SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive 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. |
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 | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER (SODIUM LACTATE 0.167 MOLAR IN PLASTIC CONTAINER).
| Breastfeeding | Sodium lactate is a normal component of breast milk and is not expected to cause adverse effects. The M/P ratio is not specifically defined but is likely similar to plasma levels. Use during breastfeeding is considered 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. |
■ FDA Black Box Warning
None
| Serious Effects |
["Severe metabolic acidosis (pH < 7.1)","Lactic acidosis","Alkalosis","Hypernatremia","Fluid overload states","Severe hepatic failure (inability to convert lactate to bicarbonate)","Known hypersensitivity to sodium lactate or any component of the formulation"]
| 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"] |
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| 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. |