HARTMANNS SOLUTION

Active substance: SODIUM LACTATE SOLUTION

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95/12260872/1013

Package leaflet: Information for the user
B. Braun Melsungen AG · 34209 Melsungen, Germany

Compound Sodium Lactate Intravenous Infusion BP
(Hartmann’s Solution)
Read all of this leaflet carefully before you start using this medicine because it contains important information for you.



•  eep this leaflet. You may need to read it again.
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• f you have any further questions, ask your doctor or pharmacist.
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•  his medicine has been prescribed for you only. Do not pass it on to others. It may harm them even if their signs of illness are the same as yours.
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• f you get any side effects, talk to your doctor or pharmacist. This includes any possible side effects not listed in this leaflet.
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What is in this leaflet:

1. What Compound Sodium Lactate is and what it is used for
2. What you need to know before you use Compound Sodium Lactate
3. How to use Compound Sodium Lactate
4. Possible side effects
5. How to store Compound Sodium Lactate
6. Contents of the pack and other information

1. What Compound Sodium Lactate is and what it is used for
Compound Sodium Lactate is a solution for supply of fluid and salts to the
body. It is supplied to you through a vein drip (an infusion). Its salt composition is similar to that of human blood.
You will receive this solution if
•  ou need to receive fluids and salts. This applies when your acid-base baly
ance is normal or your blood is a little bit too acidic (mild acidosis)
•  ou have lost water
y
•  ou have lost water and salts
y
•  ou have lost blood and need this replaced for a short time
y
y
•  our doctor wants to give you salts or some drugs that need to be dissolved
or diluted.

2. What you need to know before you use Compound
S
­ odium Lactate
Do not use Compound Sodium Lactate if you have

•  n impairment to metabolise lactate connected with high levels of lactate
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in your blood (see also section “Take special care with...”)
•  oo much water in your body (water intoxication)
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•  oo high blood volume (circulatory overload)
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•  weak heart that can not pump enough blood into your lungs or circulaa
tion (congestive heart failure)
•  bnormally high blood pressure (hypertension)
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• mpaired kidney function
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•  evere liver damage
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•  n accumulation of fluid and sodium (oedema with sodium retention)
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•  oo alkaline blood due to hyperventilation (respiratory alkalosis)
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Your doctor will not give you this medicine to correct abnormally high levels
of acids in the blood caused by your metabolism (severe metabolic acidosis)

Warnings and precautions

Your doctor will exercise particular caution if you have
• ost water while retaining the salts
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•  oo high blood levels of potassium, sodium, calcium or chloride
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•  bnormally high levels of bases in the blood caused by your metabolism
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(severe metabolic alkalosis)
•  ailure of your lungs
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•  xcess water in your body (peripheral oedema)
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•  condition where you are retaining sodium, such as high blood pressure,
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toxaemia of pregnancy (see “Pregnancy and breast-feeding”), too high levels of aldosterone in your body, treatment with cortisone
•  condition where you are retaining potassium, e.g. acute deficiency of
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water in your body, extensive tissue destruction as occurs with severe burns
•  disease associated with high levels of vitamin D in your blood such as
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sarcoidosis
•  idney stones or a history of them
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If you have constantly low blood sodium levels your doctor will take special
care to give you this solution slowly. This will prevent possible brain damages
(osmotic demyelinisation syndrome).
Children
Your doctor will take special care of your child aged less than 3 months if he/
she receives this solution.
Use as vehicle solution
Please note: If this solution is used as vehicle solution the safety information
of the additive provided by the respective manufacturer has to be taken into
account.

While you receive this solution the following parameters will be checked to
ensure that these are normal:
•  our blood salt and lactate levels
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•  our acid-base balance
y
•  our fluid balance
y

