SODIUM LACTATE IN PLASTIC CONTAINER
Clinical safety rating
cautionComprehensive clinical and safety monograph for SODIUM LACTATE IN PLASTIC CONTAINER (SODIUM LACTATE IN PLASTIC CONTAINER).
Sodium lactate is converted to bicarbonate in the liver, providing an alkalizing effect to correct metabolic acidosis.
| Metabolism | Metabolized in the liver via lactate dehydrogenase and the Cori cycle to bicarbonate and glucose. |
| Excretion | Sodium lactate is metabolized to bicarbonate in the liver via the Cori cycle; less than 5% is excreted unchanged in urine under normal conditions. Biliary/fecal elimination is negligible. |
| Half-life | The terminal elimination half-life of lactate is approximately 5–10 minutes due to rapid hepatic metabolism; this short half-life allows quick correction of metabolic acidosis when administered intravenously. |
| Protein binding | Minimal protein binding (<5%) as lactate is a small, water-soluble molecule; not significantly bound to plasma proteins. |
| Volume of Distribution | Volume of distribution approximates total body water (0.5–0.6 L/kg) because lactate distributes freely into the extracellular and intracellular spaces; this reflects its rapid equilibration. |
| Bioavailability | Intravenous: 100% (administered directly into the bloodstream). Oral: Not clinically used; oral administration is not bioavailable as lactate is metabolized in the gut and liver first-pass. |
| Onset of Action | Intravenous: Onset of alkalinizing effect occurs within minutes, typically 5–15 minutes after infusion begins, as lactate is converted to bicarbonate. |
| Duration of Action | The alkalinizing effect lasts 1–2 hours post-infusion, depending on the patient's metabolic rate and acid-base status; continuous infusion may be required for sustained effect. |
| Molecular Weight | 112.06 |
Intravenous (IV) infusion: Initial dose 300-500 mL of 1/6 M (M/6) sodium lactate solution (167 mEq/L of sodium and lactate) infused over 1-2 hours; subsequent doses based on serum bicarbonate levels and clinical response.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment (GFR <30 mL/min) due to risk of fluid overload and hypernatremia; for GFR 30-59 mL/min, use with caution and reduce infusion rate by 50%. |
| Liver impairment | Child-Pugh Class A: No adjustment; Class B: Use with caution, reduce dose by 25%; Class C: Avoid use due to impaired lactate metabolism. |
| Pediatric use | Neonates and infants: 4.5 mL/kg of M/6 sodium lactate IV over 1 hour; children: 20-30 mL/kg of M/6 sodium lactate IV at a rate not exceeding 10 mL/kg/hour, titrated to monitoring of acid-base status. |
| Geriatric use | Elderly patients: Start at low end of dosing range, monitor for fluid overload, hypernatremia, and metabolic alkalosis; infusion rate not to exceed 100 mL/hour due to reduced cardiac and renal reserve. |
| 1st trimester | Use only if clearly needed. Maternal metabolic acidosis may require treatment; sodium lactate is generally considered safe when used as a buffer or fluid replacement. |
| 2nd trimester | Use with caution. Monitor maternal and fetal status. No known teratogenic effects. |
| 3rd trimester | Use with caution. May affect maternal acid-base balance and fluid status. Avoid in preeclampsia or edema. |
Clinical note
Comprehensive clinical and safety monograph for SODIUM LACTATE IN PLASTIC CONTAINER (SODIUM LACTATE IN PLASTIC CONTAINER).
| Placental transfer | Sodium lactate crosses the placenta via passive diffusion and active transport. Fetal levels mirror maternal levels; no specific adverse effects reported. |
| Breastfeeding | Sodium lactate is a normal constituent of breast milk. Exogenous administration is unlikely to cause adverse effects in the infant due to rapid metabolism. Use caution with high doses or in neonates with metabolic disorders. |
| Lactation Rating | L1: Compatible |
| Teratogenic Risk | Sodium lactate is used as an intravenous electrolyte replenisher and alkalizing agent. Data on teratogenic risk are limited. In animal studies, sodium lactate did not show fetal harm at doses within clinical range. However, no well-controlled human studies exist. The risk is considered low but cannot be excluded. Use in pregnancy only if clearly needed. |
| Fetal Monitoring | Monitor maternal serum electrolytes, acid-base status, fluid balance, and renal function. Fetal heart rate monitoring is recommended in high-risk pregnancies or when large volumes are infused. |
| Fertility Effects | No known adverse effects on fertility in animal studies. No human data available. |
■ FDA Black Box Warning
None
| Serious Effects |
Severe metabolic alkalosisHypernatremiaHyperlactatemiaSevere hepatic impairment (lactic acid metabolism impaired)Congestive heart failure with fluid overloadAnuria or severe oliguria
| Precautions | Use with caution in patients with lactic acidosis if etiology is not correctable, Monitor serum electrolytes, acid-base status, and fluid balance, Risk of fluid overload in patients with heart failure or renal impairment |
| Food/Dietary | No known dietary restrictions or food interactions. However, monitor nutritional intake in patients receiving long-term therapy, as electrolyte imbalances may require dietary adjustments. |
| Clinical Pearls | Sodium lactate in plastic container is used as a source of bicarbonate precursor for metabolic acidosis. It is contraindicated in lactic acidosis because it requires hepatic metabolism to bicarbonate. Monitor serum lactate and pH closely during infusion. The plastic container may leach DEHP; use with caution in neonates and pregnant women. |
| Patient Advice | This medication is given intravenously to correct acid buildup in the blood. · Tell your healthcare provider if you have liver disease, as it may affect how this drug works. · Inform your doctor if you are pregnant or breastfeeding. · Report any signs of allergic reaction such as rash, itching, or difficulty breathing. · Do not suddenly stop treatment without consulting your doctor. |
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