Plasma-Lyte 148 by is a Prescription medication manufactured, distributed, or labeled by Baxter Healthcare Corporation. Drug facts, warnings, and ingredients follow.
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) is a sterile, nonpyrogenic isotonic solution in a single dose container for intravenous administration. Each 100 mL contains 526 mg of Sodium Chloride, USP (NaCl); 502 mg of Sodium Gluconate (C6H11NaO7); 368 mg of Sodium Acetate Trihydrate, USP (C2H3NaO23H2O); 37 mg of Potassium Chloride, USP (KCl); and 30 mg of Magnesium Chloride, USP (MgCl26H2O). It contains no antimicrobial agents. The pH is adjusted with hydrochloric acid. The pH is 5.5 (4.0 to 8.0).
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) administered intravenously has value as a source of water, electrolytes, and calories. One liter has an ionic concentration of 140 mEq sodium, 5 mEq potassium, 3 mEq magnesium, 98 mEq chloride, 27 mEq acetate, and 23 mEq gluconate. The osmolarity is 294 mOsmol/L (calc). Normal physiologic osmolarity range is approximately 280 to 310 mOsmol/L. The caloric content is 21 kcal/L.
The VIAFLEX plastic container is fabricated from a specially formulated polyvinyl chloride (PL 146 Plastic). The amount of water that can permeate from inside the container into the overwrap is insufficient to affect the solution significantly. Solutions in contact with the plastic container can leach out certain of its chemical components in very small amounts within the expiration period, e.g., di-2-ethylhexyl phthalate (DEHP), up to 5 parts per million. However, the safety of the plastic has been confirmed in tests in animals according to USP biological tests for plastic containers as well as by tissue culture toxicity studies.
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) has value as a source of water and electrolytes. It is capable of inducing diuresis depending on the clinical condition of the patient.
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) produces a metabolic alkalinizing effect. Acetate and gluconate ions are metabolized ultimately to carbon dioxide and water, which requires the consumption of hydrogen cations.
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) is contraindicated in patients with a known hypersensitivity to the product. See WARNINGS.
Hypersensitivity and infusion reactions have been reported with PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP). See ADVERSE REACTIONS.
Stop the infusion immediately if signs or symptoms of a hypersensitivity reaction develop, such as tachycardia, chest pain, dyspnea and flushing. Institute appropriate therapeutic countermeasures as clinically indicated.
Fluid Overload
Depending on the volume and rate of infusion, the intravenous administration of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) can cause electrolyte disturbances such as overhydration and congested states, including pulmonary congestion and edema.
Avoid PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients with or at risk for fluid and/or solute overloading. If use cannot be avoided, monitor fluid balance, electrolyte concentrations, and acid base balance, as needed and especially during prolonged use.
Hyponatremia
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) may cause hyponatremia. Hyponatremia can lead to acute hyponatremic encephalopathy characterized by headache, nausea, seizures, lethargy, and vomiting. Patients with brain edema are at particular risk of severe, irreversible and life-threatening brain injury.
The risk of hospital-acquired hyponatremia is increased in patients with cardiac or pulmonary failure, and in patients with non-osmotic vasopressin release (including SIADH) treated with high volume of hypotonic PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP).
Avoid PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in hypervolemic or overhydrated patients. If use cannot be avoided, monitor serum sodium concentrations.
Hypernatremia
Hypernatremia may occur with PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP). Conditions that may increase the risk of hypernatremia, fluid overload and edema (central and peripheral), include patients with: primary hyperaldosteronism; secondary hyperaldosteronism associated with, for example, hypertension, congestive heart failure, liver disease (including cirrhosis), renal disease (including renal artery stenosis, nephrosclerosis); and pre-eclampsia.
Certain medications, such as corticosteroids or corticotropin, may also increase risk of sodium and fluid retention, see PRECAUTIONS.
Avoid PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients with, or at risk for, hypernatremia. If use cannot be avoided, monitor serum sodium concentrations.
Hypermagnesemia
Avoid solutions containing magnesium, including PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients with or predisposed to hypermagnesemia, including patients with severe renal impairment and those patients receiving magnesium therapy (e.g., treatment of eclampsia and myasthenia gravis).
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) is not indicated for the treatment of hypomagnesemia.