Other medicines and Compound Sodium Lactate

Tell your doctor or pharmacist if you are taking, have recently taken or might
take any other medicines.
Your doctor will administer this solution to you only with caution if you are
taking
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•  ortisone or carbenoxolone
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•  edicines for the treatment of heart weakness (e.g. digitalis preparations,
digoxin).
•  edicines that cause an increase of your serum potassium level (see the
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list below).
–  edicines that increase your urine flow and retain potassium (e.g. trim
amteren, amilorid, spironolactone, alone or in association)
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–  edicines that are used for the treatment of high blood pressure (ACE
inhibitors, e.g. captopril, enalapril; Angiotensin II receptor antagonists,
eg. valsartan, losartan)
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–  ome drugs that are used to suppress your immune system (e.g. tacrolimus, cyclosporine)
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–  special drug called suxamethonium used to relax your muscles
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•  imultaneously thiazid-diuretics and vitamin D
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•  oncomitantly medicines for the treatment of brittle bone disease (e.g.
bisphosphonates, fluorides) or specific antibiotics (e.g. fluorchinolones,
tetracyclines)
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•  timulating medicinal products (e.g. ephedrine, pseudoephedrine, desamphetaminesulphate, fenfluramine hydrochloride).
Lactate leads to an alkalinisation of your urine. This may change the excretion of certain drug substances (e.g. salicylic acid).
Some drugs must not be mixed with Compound Sodium Lactate. These include drugs containing oxalate, phosphate or carbonate/bicarbonate. Doctors only add drugs to Compound Sodium Lactate if they are sure they are
safe to mix.
Incompatibility has been reported with novobiocin sodium, oxytetracycline
hydrochloride, sodium bicarbonate, sodium calcium edetate, and sulphadiazine sodium.

Pregnancy and breast-feeding

Ask your doctor or pharmacist for advice before taking or using any medicine.
Pregnancy
If you are pregnant, please inform your doctor. Your doctor will administer
this solution to you only if he thinks it is necessary.
Your doctor will exercise particular caution if you have toxaemia of pregnancy. This is a condition of the third trimester when the patient has the
following symptoms:
•  igh blood pressure
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•  welling of body tissues
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•  rotein in the urine.
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Breast-feeding
Calcium is excreted in human milk, but at therapeutic doses of Compound
Sodium Lactate no effects on the breastfed newborns/infants are anticipated. Therefore Compound Sodium Lactate can be used during breast-feeding.

Driving and using machines

This medicine has no influence on the ability to drive and use machines.

3. How to use Compound Sodium Lactate
Dosage

This medicine will be administered to you by a doctor or health-care professional.
The doctor will decide the right dose of Compound Sodium Lactate depending on your fluid and electrolyte requirements. Thus your age, weight, clinical
condition and physiological (acid-base) status will be taken into account.

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95/12260872/1013

The recommended dosages are:
Adults and adolescents
Maximum daily dose
Normal fluid requirements are met with 40 ml per kg body weight per day.
Your doctor may determine individual adaptation of the dose and infusion
rate.
Maximum infusion rate:
The infusion rate will be adjusted according to your clinical condition. The
infusion rate should normally not exceed the following values:
5 ml per kg body weight per hour
Children
The dose is adjusted according to the individual requirements of fluid and
electrolytes. Thus the patient’s age, weight, clinical and biological (acid-base
balance) conditions and concomitant therapy should be taken into account.
Elderly patients
Basically the same dosage as for adults applies, but caution will be exercised
if you are suffering from further diseases like heart weakness that may frequently be associated with advanced age.
Patients with burns
Adults
During the first 24 hours you will receive 4 ml of solution per kg per percent
burn.
Children
During the first 24 hours your child will receive 4 ml of solution per kg per
percent burn. Thus the following volume is added as maintenance for children according to his/her weight
–  or children weighing 0 – 10 kg the amount is 4 ml per kg body weight per
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hour;
–  or children weighing 10 – 20 kg the amount is 40 ml per h + 2 ml per kg
f
body weight per hour;
–  or children weighing more than 20 kg, the amount is 60 ml per h + 1 ml
f
per kg body weight per hour.
Use as vehicle solution
If Compound Sodium Lactate is used as vehicle solution for compatible electrolyte concentrates and medicinal products, the instructions for use relating to the medicinal product to be added will be observed.

If you use more Compound Sodium Lactate than you should

An overdose may lead to hyperhydration (excess fluid in the body), which
will be followed by
• ncreased skin tension,
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•  ongestion in your veins,
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•  welling of body tissues
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•  ater on the lungs or in your brain
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•  isorders of your fluid, salt and acid-base balance,
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•  igh salt levels in your blood.
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If an overdose occurs, your doctor will give you any necessary treatment.
If you have any further questions on the use of this product, ask your doctor
or pharmacist.

