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FDA approved Ringer's In Plastic Container (Ringer's solution) for parenteral replacement of extracellular fluid and electrolyte lossesThe FDA approved a new intravenous fluid called Ringer's In Plastic Container

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Key Takeaway
Note calcium prohibits co-infusion with blood; use with great care in renal, cardiac, or hepatic impairment.

The FDA has approved Ringer's In Plastic Container, a sterile solution, for the parenteral replacement of extracellular losses of fluid and electrolytes. The indication is broad, intended for use as required by the clinical condition of the patient, and the solution may include minimal carbohydrate calories. This approval provides a standard intravenous option for managing fluid and electrolyte deficits in various clinical settings. Clinicians should note specific warnings regarding its use in patients with conditions like hyperkalemia, congestive heart failure, or severe renal insufficiency due to its sodium, potassium, calcium, and lactate content. Careful administration is required to avoid fluid or solute overload, and the solution must not be infused simultaneously with blood through the same set due to the risk of coagulation from its calcium ions.

Clinical Details (Mechanism · Dosing · Trial Data · Warnings)
Mechanism of Action

Not reported in label.

Indication & Patient Population

This solution is indicated for parenteral replacement of extracellular losses of fluid and electrolytes, with or without minimal carbohydrate calories, as required by the clinical condition of the patient.

Dosing & Administration

The dose is dependent upon the age, weight and clinical condition of the patient. Additives may be incompatible; consult with a pharmacist if available. When introducing additives, use aseptic technique, mix thoroughly and do not store. The presence of calcium limits compatibility with certain drugs that form precipitates of calcium salts and prohibits simultaneous infusion through the same administration set as blood because of the likelihood of coagulation. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit.

Key Clinical Trial Data

Trial data not available in label.

Warnings & Contraindications

Solutions containing calcium ions should not be administered simultaneously through the same administration set as blood because of the likelihood of coagulation. Solutions which contain potassium should be used with great care, if at all, in patients with hyperkalemia, severe renal failure and in conditions in which potassium retention is present. Solutions containing sodium ions should be used with great care, if at all, in patients with congestive heart failure, severe renal insufficiency and in clinical states in which there exists edema with sodium retention. In patients with diminished renal function, administration of solutions containing sodium or potassium ions may result in sodium or potassium retention. Solutions containing lactate ions should be used with great care in patients with metabolic or respiratory alkalosis and where there is an increased level or an impaired utilization of lactate ions, as in severe hepatic insufficiency. The intravenous administration can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary edema. The risk of dilutional states is inversely proportional to the electrolyte concentrations of administered parenteral solutions. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentrations of such solutions.

Place in Therapy

Not reported in label.

The U.S. Food and Drug Administration (FDA) has approved a new sterile intravenous (IV) fluid called Ringer's In Plastic Container. It is a balanced salt solution used to replace water and important minerals, like sodium and potassium, that a person's body may have lost. This type of fluid is given through a vein in a hospital or clinical setting when a patient's condition requires it, such as after surgery, due to dehydration, or from other illnesses. The approval provides doctors with another standard, pre-made option to help manage these common needs. This solution is intended for use in patients whose doctors determine they need this specific balance of fluids and electrolytes. It is not for everyone, and healthcare providers will decide if it is the right choice based on a person's individual health situation. The approval means this product has been reviewed for safety and effectiveness for its intended use and can now be routinely stocked and used. It is important to know that this product has specific warnings. For example, it must be used carefully in people with certain heart or kidney problems because of its mineral content. It also cannot be given in the same IV line as a blood transfusion. As with any medical treatment, patients should talk openly with their doctor about all their health conditions and any questions they have about their care.

What this means for you:
This is a new IV fluid option for doctors to use in hospitals when patients need fluids and minerals replaced.

Study Details

Study typeFda approval
PublishedMay 1980
View Original Abstract ↓
INDICATIONS AND USAGE This solution is indicated for parenteral replacement of extracellular losses of fluid and electrolytes, with or without minimal carbohydrate calories, as required by the clinical condition of the patient.
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