Ringer's Lactate
Pronunciation: pronunciation varies by local usage.
- Generic name
- lactated Ringer's / Ringer lactate / compound sodium lactate solution
- Drug class
- balanced crystalloid intravenous fluid
- Route
- intravenous infusion
Registered_intravenous_medicine_for_clinical_use
Trade names by country: United States · United Kingdom · Australia
Australia: Compound Sodium Lactate (Hartmann's Solution) (3) · Full directory
What lactated Ringer's / Ringer lactate / compound sodium lactate solution is and how it works
A sterile, calcium-containing crystalloid solution used in clinical care to replace water and electrolytes or extracellular fluid in selected patients. The exact bag, composition, indication, rate, and compatibility rules must be checked each time. (1) (2) (3)
Uses, formulations, monitoring, and supply rules can differ by patient, product, and country. Follow the exact local product information and professional advice.
Mechanism of action: how lactated Ringer's / Ringer lactate / compound sodium lactate solution works
A balanced crystalloid solution containing sodium, potassium, calcium, chloride and lactate, used for fluid and electrolyte replacement; lactate is metabolised to bicarbonate, mainly hepatically. (2)
What lactated Ringer's / Ringer lactate / compound sodium lactate solution is used for
Use 1
Replacement of extracellular fluid and electrolytes when a balanced crystalloid is clinically appropriate (1) (2) (3)
Use 2
Selected short-term volume replacement and acid-base management uses described by the exact local product information (1) (2) (3)
Before taking lactated Ringer's / Ringer lactate / compound sodium lactate solution
Do not take / not appropriate for
- Lactated Ringer’s must not be given to newborns aged 28 days or younger who are receiving ceftriaxone, even through a separate infusion line, because fatal ceftriaxone–calcium precipitation can occur in the bloodstream. (all countries) (1)
- Lactated Ringer’s must not be given to anyone with a known hypersensitivity to any of its components. (all countries) (1)
- Deaths from calcium–ceftriaxone precipitates in the lungs and kidneys have been reported in neonates. In patients older than 28 days, ceftriaxone and calcium-containing solutions such as Lactated Ringer’s may be given sequentially only if the infusion lines are thoroughly flushed between them, or through different infusion lines at different sites. (all countries) (1)
- Lactated Ringer’s contains potassium, so it should be used with caution — and often avoided in favour of an alternative fluid — in people at risk of high blood potassium, such as those with severe kidney impairment. This is a caution requiring monitoring, not an absolute contraindication. (all countries) (1)
- In severe liver impairment the lactate in this fluid may not be metabolised properly, so Lactated Ringer’s may not produce the expected alkalinising effect. Use in this setting requires clinical judgement and monitoring rather than being automatically excluded. (all countries) (1)
Tell your clinician about
- Clinicians assess fluid status, electrolytes, acid-base status, kidney, heart and liver function, age, weight, medicines, pregnancy, and the reason for fluid therapy.
- Tell staff about kidney or heart failure, swelling, electrolyte problems, diabetes, liver disease, severe burns or head injury, allergies, and all medicines.
How to take lactated Ringer's / Ringer lactate / compound sodium lactate solution
- A healthcare professional selects the product and gives it into a vein using sterile equipment while monitoring response.
- Volume, concentration, infusion rate, duration, and added medicines are individualized. This page must not provide a calculator or bedside protocol.
Procedures and treatment changes
Tell the treating team before surgery, procedures, or any medicine change. Do not alter treatment without the responsible clinician. (1) (2) (3)
Missed dose
Not applicable as a self-managed dose. Clinical staff reassess whether further fluid is needed.
Overdose
Too much or too rapid infusion can cause fluid overload, pulmonary oedema, and electrolyte or acid-base disturbances. This needs urgent clinical assessment; healthcare professionals decide whether and how the infusion is stopped or adjusted. (1) (2) (3)
Side effects
Side effects and their urgency vary; report severe, persistent, or concerning symptoms.
Nausea and vomiting
Incidence: Common
Headache
Incidence: Common
hypersensitivity
What to notice: hypersensitivity
pulmonary oedema or severe fluid overload
What to notice: pulmonary oedema or severe fluid overload
severe electrolyte disturbance
What to notice: severe electrolyte disturbance
air embolism or incompatible precipitate-related harm
What to notice: air embolism or incompatible precipitate-related harm
Serious warnings
Breathlessness, worsening swelling, chest symptoms, confusion, seizures, marked weakness, or pain/swelling at the infusion site require prompt clinical assessment — serious
Symptoms: Breathlessness, worsening swelling, chest symptoms, confusion, seizures, marked weakness, or pain/swelling at the infusion site require prompt clinical assessment.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1) (2) (3)
Calcium-containing solutions have important incompatibilities — serious
Symptoms: Calcium-containing solutions have important incompatibilities. They must not be co-administered with ceftriaxone in neonates, and compatibility rules in older patients and with blood products or added medicines must be followed exactly.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1) (2) (3)
Fluid overload and sodium, potassium, calcium, chloride, glucose, or acid-base disturbances may occur, especially with kidney, heart, or liver impairment — serious
Symptoms: Fluid overload and sodium, potassium, calcium, chloride, glucose, or acid-base disturbances may occur, especially with kidney, heart, or liver impairment.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1) (2) (3)
Never connect flexible IV bags in series or use pressurization that can leave residual air without following the product's safeguards — serious
Symptoms: Never connect flexible IV bags in series or use pressurization that can leave residual air without following the product's safeguards.
