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10/27/2015

Lactated Ringer's Irrigation

Reason for the Shortage

    • Baxter had lactated ringer's irrigation on shortage due to increased demand.[1]
    • BBraun had lactated ringer's irrigation on shortage due to increased demand.[2]
    • Hospira had lactated ringer's irrigation on shortage due to increased demand.[3]

Available Products

    • Lactated Ringer's Irrigation Solution, BBraun, 1000 mL bottle, 16 count, NDC 00264-2203-00
    • Lactated Ringer's Irrigation Solution, BBraun, 2000 mL bottle, 8 count, NDC 00264-2203-50
    • Lactated Ringer's Irrigation Solution, BBraun, 4000 mL bottle, 4 count, NDC 00264-2203-70
    • Lactated Ringer's Irrigation Solution, Baxter, 1000 mL bottle, 12 count, NDC 00338-0114-04
    • Lactated Ringer's Irrigation Solution, Baxter, 3000 mL bag, 4 count, NDC 00338-0137-27
    • Lactated Ringer's Irrigation Solution, Baxter, 5000 mL 2 count, NDC 00338-0137-29
    • Lactated Ringer's Irrigation Solution, Pfizer, 3000 mL 4 count, NDC 00409-7828-08
    • Ringer's Irrigation Solution, BBraun, 1000 mL bottle, 16 count, NDC 00264-2202-00

Estimated Resupply Dates

    • Baxter, BBraun, and Hospira have product available to current customers.[1,2,3]

Implications for Patient Care

    • Lactated ringer's, sodium chloride, and sterile water irrigations are all widely used.[4]

Safety

    • Clinicians may need to utilize different product sizes or packaging if desired sizes are not available.
    • Multiple brands of products may be available in the system.

Alternative Agents & Management

    • Make policies to allow substitution of products based on product availability at the site. For example, an organization could choose to allow 0.9% sodium chloride solution to be substituted for lactated ringer's solution. Table 1 provides a comparison of fluid components.
    • Evaluate the clinical need for irrigation fluid replacement. Discontinue irrigations when appropriate.
    • Use smaller bag sizes when possible.
    • Consider reserving some products for specific clinical situations.
    Table 1. Comparison of Selected Irrigation Fluids5,6
    ProductmOsm/LNa (mEq/L)Cl (mEq/L)K (mEq/L)Ca (mEq/L)Lactate (mEq/L)
    Lactated Ringer's Solution2741301094328
    0.9% Sodium Chloride308154154

References

    1. Baxter (personal communications). August 14, November 7, December 12, 2014; June 16, August 11, and October 27, 2015.
    2. BBraun (personal communications). August 15, November 7, 2014; January 8, 2015; June 16, August 11, and October 27, 2015.
    3. Hospira (personal communications and website). August 15, November 7 and 26, December 12 and 22, 2014; January 9, March 31, June 16, August 11, and October 27, 2015.
    4. McEvoy GK, Snow EK, Kester L, Litvak K, Miller J, Welsh OH, eds. AHFS DI (Lexi-Comp Online). Bethesda, MD: American Society of Health-System Pharmacists; 2014.
    5. Hospira. Lactated Ringer's Irrigation, USP [product information]. Lake Forest, IL: Hospira; 2009.
    6. Hospira. 0.45% Sodium Chloride Irrigation, USP, and 0.9% Sodium Chloride Irrigation, USP, [product information]. Lake Forest, IL: Hospira; 2009.

Updated

Updated October 27, 2015 by Michelle Wheeler, PharmD, Drug Information Specialist. Created June 16, 2015 by Jane Chandramouli, PharmD, Drug Information Specialist. Copyright 2017, Drug Information Service, University of Utah, Salt Lake City, UT.

Disclaimer

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