SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER (SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER).
Sodium lactate is a source of bicarbonate precursor. It is metabolized to bicarbonate in the liver, which buffers metabolic acidosis, restoring acid-base balance.
| Metabolism | Primarily hepatic gluconeogenesis; lactate is converted to glucose via the Cori cycle, or oxidized to carbon dioxide and water; metabolism requires adequate liver function. |
| Excretion | Primarily renal as bicarbonate and lactate; <5% unchanged. |
| Half-life | 30–60 minutes for lactate conversion; bicarbonate component determined by CO2 excretion. |
| Protein binding | Negligible (<1%); does not bind significantly to plasma proteins. |
| Volume of Distribution | 0.4-0.6 L/kg; distributes primarily in extracellular fluid. |
| Bioavailability | Intravenous: 100% |
| Onset of Action | Intravenous: 1-2 minutes for buffering effect. |
| Duration of Action | 30-120 minutes dependent on metabolic turnover and acid-base status. |
| Molecular Weight | 112.06 |
Intravenous infusion: The typical adult dose is 300-500 mL of 1/6 Molar sodium lactate solution (approximately 167 mEq/L each of sodium and lactate, 1 L contains 167 mEq of sodium and lactate) administered as a continuous intravenous infusion at a rate of 0.5-2.5 mL/kg/hour, adjusted based on the severity of acidosis and clinical response. Maximum infusion rate: 2.5 mL/kg/hour.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal dysfunction (eGFR < 30 mL/min/1.73 m²) due to risk of hypernatremia and volume overload. In patients with eGFR 30-59 mL/min/1.73 m², use with caution, reduce infusion rate by 25-50%, and monitor serum sodium and fluid balance closely. |
| Liver impairment | Contraindicated in severe hepatic impairment (Child-Pugh Class C) due to impaired lactate metabolism. In Child-Pugh Class A or B, use with caution, reduce infusion rate by 50%, and monitor arterial blood gases and lactate levels frequently. |
| Pediatric use | Intravenous infusion: Administer 3-5 mL/kg of 1/6 Molar sodium lactate as a bolus over 30 minutes, followed by a continuous infusion at 0.5-1 mL/kg/hour, titrated to correct metabolic acidosis. Maximum infusion rate: 2 mL/kg/hour. |
| Geriatric use | Use with caution due to decreased renal function and higher risk of fluid overload. Start at lower end of dosing range (0.5-1 mL/kg/hour) and monitor serum electrolytes, fluid balance, and renal function closely. Contraindicated if eGFR < 30 mL/min/1.73 m². |
| 1st trimester | Sodium lactate is a component of Ringer's lactate solution, used for fluid and electrolyte resuscitation. It is considered safe in pregnancy when clinically indicated, as it is a physiologic substance. No known teratogenic effects in humans. |
| 2nd trimester | Safe when used as directed; monitor maternal electrolytes and fluid balance. |
| 3rd trimester | Safe when used as directed; monitor for fluid overload, especially in preeclampsia. |
Clinical note
Comprehensive clinical and safety monograph for SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER (SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER).
| Placental transfer | Sodium lactate readily crosses the placenta, as it is a small molecule and a normal metabolite. It equilibrates between maternal and fetal compartments. |
| Breastfeeding | Sodium lactate is a normal constituent of milk and body fluids. Exogenous administration is unlikely to pose a risk to the nursing infant. However, use only if clearly needed and monitor infant for electrolyte imbalance if high doses are used. |
| Lactation Rating | Safe |
| Teratogenic Risk | Sodium lactate is a normal metabolic intermediate and component of IV fluids. No teratogenic effects are known at therapeutic doses. Risk cannot be ruled out in first trimester, but no specific fetal risks are associated with maternal administration of this physiologic compound. |
| Fetal Monitoring | Monitor serum electrolytes, acid-base status, fluid balance, and renal function. In pregnant patients, additional monitoring of uterine activity and fetal heart rate if administering large volumes or in setting of preeclampsia. |
| Fertility Effects | No known effects on fertility at therapeutic doses. |
■ FDA Black Box Warning
None.
| Serious Effects |
Severe metabolic alkalosisHyperlactatemiaSevere hepatic failure (impaired lactate metabolism)Lactic acidosis
| Precautions | Use with caution in patients with impaired liver function, lactic acidosis, or conditions predisposing to lactic acidosis (e.g., shock, hypoxia). Monitor serum electrolytes and acid-base status. Risk of hyperlactatemia if metabolism is impaired. |
| Food/Dietary | No specific food interactions known. However, patients on sodium-restricted diets should account for the sodium content of this solution (approximately 167 mEq/L). |
| Clinical Pearls | Sodium lactate 1/6 Molar is a crystalloid solution providing approximately 167 mEq/L of sodium and 167 mEq/L of lactate. It is metabolized to bicarbonate in the liver, making it useful for correcting metabolic acidosis, especially in patients with lactic acidosis or those unable to tolerate bicarbonate due to hypocalcemia or hypercapnia. Monitor serum electrolytes, lactate levels, and acid-base status. Avoid in severe liver dysfunction as conversion to bicarbonate is impaired. Use with caution in patients with heart failure or renal impairment due to sodium load. For intravenous use only; do not administer with calcium-containing solutions due to precipitation risk. |
| Patient Advice | This medication is a solution that helps correct acid buildup in your blood. · It will be given through a vein (intravenously) by a healthcare professional. · You may need frequent blood tests to monitor your electrolyte levels and acid-base balance. · Inform your doctor if you have liver disease, heart failure, or kidney problems. · Report any signs of fluid overload such as shortness of breath, swelling in the ankles or legs. · Do not take any other medications or supplements without consulting your doctor. · This solution contains sodium; discuss any dietary sodium restrictions with your healthcare provider. |
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