SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER (SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER).
Sodium lactate is an alkalinizing agent that is metabolized to bicarbonate in the liver, increasing plasma bicarbonate concentration and buffering hydrogen ions, thereby correcting metabolic acidosis. The lactate ion is converted to pyruvate and then to glucose or oxidized via the Krebs cycle, yielding bicarbonate.
| Metabolism | Lactate is metabolized primarily in the liver via lactate dehydrogenase to pyruvate, then enters the gluconeogenesis pathway or the Krebs cycle for oxidation to carbon dioxide and water, generating bicarbonate. Metabolism is dependent on hepatic function. |
| Excretion | Sodium lactate is metabolized to bicarbonate primarily in the liver (60-70%) and kidneys (30-40%). Excretion of unmetabolized lactate is minimal (<5%) via urine. Biliary/fecal excretion negligible. |
| Half-life | Lactate has a plasma half-life of approximately 5-10 minutes in healthy individuals. In patients with hepatic impairment or shock, half-life may be prolonged to 1-2 hours due to reduced metabolism. |
| Protein binding | Lactate is not significantly protein-bound (<1%). It is freely filtered and metabolized. |
| Volume of Distribution | Volume of distribution for lactate is approximately 0.3-0.5 L/kg, reflecting distribution into total body water and rapid cellular uptake. |
| Bioavailability | Only relevant route is intravenous; oral lactate is rapidly metabolized in the liver (first-pass effect), but no IV bioavailability data exists; effectively 100% for IV administration. |
| Onset of Action | Intravenous: Onset of alkalinizing effect occurs within 5-15 minutes, correlating with conversion to bicarbonate. |
| Duration of Action | Duration of alkalinizing effect is 1-2 hours after IV infusion, depending on metabolic capacity and acid-base status. Effects on serum bicarbonate last 30-60 minutes after cessation. |
| Molecular Weight | 112.06 |
Intravenous infusion; initial dose 300-500 mL (50-83 mmol) administered over 1-2 hours; subsequent doses based on serum bicarbonate and clinical response. Maximum infusion rate: 300 mL/h.
| Dosage form | INJECTABLE |
| Renal impairment | GFR 30-50 mL/min: caution, monitor for volume overload and electrolyte disturbances; GFR <30 mL/min: avoid due to risk of sodium overload and metabolic alkalosis. No specific dose reduction; use with close monitoring. |
| Liver impairment | Child-Pugh A-B: no adjustment; Child-Pugh C: caution due to impaired lactate metabolism; monitor for acidosis/alkalosis. |
| Pediatric use | Neonates and infants: 2-5 mL/kg (0.33-0.83 mmol/kg) intravenously over 1-2 hours; repeated as needed based on acid-base status. Children: 5-10 mL/kg (0.83-1.66 mmol/kg) IV over 1-2 hours. Maximum infusion rate: 5 mL/kg/h. |
| Geriatric use | Start at lower end of adult dose (300 mL) due to decreased renal function and risk of fluid overload; monitor electrolytes and volume status closely. |
| 1st trimester | Sodium lactate is a component of normal physiological fluids; no evidence of fetal harm at therapeutic doses. Use only if clearly needed. |
| 2nd trimester | Sodium lactate is a component of normal physiological fluids; no evidence of fetal harm at therapeutic doses. Use only if clearly needed. |
| 3rd trimester | Sodium lactate is a component of normal physiological fluids; no evidence of fetal harm at therapeutic doses. Use only if clearly needed. |
Clinical note
Comprehensive clinical and safety monograph for SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER (SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER).
| Placental transfer | Sodium lactate readily crosses the placenta as part of normal fetal-maternal exchange; no specific data on exogenous administration, but considered to be similar to endogenous transfer. |
| Breastfeeding | Sodium lactate is a normal constituent of breast milk; administration of therapeutic doses is unlikely to affect breastfeeding infant. Monitor maternal electrolyte balance. |
| Lactation Rating | Safe |
| Teratogenic Risk | Sodium lactate, as a component of lactated Ringer's solution, is generally considered safe during pregnancy. No teratogenic effects have been reported in humans. It is used intravenously for fluid and electrolyte replacement. The risk to the fetus is minimal when used according to standard clinical practice across all trimesters. |
| Fetal Monitoring | Monitor maternal vital signs, fluid balance, electrolytes, and acid-base status. Fetal heart rate monitoring may be indicated in obstetric patients receiving significant volumes or in cases of maternal metabolic acidosis. |
| Fertility Effects | No known adverse effects on fertility have been reported at therapeutic doses. Sodium lactate is a physiologic substance and does not impair reproductive function. |
■ FDA Black Box Warning
None
| Serious Effects |
Severe hypernatremiaSevere metabolic alkalosisAnuria or severe renal impairment with oliguriaHypocalcemia (may worsen)Lactic acidosis (theoretical concern, but sodium lactate is used in certain resuscitation scenarios)
| Precautions | Use with caution in patients with impaired liver function, as conversion to bicarbonate may be reduced, Risk of metabolic alkalosis with excessive administration, Should not be used in severe metabolic acidosis (pH < 7.1) or lactic acidosis, Monitor serum electrolytes, pH, and fluid status during administration, Contains sodium; use with caution in patients with congestive heart failure, edema, or renal impairment |
| Food/Dietary | No significant food-drug interactions are known. However, patients on sodium-restricted diets should be informed of the sodium content of this solution. |
| Clinical Pearls | Sodium lactate 0.167 Molar is an isotonic crystalloid solution primarily used as a source of bicarbonate precursors in metabolic acidosis. Monitor serum lactate levels to distinguish iatrogenic hyperlactatemia from lactic acidosis. Avoid in patients with severe metabolic alkalosis or hypernatremia. Use with caution in hepatic impairment due to impaired lactate clearance. In cardiac arrest, consider use only if indicated by arterial blood gas; routine use is not recommended. |
| Patient Advice | This intravenous solution provides electrolytes and fluid to help correct body acid imbalance. · Tell your healthcare provider if you have a history of liver disease, kidney problems, or are on a low-sodium diet. · Report any symptoms such as muscle twitching, confusion, or irregular heartbeat during infusion. · You may experience temporary discomfort or swelling at the infusion site. |
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