Lactated Ringer's Injection Βιοσερ (Potassium Chloride, Sodium Chloride, Calcium Chloride Dihydrate, Sodium Lactate)

Lactated Ringer's Injection is an intravenous electrolyte solution used in several clinical situations where fluid and electrolyte balance must be rapidly restored.

• Fluid resuscitation in hypovolemia: restores intravascular volume and supports circulation.
• Electrolyte replacement: supplies sodium, potassium, calcium and lactate to correct deficits.
• Perioperative fluid management: maintains hemodynamic stability during surgery.
• Acute blood loss: provides rapid volume expansion to counteract hemorrhagic shock.

• Lactated Ringer's solution delivers sodium, potassium, calcium, and lactate ions directly into the bloodstream. The sodium and chloride expand extracellular fluid, while potassium and calcium replenish essential electrolytes. Lactate is metabolized by the liver to bicarbonate, helping to correct metabolic acidosis and maintain acid‑base balance.

Lactated Ringer's Injection may be associated with a range of adverse reactions, most of which are related to the infusion process or electrolyte shifts.

Common Side Effects

• Injection site pain or irritation.
• Phlebitis or mild inflammation of the vein.
• Transient hyperkalemia.
• Mild hypernatremia.
• Mild metabolic alkalosis.
• Mild hypercalcemia.

Serious or Rare Side Effects

• Anaphylactic or severe allergic reaction.
• Severe hyperkalemia leading to cardiac arrhythmia.
• Fluid overload causing pulmonary edema.
• Severe electrolyte disturbances (e.g., marked hypercalcemia).
• Cardiac arrest due to electrolyte imbalance.
• Severe metabolic acidosis if lactate metabolism is impaired.

When using Lactated Ringer's Injection, clinicians should observe several safety measures to minimize risks.

• Assess fluid status: avoid overload in patients with heart failure or renal impairment.
• Monitor electrolytes: especially potassium and calcium levels during and after infusion.
• Use caution in renal dysfunction: adjust volume and monitor renal function.
• Avoid in severe hyperkalemia: the solution contains potassium.
• Pregnancy and lactation: limited data, weigh benefits against potential risks.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Lactated Ringer's Injection can interact with other medications that affect electrolyte balance or fluid status.

Major Interactions (Avoid)

• Potassium chloride or other potassium supplements: risk of dangerous hyperkalemia.
• Calcium-containing IV solutions given simultaneously: may cause hypercalcemia.
• Blood products with citrate anticoagulant: citrate can bind calcium, worsening hypocalcemia.

Moderate Interactions (Monitor Closely)

• Loop or thiazide diuretics: increase electrolyte loss, requiring close monitoring.
• ACE inhibitors or ARBs: may raise potassium levels.
• NSAIDs: can impair renal function and affect fluid handling.
• Insulin therapy: shifts potassium intracellularly, altering serum levels.