SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER
Clinical safety rating: caution
Comprehensive 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. |
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 |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
Comprehensive clinical and safety monograph for SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER (SODIUM LACTATE 1/6 MOLAR IN PLASTIC CONTAINER).
| Breastfeeding | Sodium lactate is a normal constituent of breast milk. Exogenous administration is unlikely to significantly alter milk levels. M/P ratio not established. Considered compatible with breastfeeding. |
| 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. |
■ FDA Black Box Warning
None.
| Serious Effects |
Severe lactic acidosis, hyperlactatemia, severe hepatic impairment, metabolic alkalosis, hypocalcemia, and patients with known hypersensitivity to sodium lactate.
| 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. |
Loading safety data…
| 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. |
| 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. |