LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive clinical and safety monograph for LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER (LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER).
Lactated Ringer's and Dextrose 5% is a crystalloid solution that provides fluid, electrolytes, and calories. Lactate is metabolized to bicarbonate in the liver, providing buffering capacity. Dextrose is metabolized to carbon dioxide and water, providing energy. The solution expands extracellular fluid volume and replaces electrolyte deficits.
| Metabolism | Lactate is primarily metabolized to bicarbonate in the liver; dextrose is metabolized via glycolysis and oxidative phosphorylation to carbon dioxide and water. |
| Excretion | Lactate: primarily hepatic metabolism to bicarbonate; renal excretion minimal (<5%). Dextrose: metabolized to CO2 and water; <1% excreted unchanged in urine. Electrolytes: renal excretion proportional to intake. |
| Half-life | Lactate: ~1.5 hours (hepatic conversion); dextrose: ~0.5 hours (insulin-dependent); prolonged in hepatic or renal impairment. |
| Protein binding | None significant (<1%); lactate, dextrose, and electrolytes are not protein bound. |
| Volume of Distribution | Lactate and dextrose distribute into total body water: approximately 0.5 L/kg; electrolytes (Na+, Cl-, Ca2+) distribute into extracellular fluid: 0.2 L/kg. |
| Bioavailability | Intravenous: 100% (only route of administration). |
| Onset of Action | IV: hemodynamic effects (volume expansion) within minutes; lactate metabolism begins immediately; dextrose elevates blood glucose within 1–2 minutes. |
| Duration of Action | Volume expansion: 1–2 hours; lactate buffering effect: 2–4 hours; dextrose effect: 1–2 hours (duration depends on metabolic state). |
Intravenous infusion; adult dose is 500-1000 mL at a rate of 5-10 mL/kg/hour, adjusted based on clinical response, fluid status, and serum glucose/electrolytes. Usual max rate 30 mL/kg/day or 2000 mL/day unless otherwise indicated.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in anuria. For GFR 10-50 mL/min: use with caution; monitor fluid balance, electrolytes, and glucose. For GFR <10 mL/min: avoid due to risk of hyperkalemia and volume overload. No specific dose reduction equation; adjust rate based on renal function. |
| Liver impairment | No standard Child-Pugh based dose adjustment. Use with caution in severe hepatic impairment due to altered lactate metabolism; monitor lactate levels and avoid in severe liver failure. |
| Pediatric use | Neonates and infants: 10-20 mL/kg per dose as intravenous infusion; rate not to exceed 5 mL/kg/hour. Children: 5-10 mL/kg/hour, max 30 mL/kg/day or 2000 mL/day. Adjust based on glucose monitoring. |
| Geriatric use | Elderly: initiate at lower end of dosing range (e.g., 500 mL initial infusion), monitor for fluid overload, hyperglycemia, and electrolyte disturbances due to decreased renal and cardiac reserve. Typical rate: 5 mL/kg/hour max. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER (LACTATED RINGER'S AND DEXTROSE 5% IN PLASTIC CONTAINER).
| Breastfeeding | Compatible with breastfeeding. Dextrose and electrolytes are normal blood constituents. No M/P ratio available. Use usual precautions for IV fluids. |
| Teratogenic Risk | Lactated Ringer's and dextrose 5% is a crystalloid solution. No teratogenic effects are reported. In first trimester, use only if clearly needed. Second and third trimesters: no known fetal risk, but monitor maternal glucose and electrolytes due to dextrose load. |
■ FDA Black Box Warning
No FDA black box warnings.
| Serious Effects |
["Hypersensitivity to any component","Hyperlactatemia or lactic acidosis","Severe metabolic alkalosis","Patients with impaired lactate metabolism (e.g., severe hepatic insufficiency)"]
| Precautions | ["Use with caution in patients with heart failure, renal impairment, or conditions with sodium retention.","Monitor serum electrolytes, fluid balance, and acid-base status.","Avoid in patients with lactic acidosis or severe metabolic alkalosis.","Do not administer simultaneously with blood through same infusion set due to risk of hemolysis."] |
Loading safety data…
| Fetal Monitoring |
| Monitor maternal vital signs, urine output, serum electrolytes, glucose, and fluid balance. Fetal monitoring if prolonged infusion or maternal compromise. |
| Fertility Effects | No known effects on fertility. Not studied for reproductive impact. |