Acidosis
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) is not for use for the treatment of lactic acidosis or severe metabolic acidosis in patients with severe liver and/or renal impairment.
Alkalosis
Excess administration of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) can result in metabolic alkalosis. Avoid PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients with alkalosis or at risk for alkalosis.
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) is not indicated for the treatment of hypochloremic hypokalemic alkalosis. Avoid use in patients with hypochloremic hypokalemic alkalosis.
Hypocalcemia
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) contains no calcium, and an increase in plasma pH due to its alkalinizing effect may lower the concentration of ionized (not-protein bound) calcium. Avoid PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients with hypocalcemia.
Hyperkalemia
Potassium-containing solutions, including PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) may increase the risk of hyperkalemia.
Patient’s at increased risk of developing hyperkalemia include those:
Avoid PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients with, or at risk for hyperkalemia If use cannot be avoided, monitor serum potassium concentrations.
Although PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) has a potassium concentration similar to the concentration in plasma, it is insufficient to produce a useful effect in case of severe potassium deficiency; therefore, it is not indicated for correction of severe potassium deficiency.
In patients with renal impairment, administration of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) may result in sodium and/or potassium or magnesium retention (see WARNINGS). Avoid PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients with severe renal impairment or conditions that may cause sodium and/or potassium retention or magnesium retention, fluid overload, or edema. If use cannot be avoided, monitor patients with severe renal impairment for development of these adverse reactions.
Other Products that Affect Fluid and/or Electrolyte Balance
Administration of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) to patients treated concomitantly with drugs associated with sodium and fluid retention may increase the risk of hypernatremia and volume overload. Avoid use of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients receiving such products, such as corticosteroids or corticotropin. If use cannot be avoided, monitor serum electrolytes, fluid balance and acid-base balance.
Other Drugs that Increase the Risk of Hyponatremia
Administration of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients treated concomitantly with medications associated with hyponatremia may increase the risk of developing hyponatremia.
Avoid use of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients receiving products, such as diuretics, and certain antiepileptic and psychotropic medications. Drugs that increase the vasopressin effect reduce renal electrolyte free water excretion and may also increase the risk of hyponatremia following treatment with intravenous fluids. If use cannot be avoided, monitor serum sodium concentrations.
Lithium
Renal clearance of lithium may be increased during administration of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP). Monitor serum lithium concentrations during concomitant use.
Other Products that Increase the Risk of Hyperkalemia
Because of its potassium content, avoid use of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in patients receiving products that can cause hyperkalemia or increase the risk of hyperkalemia, such as potassium sparing diuretics, ACE inhibitors, angiotensin II receptor antagonists, or the immunosuppressants tacrolimus and cyclosporine. If use cannot be avoided, monitor serum potassium concentrations.
Drugs with pH Dependent Renal Elimination
Due to its alkalinizing effect (formation of bicarbonate), PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) may interfere with the elimination of drugs with pH dependent renal elimination. Renal clearance of acidic drugs may be increased. Renal clearance of alkaline drugs may be decreased.
There have been reports of positive test results using the Bio-Rad Laboratories Platelia Aspergillus EIA test in patients receiving Baxter gluconate containing PLASMA-LYTE solutions. These patients were subsequently found to be free of Aspergillus infection. Therefore, positive test results for this test in patients receiving Baxter gluconate containing PLASMA-LYTE solutions should be interpreted cautiously and confirmed by other diagnostic methods.
Studies with PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) have not been performed to evaluate carcinogenic potential, mutagenic potential, or effects on fertility.
Animal reproduction studies have not been conducted with PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP). It is also not known whether PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) should be given to a pregnant woman only if clearly needed.
It is not known where this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) is administered to a nursing mother.
The use of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in pediatric patients is based on clinical practice.
Geriatric patients are at increased risk of developing electrolyte imbalances. PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Therefore, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function, and of concomitant disease or other drug therapy. Consider monitoring renal function in elderly patients
The following adverse reactions associated with the use of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) were identified in clinical trials or postmarketing reports. Because postmarketing reactions were reported voluntarily from a population of uncertain size, it is not always possible to estimate their frequency, reliably, or to establish a causal relationship to drug exposure.
