Sodium chloride, potassium chloride, and calcium chloride

Renal Impairment Administration of Ringer's Injection to patients with or at risk of severe renal impairment, may result in hyperkalemia and/or fluid overload [see Warnings and Precautions (5.4 , 5.7) ] . Avoid Ringer's Injection in patients with severe renal impairment. If use cannot be avoided in such patients, monitor for development of these adverse reactions.

Important Preparation Instructions Visually inspect the Ringer's Injection solution for particulate matter and discoloration. Do not administer Ringer's Injection unless the solution is clear and the container is undamaged and the container seals are intact. If additives are determined to be compatible with Ringer's Injection, then using aseptic technique, mix thoroughly; do not store solutions containing additives.

After mixing, do not use if there is discoloration or formation of precipitates. To reduce the risk of air embolism, adhere to the following Ringer's Injection preparation instructions [see Warnings and Precautions ] : Use a non-vented infusion set or close the vent on a vented set. Use a dedicated line without any connections (do not connect flexible containers in series).

The use of pressure infusion is not recommended as a method to increase flow rates. However, if pressure infusion is required, ensure that any air within the bag is fully evacuated prior to initiation of infusion. If using a pumping device to administer Ringer's Injection, turn off the pump before the container is empty.

To Open: Tear outer wrap at notch and remove solution container. If supplemental medication is desired, follow directions below before preparing for administration. Some opacity of the plastic due to moisture absorption during the sterilization process may be observed. This is normal and does not affect the solution quality or safety.

The opacity will diminish gradually. Preparation for Administration (Use aseptic technique) Close flow control clamp of administration set. Remove cover from outlet port at bottom of container. Insert piercing pin of administration set into port with a twisting motion until the set is firmly seated. NOTE: See administration set carton for complete directions.

Suspend container from hanger. Squeeze and release drip chamber to establish proper fluid level in chamber. Open flow control clamp and clear air from set. Close clamp. Attach set to venipuncture device. If device is not indwelling, prime and make venipuncture. Regulate rate of administration with flow control clamp.

Important Administration Instructions Ringer's Injection is for intravenous use. Use immediately after opening the container. Discard the unused portion. Some additives may be incompatible [see Dosage and Administration ] . To Add Medication Before Solution Administration Prepare medication site. Using syringe with the recommended gauge needle, puncture medication port and inner diaphragm and inject.

Squeeze and tap ports while ports are upright and mix solution and medication thoroughly. To Add Medication During Solution Administration Close clamp on the set. Prepare medication site. Using syringe with the recommended gauge needle of appropriate length (at least 5/8 inch), puncture resealable medication port and inner diaphragm and inject.

Remove container from IV pole and/or turn to an upright position. Evacuate both ports by tapping and squeezing them while container is in the upright position. Mix solution and medication thoroughly. Return container to in use position and continue administration.

Drug Incompatibilities Do not administer Ringer's Injection simultaneously with ceftriaxone in neonates (28 days of age or younger) due to serious risks [see Contraindications and Warnings and Precautions ]. However, in patients older than 28 days, ceftriaxone and Ringer's Injection may be administered sequentially if the infusion lines are thoroughly flushed between infusions with a compatible fluid [see Warnings and Precautions ] .

Do not administer Ringer's Injection simultaneously with citrate anticoagulated/preserved blood through the same administration set because of the likelihood of coagulation precipitated by the calcium content of Ringer's Injection .