Ringer-Locke solution: instructions for use and price

Pharmacodynamics and pharmacokinetics

Ringer-Locke solution is capable of regulating the water-salt and acid-base balance in the human and animal body. The product is closest to the natural composition of blood plasma . The drug inhibits the processes of aggregation blood elements and improves tissue perfusion .

Electrolytes thin the blood, and glucose prevents the development of hypoglycemia .

Very quickly after injection, the drug is distributed to organs and tissues.

Side effects, possible overdose

Since Ringer's solution is dripped to improve the patient's condition in particularly severe cases, self-treatment with this remedy is strictly prohibited. Therapy under medical supervision in most cases occurs without unpleasant effects. However, some patients may develop side effects:

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allergic reaction to any component of the drug;
excess water in the body or a separate part of it;
decrease in the amount of potassium in the blood.

Negative effects are easily eliminated by reducing the dose of the drug. Complete discontinuation of therapy is necessary in case of severely developed allergies. Symptoms are eliminated with special desensitizing procedures.

Drinking the drug is prohibited. In case of overdose or accidental ingestion of a large amount of the drug, side effects increase. Severe swelling and heart rhythm disturbances may occur. Therapy in this case comes down to prescribing diuretics and restoring electrolyte concentrations.

Indications for use

The drug is prescribed:

during dehydration and severe intoxication of the body due to dysentery , food poisoning, diarrhea and vomiting, El Tor cholera ;
if dehydration occurs due to circulatory disorders, severe blood loss;
for burns, frostbite, shock ;
if inflammation of the peritoneum develops - peritonitis .

Ringer-Locke solution is also used for animals with similar symptoms, albeit in a different dosage.

Similar drugs

Ringer's solution is almost always well tolerated by patients. However, there are situations when it is necessary to replace the drug with another one that is similar in action. The most popular analogues of the described medication are:

№	Name of the drug	Active ingredient	Manufacturer	Price in rubles per bottle 200 ml
1	Acesol	complex salt composition	DALHIMFARM JSC, Russia	30-40
2	Disol	complex salt composition	GROTEX LLC, Russia	40-50
3	Trisol	complex salt composition	JSC Kraspharma, Russia	30-40
4	Sterofundin	complex salt composition	B. Braun Melsungen, Germany	400-500
5	Ringer Lactate	complex salt composition + sodium lactate	Farmland LLC Republic of Belarus	30-40

All drugs similar to Ringer's solution have a similar composition and the same indications. These products effectively replenish the volume of blood circulating in the body and have a detoxifying effect. However, the use of all of these medications is possible only in medical institutions, since the drugs are not intended for home treatment.

Interaction

Caution should be used when combining the medicine with certain drugs, such as NSAIDs , estrogens or anabolic steroids .

When combined with cardiac glycosides, the load on the cardiovascular system increases.

Concomitant use with diuretics , angiotensin-converting enzyme or potassium supplements can lead to hyperkalemia .

Ringer solution for infusion 500ml No. 1

Name

Ringer solution for inf. in polymeric contact. 500 ml in pack No. 1

Description

The drug is a clear, colorless solution.

Release form

Solution for infusion

Dosage

500ml

Pharmacological properties

Pharmacodynamics

A rehydrating agent, it has a detoxifying effect, stabilizes the water and electrolyte composition of the blood. When used as a means of replenishing the volume of circulating blood, due to the rapid exit from the bloodstream into the intercellular space, the effect lasts only for 30-40 minutes (and therefore the solution is suitable only for short-term replenishment of the volume of circulating blood). Sodium, the main cation of extracellular fluid, takes part in the control of water distribution, water balance, and osmotic pressure of body fluids. Sodium is also associated with chlorine and bicarbonate in regulating the acid-base status of body fluids. Potassium, the main cation of intracellular fluid, takes part in the metabolism of carbohydrates and protein synthesis, and is needed to regulate the conduction of nerve impulses and muscle contraction. Calcium, in ionized form, is needed for the functional mechanism of blood coagulation, normal heart function, and regulation of neuromuscular excitability

Pharmacokinetics

The drug does not undergo metabolic transformations in the body. It is quickly excreted by the kidneys, 80% is excreted within 4 hours, and completely excreted after 12-24 hours. Information on pharmacokinetics refers to the ions included in the composition of the drug.

