Ringer's solution

May form a ceftriaxone-calcium precipitate when administered with ceftriaxone in the same IV line. Incompatible with amphotericin B, cortisone, erythromycin lactobionate, ethyl alcohol, thiopental sodium, disodium edetate, etamivan, carbonate, and oxalate- or phosphate-containing solutions.

Sodium or potassium overload, fluid overload (hyperhydration), decompensated congestive cardiac failure. Concomitant use with ceftriaxone in neonates (≤28 days).

Patient with non-osmotic vasopressin release (including SIADH), other heart disease; reduced cerebral compliance (e.g. brain oedema); hypercalcaemia, calcium renal calculi or history of such calculi; at risk of hyperchloraemia. Renal and hepatic impairment. Elderly. Pregnancy and lactation.

Significant: Fluid and/or solute overload resulting in dilution of serum electrolyte concentrations, overhydration and congested states, including pulmonary oedema; electrolyte disturbances (e.g. hyponatraemia), acid-base imbalance.
Gastrointestinal disorders: Nausea, vomiting, abdominal pain, diarrhoea.
General disorders and administration site conditions: Infection at the inj site, venous thrombosis or phlebitis extending from the inj site, extravasation; chills, pyrexia.

Monitor serum electrolytes, fluid balance, and acid-base balance.

Symptoms: Hypervolaemia with tightened skin, venous stasis, pulmonary or cerebral oedema, disturbed acid-base and electrolyte balance. Management: Administer fast-acting diuretics (e.g. furosemide). In case of oliguria or anuria, perform hypertonic haemofiltration to remove excess fluid.

Increased risk of hyponatraemia with drugs stimulating vasopressin release (e.g. chlorpropamide, clofibrate, carbamazepine, vincristine, SSRIs, ifosfamide, antipsychotics, narcotics), drugs potentiating vasopressin action (e.g. NSAIDs, cyclophosphamide), vasopressin analogues (e.g. desmopressin, oxytocin, vasopressin, terlipressin), diuretics and antiepileptics (e.g. oxcarbazepine). May increase the risk of serious cardiac arrhythmia with digitalis glycosides. May increase the risk of sodium and fluid retention with corticosteroids. May increase the risk of hyperkalaemia with potassium-sparing diuretics (e.g. amiloride, spironolactone, triamterene), ACE inhibitors, ARBs, tacrolimus, and ciclosporin.
Potentially Fatal: Concomitant use with ceftriaxone may result in the formation of ceftriaxone-calcium precipitate in the bloodstream of neonates (≤28 days), even if separate infusion lines are used.

Description:
Mechanism of Action: Ringer's solution is an isotonic solution of electrolytes containing sodium chloride, potassium chloride and calcium chloride dihydrate. Its main effect is the expansion of the extracellular compartment including interstitial and intravascular fluids.

Store at or below 25°C.

Dung dịch tiêm tĩnh mạch & các loại dung dịch vô trùng khác

Baxter Healthcare Ltd. Ringers Solution for Infusion data sheet 01 May 2019. Medsafe. http://www.medsafe.govt.nz. Accessed 03/10/2024.

Joint Formulary Committee. Potassium Chloride with Calcium Chloride Dihydrate and Sodium Chloride. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 03/10/2024.

Ringer's Injection. UpToDate Lexidrug, Lexi-Drugs Multinational Online. Waltham, MA. UpToDate, Inc. https://online.lexi.com. Accessed 03/10/2024.

Ringer's Solution for Infusion (Fresenius Kabi Limited). MHRA. https://products.mhra.gov.uk. Accessed 03/10/2024.

Ringers Injection, Solution (B. Braun Medical Inc.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed. Accessed 03/10/2024.