Hypersensitivity and Infusion Reactions: tachycardia, palpitations, chest pain, chest discomfort, dyspnea, flushing, hyperemia, asthenia, feeling abnormal, piloerection, edema peripheral, pyrexia, hypotension, wheezing, urticaria, cold sweat, chills.
General Disorders and Administration Site Conditions: infusion site pain, burning sensation.
Metabolism and nutrition disorders: hyperkalemia, hyponatremia.
Nervous System Disorders: hyponatremic encephalopathy.
Excessive administration of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) can cause:
When assessing an overdose, any additives in the solution must also be considered.
The effects of an overdose may require immediate medical attention and treatment.
Interventions include discontinuation of PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP), dose reduction, and other measures as indicated for the specific clinical constellation (e.g., monitoring of fluid balance, electrolyte concentrations and acid base balance).
Important Administration Instructions
Dosing Information
The choice of product, dosage, volume, rate, and duration of administration is dependent upon the age, weight and clinical condition of the patient and concomitant therapy, and administration should be determined by a physician experienced in intravenous fluid therapy.
Introduction of Additives
Additives may be incompatible.
Evaluate all additions to the plastic container for compatibility and stability of the resulting preparation. Consult with a pharmacist, if available.
If, in the informed judgment of the physician, it is deemed advisable to introduce additives, use aseptic technique. Mix thoroughly when additives have been introduced. After addition, if there is a discoloration and/or the appearance of precipitates, insoluble complexes or crystals, do not use. Do not store solutions containing additives. Discard any unused portion.
PLASMA-LYTE 148 Injection (Multiple Electrolytes Injection, Type 1, USP) in VIAFLEX plastic containers is available as shown below:
Code | Size
(mL) | NDC |
---|---|---|
2B2534 |
1000 |
NDC: 0338-0179-04 |
2B2533 |
500 |
NDC: 0338-0179-03 |
Exposure of pharmaceutical products to heat should be minimized. Avoid excessive heat. It is recommended the product be stored at room temperature (25°C); brief exposure up to 40°C does not adversely affect the product.
For Information on Risk of Air Embolism – see PRECAUTIONS
Tear overwrap down side at slit and remove solution container. Visually inspect the container. If the outlet port protector is damaged, detached, or not present, discard container as solution path sterility may be impaired. 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. Check for minute leaks by squeezing inner bag firmly. If leaks are found, discard solution as sterility may be impaired. If supplemental medication is desired, follow directions below.
To add medication before solution administration
To add medication during solution administration
500 mL Container Label
2B2533
NDC: 0338-0179-03
PLASMA-LYTE 148
Injection
(Multiple Electrolytes Injection
Type 1 USP)
500 mL
EACH 100 mL CONTAINS 526 mg SODIUM CHLORIDE USP 502 mg
SODIUM GLUCONATE USP 368 mg SODIUM ACETATE TRIHYDRATE
USP 37 mg POTASSIUM CHLORIDE USP 30 mg MAGNESIUM
CHLORIDE USP pH ADJUSTED WITH HYDROCHLORIC ACID pH 5.5