Indications for use

Short-term replenishment of circulating blood volume, isotonic and hypotonic dehydration of various origins.

Directions for use and doses

Before administration, the doctor is obliged to conduct a visual inspection of the bottle with the drug intended for transfusion. The solution must be clear and free of suspended particles or sediment. The medicine is considered suitable for use if the label is present and the packaging is sealed. The results of the visual examination and label data (name of the drug, manufacturer, batch number and expiration date) must be recorded in the patient’s medical history. Dosage. The rate of infusion and the volume of injected solution depend on the clinical condition of the patient, body weight, age, type and degree of dehydration/hypovolemia, and concomitant therapy. When used simultaneously with other drugs administered intravenously, incompatibility must be taken into account. Adolescents, adults and elderly patients: Maximum daily dose: For adults, elderly patients (over 65 years of age) and adolescents (12-18 years of age) maximum daily volume: 500-3000 ml/24 hours or 30-40 ml/kg/24 hours . If necessary, it is permissible to administer up to 50 ml/kg/24 hours. Maximum infusion rate: For adults, elderly patients (over 65 years old) and adolescents (12-18 years old) the maximum infusion rate is 60-80 drops per minute, for severe disease - up to 90 drops per minute (up to 5 ml / kg / hour or 1.7 drops/kg/min.). Conversion of milliliters into drops: 20 drops are approximately equal to 1 ml of solution. Directions for use: Intravenous, drip, at an average rate of 60 drops per minute; in severe cases of the disease - in a stream. The duration of use depends on the clinical condition of the patient, on average 3-5 days.

Use during pregnancy and lactation

Clinical and preclinical studies on the use of Ringer's solution during pregnancy and lactation have not been conducted. Practice shows that with timely examination of fluid and electrolyte balance, there are no contraindications for use during pregnancy and lactation.

Precautionary measures

For patients with heart and/or pulmonary insufficiency, large volumes of fluid can only be administered in exceptional cases, under the supervision of a physician. During the infusion of Ringer's solution, it is necessary to monitor indicators of water-salt metabolism with control of the content of sodium, potassium, calcium and chlorine ions in the blood plasma. Administration of sodium chloride solutions to patients with arterial hypertension, heart failure, peripheral edema, pulmonary edema, cerebral edema, renal dysfunction, preeclampsia, hyperaldosteronism, other diseases or treatments (for example, corticosteroids/steroids) characterized by sodium retention in the body ( see also section “Interaction with other drugs”), should be carried out with caution. The administration of potassium chloride solutions to patients with cardiac disease or the presence of predisposing factors for hyperkalemia, such as renal or adrenal insufficiency, acute dehydration, or significant tissue destruction, for example, as a result of severe burns, should be carried out with caution. The administration of calcium chloride solutions must be carried out with caution, carefully following the intravenous technique, to prevent extravasation or intramuscular administration. Solutions containing calcium ions should be administered with caution to patients with impaired renal function or diseases associated with increased vitamin D concentrations, such as sarcoidosis. It is unacceptable to use the same infusion system for joint administration of Ringer's solution and blood transfusion, as this can lead to the formation of blood clots. Ringer's solution does not provide sufficient concentrations of potassium and calcium to correct serious electrolyte imbalances. Therefore, after reversing dehydration with Ringer's solution, other infusion solutions can be used to further correct electrolyte abnormalities, if necessary. When using and mixing Ringer's solution with other drugs simultaneously, the rules of asepsis should be observed.