4. Possible side effects
Like all medicines, Compound Sodium Lactate can cause side effects,
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­ lthough not everybody gets them.
However, it is unlikely that any adverse effect occurs as long as this medicine
is used as directed.
Yet, if you notice any side effects, please tell your doctor or pharmacist.

5. How to store Compound Sodium Lactate
Keep this medicine out of the sight and reach of children.
Do not use this medicine after the expiry date which is stated on the label.
The expiry date refers to the last day of that month.
This medicinal product does not require any special storage conditions.
Containers are for single-use only. Discard container and any unused content
after use.
No special requirements for disposal. Only to be used if the solution is clear,
colourless and the container and its closure do not show visible signs of
damage.
Do not reconnect partially used containers.

6. Contents of the pack and other information
What Compound Sodium Lactate contains
•  he active substances:
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1000 ml of the solution contain
Sodium chloride
Sodium lactate solution (50% w/w)
  (equivalent to sodium lactate, 3.12 g)
Potassium chloride
Calcium chloride dihydrate
Electrolyte concentrations:
Sodium
Potassium
Calcium
Chloride
Lactate
•  he other ingredient is
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Water for injections

6.00 g
6.24 g
0.40 g
0.27 g
131  mmol/l
5.4 mmol/l
1.8 mmol/l
112  mmol/l
28  mmol/l

Theoretical osmolarity:
277 mOsm/l
Titration acidity: < 1 mmol/l
pH:
5.0 – 7.0

What Compound Sodium Lactate looks like and contents of the
pack
It is a solution for infusion, i.e. for administration by a vein drip.
It is a clear, colourless solution of salts in water.
It comes in
•  olyethylene bottles containing 500 ml or 1000 ml,
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available in packs of 10 × 500 ml and 10 × 1000 ml
•  lastic bags containing 500 ml or 1000 ml,
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available in packs of 20 × 500 ml and 10 × 1000 ml
Not all pack sizes may be marketed

Marketing authorisation holder and manufacturer
B. Braun Melsungen AG
Carl-Braun-Straße 1
34212 Melsungen, Germany
Postal address
34209 Melsungen, Germany
Phone: +49-5661-71-0
Fax: +49-5661-71-4567

This leaflet was last revised in 2013-09-26.
The following information is only intended for health-care professionals:

Special warnings and precautions for use
Lactate utilisation may be impaired in the presence of hypoxia or hepatic insufficiency.
Compound sodium lactate contains an amount of potassium that is similar to that of the physiological concentration of potassium in human blood. ­ evertheless
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it is not suitable for the treatment of patients with severe potassium deficiency.
As the solution contains metabolisable ions (e.g. lactate) it may cause metabolic alkalosis.
Care should be taken to prevent extravasation during intravenous infusion.
In case of concomitant blood transfusion, the solution must not be administered via the same infusion set.
If lactate accumulates during infusion, the dosage and infusion rate should be reduced or administration of the solution should eventually be discontinued.
Important information about the container
The plastic container contains a significant volume of air. To avoid risk of air embolism, all air must be expelled before starting a pressure infusion.
Treatment of overdose:
Cessation of infusion, administration of diuretics with continuous monitoring of serum electrolytes, correction of electrolyte and acid-base imbalances.
In severe cases of overdose dialysis may be necessary.
Shelf life after admixture of additives
From the microbiological point of view, the product should be used immediately. If not used immediately, in-use storage times and conditions prior to use are
the responsibility of the user and would normally not be longer than 24 hours at 2 to 8°C, unless dilution has taken place in controlled and validated aseptic
conditions.

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B. Braun Melsungen AG
34209 Melsungen, Germany

30.09.13 10:50

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Source: Medicines and Healthcare Products Regulatory Agency

Disclaimer: Every effort has been made to ensure that the information provided here is accurate, up-to-date and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. This information has been compiled for use by healthcare practitioners and consumers in the United States. The absence of a warning for a given drug or combination thereof in no way should be construed to indicate that the drug or combination is safe, effective or appropriate for any given patient. If you have questions about the substances you are taking, check with your doctor, nurse or pharmacist.

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