(4.0 TO 8.0) mEq/L SODIUM 140 POTASSIUM 5 MAGNESIUM 3
CHLORIDE 98 ACETATE 27 GLUCONATE 23 OSMOLARITY 294
mOsmol/L (CALC) STERILE NONPYROGENIC SINGLE DOSE CONTAINER
ADDITIVES MAY BE INCOMPATIBLE CONSULT WITH PHARMACIST IF
AVAILABLE WHEN INTRODUCING ADDITIVES USE ASEPTIC TECHNIQUE
MIX THOROUGHLY DO NOT STORE DOSAGE INTRAVENOUSLY AS
DIRECTED BY A PHYSICIAN SEE DIRECTIONS CAUTIONS SQUEEZE AND
INSPECT INNER BAG WHICH MAINTAINS PRODUCT STERILITY DISCARD IF
LEAKS ARE FOUND MUST NOT BE USED IN SERIES CONNECTIONS DO
NOT USE UNLESS SOLUTION IS CLEAR RX ONLY STORE UNIT IN
MOISTURE BARRIER OVERWRAP AT ROOM TEMPERATURE (25°C/77°F)
UNTIL READY TO USE AVOID EXCESSIVE HEAT SEE INSERT
VIAFLEX CONTAINER
PL 146 PLASTIC
FOR PRODUCT INFORMATION
1-800-933-0303
BAXTER PLASMA-LYTE VIAFLEX
AND PL 146 ARE TRADEMARKS OF
BAXTER INTERNATIONAL INC
Baxter logo
BAXTER HEALTHCARE CORPORATION
DEERFIELD IL 60015 USA
MADE IN USA
500 mL Viaflex Carton Label
2B2533Q
24-500 ML
VIAFLEX CONTAINER
PLASMA-LYTE 148 INJECTION (MULTIPLE
ELECTROLYTES INJECTION, TYPE 1, USP)
EXP
XXXXX
SECONDARY BAR CODE
(17) YYMM00 (10) XXXXX
LOT
XXXXX
PRIMARY BAR CODE
(01) 50303380179034
1000 mL Container Label
LOT
EXP
2B2534
NDC: 0338-0179-04
Plasma-Lyte
148 Injection
(Multiple Electrolytes
Injection Type 1 USP)
1000 mL
EACH 100 mL CONTAINS 526 mg SODIUM CHLORIDE USP 502
mg SODIUM GLUCONATE USP 368 mg SODIUM ACETATE
TRIHYDRATE USP 37 mg POTASSIUM CHLORIDE USP 30 mg
MAGNESIUM CHLORIDE USP pH ADJUSTED WITH HYDROCHLORIC
ACID pH 5.5 (4.0 TO 8.0) mEq/L SODIUM 140 POTASSIUM 5
MAGNESIUM 3 CHLORIDE 98 ACETATE 27 GLUCONATE 23
OSMOLARITY 294 mOsmol/L (CALC) STERILE NONPYROGENIC
SINGLE DOSE CONTAINER ADDITIVES MAY BE INCOMPATIBLE
CONSULT WITH PHARMACIST IF AVAILABLE WHEN INTRODUCING
ADDITIVES USE ASEPTIC TECHNIQUE MIX THOROUGHLY DO NOT
STORE DOSAGE INTRAVENOUSLY AS DIRECTED BY A PHYSICIAN
SEE DIRECTIONS CAUTIONS SQUEEZE AND INSPECT INNER BAG
WHICH MAINTAINS PRODUCT STERILITY DISCARD IF LEAKS ARE
FOUND MUST NOT BE USED IN SERIES CONNECTIONS DO NOT USE
UNLESS SOLUTION IS CLEAR RX ONLY STORE UNIT IN MOISTURE
BARRIER OVERWRAP AT ROOM TEMPERATURE (25°C/77°F) UNTIL
READY TO USE AVOID EXCESSIVE HEAT SEE INSERT
VIAFLEX CONTAINER PL 146 PLASTIC
BAXTER PLASMA-LYTE VIAFLEX AND PL 146 ARE
TRADEMARKS OF BAXTER INTERNATIONAL INC
FOR PRODUCT INFORMATION 1-800-933-0303
Baxter logo
BAXTER HEALTHCARE CORPORATION
DEERFIELD IL 60015 USA
MADE IN USA
1000 mL Viaflex Carton Label
2B2534X
14-1000 ML
VIAFLEX® CONTAINER
PLASMA-LYTE® 148 INJECTION
(MULTIPLE ELECTROLYTES INJ, TYPE 1, USP)
EXP
XXXXX
SECONDARY BAR CODE
(17) YYMM00 (10) XXXXX
LOT
XXXXX
PRIMARY BAR CODE
(01) 50303380179041
PLASMA-LYTE 148
sodium chloride, sodium gluconate, sodium acetate, potassium chloride, and magnesium chloride injection, solution |
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Labeler - Baxter Healthcare Corporation (005083209) |
Registrant - Baxter Healthcare Corporation (005083209) |
Establishment | |||
Name | Address | ID/FEI | Business Operations |
---|---|---|---|
Baxter Healthcare Corporation | 059140764 | ANALYSIS(0338-0179) , MANUFACTURE(0338-0179) , LABEL(0338-0179) , PACK(0338-0179) , STERILIZE(0338-0179) |
Establishment | |||
Name | Address | ID/FEI | Business Operations |
---|---|---|---|
Baxter Healthcare Corporation | 194684502 | ANALYSIS(0338-0179) |