Interaction with other drugs

Sodium-related interactions: - corticosteroids/steroids and carbenoxolone, with simultaneous use there may be an increase in sodium and water retention (edema and hypertension); Potassium-related interactions: – potassium-sparing diuretics (amiloride, spironolactone, triamterene alone or in combination); – angiotensin-converting enzyme (ACE) inhibitors and, therefore, angiotensin II receptor antagonists; – cyclosporine, tacrolimus; These drugs increase the concentration of potassium in the blood plasma and may, for example, in the case of renal failure, increase the development of life-threatening hyperkalemia. Calcium-Related Interactions: – Exposure to digitalis glycosides increases calcium levels and can cause serious and life-threatening cardiac arrhythmias; – administration of thiazide diuretics and vitamin D simultaneously with calcium may cause the development of hypercalcemia; – absorption of bisphosphonates, fluorides, some fluoroquinolones and tetracyclines is reduced, and the release of calcium salts increases. The simultaneous use of calcium salts with bisphosphonates, fluorides, some fluoroquinolones and tetracyclines may lead to a decrease in their bioavailability.

Contraindications

Hypersensitivity to the components of the drug, decompensated heart failure, pulmonary edema, cerebral edema, oliguria, anuria, acidosis, hypervolemia, hyperchloremia, hypercalcemia, hypernatremia, concomitant therapy with GCS. With caution - heart failure, arterial hypertension, impaired liver or kidney function. Hypertensive dehydration, hyperkalemia, ascites in liver cirrhosis, simultaneous use of cardiac glycosides.

Compound

Sodium chloride Potassium chloride Calcium chloride hexahydrate in the form of calcium chloride Excipient: Water for injection

Overdose

Overdose can lead to hypernatremia, hyperchloremia, hypercalcemia, hyperkalemia and metabolic acidosis. Overdose or too rapid administration, especially in patients with impaired renal function and decreased sodium excretion, leads to sodium overload and edema. In this case, dialysis is necessary. Excessive administration of potassium, especially in patients with impaired renal function, can lead to the development of hyperkalemia. Symptoms include limb paraesthesia, muscle weakness, paralysis, cardiac arrhythmia, heart block, cardiac arrest and confusion. Treatment of hyperkalemia includes calcium, insulin (with glucose), sodium bicarbonate, ion exchange resins, or dialysis. Excessive administration of calcium salts can lead to hypercalcemia. Symptoms of hypercalcemia may include loss of appetite, nausea, vomiting, constipation, abdominal pain, muscle weakness, confusion, polydipsia, polyuria, nephrocalcinosis, and in severe cases, cardiac arrhythmia and coma. Too rapid intravenous administration of calcium salts may also result in oral tingling and burning, redness, and peripheral vasodilation. Mild asymptomatic hypercalcemia can usually be corrected by replacing the infusion of solutions containing calcium with an infusion of solutions without calcium. It is recommended to discontinue medications that aggravate hypercalcemia, such as vitamin D. Severe hypercalcemia requires emergency treatment (eg, loop diuretics, hemodialysis, calcitonin, bisphosphonates, or trisodium edetate). Excessive administration of chloride ions can lead to loss of bicarbonate leading to hyperchloremic acidosis. In case of overdose of a drug prescribed simultaneously with Ringer's solution, appropriate therapy is used.

Side effect

When using Ringer's solution, the following adverse reactions were very often recorded (in more than 10% of patients): - overhydration, in patients with heart failure - aggravation of congestion in the systemic and pulmonary circulation (peripheral edema, pulmonary edema); – electrolyte disturbances. Side effects may be due to improper intravenous infusion technique. These include fever, injection site reactions, pain, phlebitis, venous thrombosis, and hematoma. Side effects may be associated with the addition of other drugs to Ringer's solution. If adverse reactions occur, administration of Ringer's solution should be discontinued. If an adverse reaction occurs, the infusion should be stopped, the patient's condition assessed and the necessary therapeutic measures prescribed. To reduce the risk of possible incompatibility that may occur when mixing this solution with other prescribed supplements, the final infusion solution should be checked for cloudiness or precipitation immediately after mixing, before use, and periodically during use. If the contents of the container become cloudy, do not use.