FDA

Ringer'S in Plastic Container

Approved 16 May 1980InjectionInjectable

The FDA lists this product in 8 strengths and forms.

Indications

Ringer's Injection is indicated for use as a source of water and electrolytes in adults and pediatric patients. Ringer's Injection is indicated for use as a source of water and electrolytes in adults and pediatric patients. ( 1 )

Contraindications

Ringer's Injection is contraindicated in: Neonates (28 days of age or younger) who are receiving concomitant treatment with ceftriaxone, even if separate infusion lines are used, due to the risk of fatal ceftriaxone-calcium salt precipitation in the neonate's bloodstream [see Warnings and Precautions (5.1) and Specific Populations (8.4) ] . Patients with known hypersensitivity to any components of Ringer's Injection [see Warnings and Precautions (5.3) ] .

Concomitant treatment with ceftriaxone in neonates (28 days of age or younger). ( 4 ) Patients with known hypersensitivity to Ringer's Injection. ( 4 )

Warnings and precautions

Serious Risks with Inappropriate Use with Ceftriaxone : Deaths have occurred in neonates (28 days of age or younger) who received concomitant intravenous calcium-containing solutions with ceftriaxone. In patients older than 28 days, ceftriaxone and Ringer's Injection may be administered sequentially if the infusion lines are thoroughly flushed between infusions. ( 4 , 5.1 , 8.4 ) Air Embolism : Use a non-vented infusion set or close the vent on a vented set and use a dedicated line without any connections.

Pressure infusion is not recommended to increase flow rates, but if necessary, remove all air from the bag prior to initiating infusion. ( 5.2 ) Hypersensitivity Reactions : Stop the Ringer's Injection infusion immediately if signs or symptoms of a hypersensitivity reaction develop. ( 5.3 ) Potassium Imbalances, Hyponatremia, Hypercalcemia, Fluid Overload : See Full Prescribing Information for risk management recommendations.

( 5.4 , 5.5 , 5.6 , 5.7 )

5.1Serious Risk with Concomitant Use with Ceftriaxone Precipitation

Contraindications

Concomitant treatment with ceftriaxone in neonates (28 days of age or younger). ( 4 ) Patients with known hypersensitivity to Ringer's Injection. ( 4 )

Warnings and precautions

( 5.4 , 5.5 , 5.6 , 5.7 )

5.1Serious Risk with Concomitant Use with Ceftriaxone Precipitation

Interactions

Drugs that Affect Electrolyte and/or Fluid Balance : Avoid concomitant use. If concomitant use cannot be avoided, closely monitor electrolyte concentrations and fluid balance. ( 7.1 ) Lithium : Avoid concomitant use. If concomitant use is unavoidable monitor serum lithium concentrations more frequently. ( 7.2 ) Digoxin : Consider reducing the volume or rate of Ringer's Injection due to the increased risk of digoxin toxicity with calcium-containing solutions.

( 7.3 )

7.1 Drugs that Affect Electrolyte and/or Fluid Balance Hyperkalemia Administration of Ringer's Injection to patients concomitantly treated or recently treated with drugs that are associated with hyperkalemia increases the risk of severe and potentially fatal hyperkalemia, especially in the presence of other hyperkalemia risk factors . Avoid use of Ringer's Injection in patients receiving drugs that are associated with hyperkalemia (e.g., potassium-sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists, or calcineurin inhibitors).

If concomitant use cannot be avoided, closely monitor serum potassium concentrations during concomitant use [see Warnings and Precautions (5.4) ]. Hyponatremia Administration of Ringer's Injection to patients treated concomitantly with drugs associated with hyponatremia may increase the risk of developing hyponatremia. These drugs include diuretics and those that cause SIADH (e.g., arginine vasopressin analogs, certain antiepileptic, psychotropic, or cytotoxic drugs.

Avoid use of Ringer's Injection in patients receiving such drugs. If use cannot be avoided, closely monitor serum sodium concentrations during concomitant use [see Warnings and Precautions (5.5) ] . Hypercalcemia Avoid the use of Ringer's Injection in patients treated with thiazide diuretics or vitamin D because these drugs can increase the risk of hypercalcemia. If use cannot be avoided, closely monitor serum calcium concentrations during concomitant use [see Warnings and Precautions (5.6) ].

Hypernatremia and Fluid Retention Administration of Ringer's Injection to patients treated concomitantly with drugs associated with sodium and fluid retention (e.g., corticosteroids or corticotropin) may increase the risk of hypernatremia and volume overload. Avoid use of Ringer's Injection in patients receiving such drugs. If use cannot be avoided, closely monitor serum electrolytes, fluid balance, and acid-base balance during concomitant use.

7.2Lithium

Renal sodium and lithium clearance may be increased during concomitant use of Ringer's Injection and lithium and may result in decreased lithium concentrations. Avoid use of Ringer's Injection in patients receiving lithium. If use cannot be avoided, increase the frequency of monitoring of serum lithium concentrations during concomitant use.

7.3Digoxin Administration

of calcium via use of Ringer's Injection may increase digoxin's effects and lead to digoxin toxicity including serious or fatal cardiac arrhythmias. In digoxin-treated patients, consider reducing the volume and/or rate of Ringer's Injection administration .

Ringer'S in Plastic Container

Indications

Contraindications

Warnings and precautions

5.1Serious Risk with Concomitant Use with Ceftriaxone Precipitation

Two medicines in one question?

Ringer'S in Plastic Container

Indications

Contraindications

Warnings and precautions

5.1Serious Risk with Concomitant Use with Ceftriaxone Precipitation

Two medicines in one question?

5.2Air Embolism Cases

5.3Hypersensitivity Reactions

5.4Potassium Imbalances Hyperkalemia

5.5Hyponatremia Ringer's

5.6Hypercalcemia Ringer's

Interactions

7.2Lithium

7.3Digoxin Administration

Pregnancy and breastfeeding

8.1Pregnancy Risk Summary Exposure to Ringer's Injection

Adverse reactions

Composition

Strengths and forms

Official product information

At a glance