Action: Follow the urgency stated and seek prompt or emergency care when indicated. (1) (2) (3)
Interactions
| Medicine or test | Effect | Action |
|---|---|---|
| Ceftriaxone (in neonates) | Must not be co-administered with calcium-containing solutions such as Ringer's lactate in neonates because of the risk of fatal calcium-ceftriaxone precipitate; compatibility rules in older patients also apply and must be checked against local product information. | (2) |
| Blood products administered through the same infusion set | Calcium-containing solutions can cause clotting when given through the same line as blood/blood products; the label warns this combination must be avoided unless the set is flushed per instructions. | (1) |
| Medicines or additives incompatible with the solution's pH or ion content | The exact product label and institutional compatibility references must be checked before adding any medicine to the bag or co-infusing through the same line. | (2) |
Pregnancy, breastfeeding, kidney/liver function, age
Newborns
The ceftriaxone-calcium prohibition is critical; neonatal fluid therapy requires specialist calculation and monitoring. (1) (2) (3)
Children
A clinician experienced in paediatric IV fluids chooses volume and rate. (1) (2) (3)
Pregnancy
Use when clinically indicated after individual assessment. (1) (2) (3)
Breastfeeding
Lactated Ringer’s has been used as a source of water and electrolytes for decades and is not expected to cause harm to a breastfed infant, although there are no data on its presence in human milk. Your clinician weighs the benefits of breastfeeding against your own clinical need for fluid therapy. (1) (2) (3)
Renal_impairment
Kidney, heart, or liver impairment can markedly increase risk and usually requires reduced exposure or an alternative. (1) (2) (3)
Hepatic_impairment
Kidney, heart, or liver impairment can markedly increase risk and usually requires reduced exposure or an alternative. (1) (2) (3)
Monitoring
During treatment
- Fluid input/output, weight, circulation and signs of oedema
- Serum electrolytes, glucose, kidney function, and acid-base status as clinically indicated
- Infusion site and equipment
- Compatibility and the exact product label before adding medicines
Storage
Healthcare facilities follow the exact bag's storage, inspection, single-use, overwrap, expiry, and disposal instructions. Do not use a damaged, leaking, cloudy, discoloured, or particulate-containing bag.
Professional information
Clinician-facing context only. This section does not replace the current local product information or institutional IV-fluid and compatibility policies.
United Kingdom (Hartmann's Solution)
Indication: Fluid and electrolyte replacement / maintenance by IV infusion
Dose summary: The UK SmPC gives an adult volume range of 500 mL to 3 litres per 24 hours, with an infusion rate of approximately 40 mL/kg/24 h using standard maintenance-fluid calculations.
Renal context: The UK SmPC explicitly directs less liquid volume in patients with renal impairment, and contraindicates use in severe renal insufficiency with oliguria/anuria; overdose (particularly with renal impairment) can cause metabolic alkalosis and hypokalaemia. (2)
Hepatic guidance
Lactate metabolism to bicarbonate occurs mainly in the liver; use with caution in significant hepatic impairment, per current local product information.
Overdose note
Fluid overdose or overly rapid infusion, particularly in patients with renal or cardiac impairment, can cause fluid overload, metabolic alkalosis and hypokalaemia; stop the infusion and seek urgent clinical assessment. (2)
Frequently asked questions
What is lactated Ringer's / Ringer lactate / compound sodium lactate solution used for?
lactated Ringer's / Ringer lactate / compound sodium lactate solution is prescribed for approved indications. Always follow your healthcare provider's guidance.
What are the side effects of lactated Ringer's / Ringer lactate / compound sodium lactate solution?
Common side effects may include gastrointestinal symptoms and headache. Serious side effects require immediate medical attention.
Can I take lactated Ringer's / Ringer lactate / compound sodium lactate solution with other medications?
Always inform your healthcare provider about all medications you are taking, including over-the-counter products and supplements.
What is the mechanism of action of lactated Ringer's / Ringer lactate / compound sodium lactate solution?
A balanced crystalloid solution containing sodium, potassium, calcium, chloride and lactate, used for fluid and electrolyte replacement; lactate is metabolised to bicarbonate, mainly hepatically. (2)
What is the generic name of Ringer's Lactate?
The generic name is lactated Ringer's / Ringer lactate / compound sodium lactate solution.
What class of drug is lactated Ringer's / Ringer lactate / compound sodium lactate solution?
Ringer's Lactate is classed as: balanced crystalloid intravenous fluid.
References
- Lactated Ringer's Injection — Baxter official labelU.S. National Library of Medicine DailyMed · United States · dated 2025-10-29 · accessed 2026-07-22 · source 1
- Hartmann's Solution Compound Sodium Lactate IV Infusion BP — SmPCelectronic Medicines Compendium (UK) · United Kingdom · dated 2025-02-11 · accessed 2026-07-22 · source 2
- Compound Sodium Lactate (Hartmann's Solution) 250 mL injection bag — ARTG 148935Therapeutic Goods Administration · Australia · dated 2009-03-12 · accessed 2026-07-22 · source 3
Brand names by country
Single-ingredient lactated Ringer's / Ringer lactate / compound sodium lactate solution names are shown separately by country. Product availability, strengths, and supply rules can change; combination products are not included here.
Priority countries
United States
- Lactated Ringer's Injection (1)verified
United Kingdom
- Hartmann's Solution / Compound Sodium Lactate IV Infusion BP (2)verified
Australia
- Compound Sodium Lactate (Hartmann's Solution) (3)verified