Hartmann's Solution
Generic Name
Ringer's Lactate Solution (Compound Sodium Lactate Injection)
Manufacturer
Various (e.g., Square Pharmaceuticals, Beximco Pharma, Eskayef Pharmaceuticals)
Country
Global
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Description
Overview of the medicine
Hartmann's Solution is an isotonic intravenous solution used for fluid and electrolyte replacement, particularly in cases of hypovolemia, dehydration, and metabolic acidosis.
Uses & Indications
Dosage
Adults
Dosage is highly individualized, based on patient's age, weight, clinical condition, and fluid/electrolyte balance. Typically, infusion rates range from 40-80 drops/minute (100-200 mL/hour), but can be higher in acute hypovolemia.
Elderly
Use with caution; adjust dosage based on cardiovascular and renal function. Monitor for signs of fluid overload.
Renal_impairment
Use with extreme caution; contra-indicated in severe renal failure due to risk of hyperkalemia and fluid overload. Monitor serum electrolytes closely.
How to Take
Administer intravenously via a sterile intravenous catheter. The rate and volume of infusion should be determined by a physician based on the patient's condition.
Mechanism of Action
It replenishes extracellular fluid volume and provides essential electrolytes (sodium, potassium, calcium, chloride). The lactate component is metabolized by the liver into bicarbonate, which helps to correct metabolic acidosis.
Pharmacokinetics
Onset
Immediate
Excretion
Excess water and electrolytes are excreted primarily via the kidneys. Bicarbonate produced from lactate is used or excreted.
Half life
Plasma half-life of lactate is approximately 20-60 minutes in normal physiological conditions; overall fluid half-life depends on fluid status.
Absorption
Administered directly into the bloodstream intravenously, ensuring immediate systemic availability.
Metabolism
Lactate is primarily metabolized in the liver to bicarbonate. A small amount may be metabolized in the kidneys and other tissues.
Side Effects
Contraindications
- Severe metabolic alkalosis or conditions where lactate metabolism is impaired (e.g., severe liver disease).
- Severe renal failure with oliguria or anuria, due to risk of hyperkalemia and fluid overload.
- Congestive heart failure, especially in patients with impaired cardiac output, due to risk of fluid overload.
- Hypernatremia, hyperkalemia, hypercalcemia.
- Conditions requiring strict sodium restriction.
Drug Interactions
Digoxin
Calcium in Hartmann's solution may potentiate digoxin toxicity.
Corticosteroids
May increase sodium and water retention, leading to fluid overload.
Thiazide diuretics
May increase the risk of hypercalcemia.
Alkalinizing agents
Concurrent use may lead to metabolic alkalosis.
ACE inhibitors/Angiotensin II Receptor Blockers (ARBs)
Increased risk of hyperkalemia.
Potassium-sparing diuretics (e.g., spironolactone, amiloride)
Increased risk of hyperkalemia.
Storage
Store below 30°C. Protect from freezing. Do not use if solution is cloudy, discolored, or contains visible particles. Do not store partially used containers.
Overdose
Overdose can lead to fluid overload (edema, pulmonary congestion), electrolyte imbalances (hypernatremia, hyperkalemia, hypercalcemia, metabolic alkalosis), and cardiac dysfunction. Management involves immediate cessation of infusion, administration of diuretics, and correction of electrolyte imbalances.
Pregnancy & Lactation
Hartmann's Solution is generally considered safe for use during pregnancy and lactation when clinically indicated and administered under careful medical supervision. Monitor fluid and electrolyte balance.
Side Effects
Contraindications
- Severe metabolic alkalosis or conditions where lactate metabolism is impaired (e.g., severe liver disease).
- Severe renal failure with oliguria or anuria, due to risk of hyperkalemia and fluid overload.
- Congestive heart failure, especially in patients with impaired cardiac output, due to risk of fluid overload.
- Hypernatremia, hyperkalemia, hypercalcemia.
- Conditions requiring strict sodium restriction.
Drug Interactions
Digoxin
Calcium in Hartmann's solution may potentiate digoxin toxicity.
Corticosteroids
May increase sodium and water retention, leading to fluid overload.
Thiazide diuretics
May increase the risk of hypercalcemia.
Alkalinizing agents
Concurrent use may lead to metabolic alkalosis.
ACE inhibitors/Angiotensin II Receptor Blockers (ARBs)
Increased risk of hyperkalemia.
Potassium-sparing diuretics (e.g., spironolactone, amiloride)
Increased risk of hyperkalemia.
Storage
Store below 30°C. Protect from freezing. Do not use if solution is cloudy, discolored, or contains visible particles. Do not store partially used containers.
Overdose
Overdose can lead to fluid overload (edema, pulmonary congestion), electrolyte imbalances (hypernatremia, hyperkalemia, hypercalcemia, metabolic alkalosis), and cardiac dysfunction. Management involves immediate cessation of infusion, administration of diuretics, and correction of electrolyte imbalances.
Pregnancy & Lactation
Hartmann's Solution is generally considered safe for use during pregnancy and lactation when clinically indicated and administered under careful medical supervision. Monitor fluid and electrolyte balance.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
Typically 2-3 years from the date of manufacture when stored properly. Check individual product label.
Availability
Hospitals, Clinics, Pharmacies
Approval Status
Widely approved globally (e.g., FDA, DGDA)
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensively studied and validated in clinical practice for fluid resuscitation and electrolyte management, particularly in surgical and critical care settings. Ongoing research compares its efficacy and safety with other crystalloids.
Lab Monitoring
- Serum electrolytes (Na+, K+, Ca++, Cl-)
- Blood gas analysis (pH, bicarbonate, lactate)
- Renal function tests (BUN, creatinine)
- Fluid balance charts (intake and output)
Doctor Notes
- Crucial for fluid resuscitation in hypovolemia and burns, and effective in correcting metabolic acidosis.
- Careful monitoring of fluid balance, serum electrolytes, and acid-base status is essential, especially in patients with cardiac, renal, or hepatic impairment.
- Avoid in severe hyperkalemia or severe liver dysfunction where lactate metabolism is impaired.
Patient Guidelines
- This medicine will be administered by a healthcare professional.
- Report any discomfort, pain, swelling at the infusion site, or difficulty breathing immediately.
- Inform your doctor about any pre-existing medical conditions, especially heart or kidney problems.
Missed Dose Advice
Not applicable as it is administered by healthcare professionals in a clinical setting based on ongoing patient needs.
Driving Precautions
Not applicable as patients receiving Hartmann's Solution are typically in a hospital setting and not expected to drive.
Lifestyle Advice
- Not applicable as it is an acute care intravenous fluid administered in a controlled medical setting.
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International brand names for this medicine. Click a brand to search for detailed information.