thrombosis

Presentation

Intravenous infusion of sodium lactate compound

Drugs List

Therapeutic Indications

Uses

Coma - diabetic
Correction of fluid and electrolyte loss
Metabolic acidosis - mild to moderate

Dosage

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.

The amount of compound sodium lactate solution needed to restore normal blood volume is 3 to 5 times the volume of lost blood.

Adults

Elderly

Children

Administration

For intravenous infusion.

The infusion rate is usually 40ml/kg/24 hours in adults.

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

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

Contraindications

Neonates under 1 month
Cardiac arrhythmias
Decompensated cardiac failure
Hypervolaemia
Metabolic alkalosis
Severe hepatic impairment
Severe renal impairment

Precautions and Warnings

Burns
Children aged 1 to 6 months
Elderly
Peripheral oedema
Adrenal insufficiency
Cardiac disorder
Cardiac failure
Dehydration
Diabetes insipidus
Eclampsia
Hepatic impairment
Hypercalcaemia
Hyperchloraemia
Hyperkalaemia
Hypernatraemia
Hypertension
Pre-eclampsia
Pulmonary oedema
Renal impairment

Not all available brands are licensed for all indications
Potassium deficient patients should receive potassium supplements
Avoid rapid infusion rates
Use only if the solution is clear and colourless
Monitor acid-base balance
Monitor blood glucose
Monitor ECG prior to and during treatment in existing cardiac abnormalities
Monitor fluid balance
Monitor patients with cardiac disorders
Monitor serum electrolytes
Discontinue if allergic reaction occurs
Discontinue if lactic acidosis is suspected

The manufacturer recommends that sodium lactate compound is contraindicated in severe metabolic acidosis. Some sources suggest that sodium lactate is no longer used in metabolic acidosis because of the risk of producing lactic acidosis, particularly in seriously ill patients with poor tissue perfusion or impaired hepatic function.

Pregnancy and Lactation

Pregnancy

Sodium lactate compound infusion can be given during pregnancy but should be used with caution in toxaemia of pregnancy.

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 ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Sodium lactate compound infusion 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 https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Allergic reaction
Anaphylactic reaction
Anaphylactoid reaction
Angioedema
Anxiety
Bradycardia
Breathing difficulties
Bronchospasm
Chest pain
Chest tightness
Cough
Electrolyte disturbances
Erythema
Flushing
Headache
Hyperkalaemia
Hypervolaemia
Hypoesthesia
Hypotension
Nasal congestion
Nausea
Numbness
Panic attack
Paraesthesia
Pruritus
Pyrexia
Quincke's oedema
Rash
Sneezing
Swelling
Tachycardia
Taste disturbances
Throat irritation
Thrombophlebitis (injection site)
Urticaria
Venous thrombosis

Overdosage

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 ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: August 2013

Reference Sources

Summary of Product Characteristics: Compound Sodium Lactate Intravenous Infusion BP (Hartmann's Solution). Baxter Healthcare Ltd. Revised February 2013.

Summary of Product Characteristics: Hartmann's Solution for Injection BP as Steriflex No.11 or freeflex. Fresenius Kabi Ltd. Revised January 2010.

NICE Evidence Services Available at: www.nice.org.uk Last accessed: 05 September 2017