Viaflo Hartmann (Ringer lactate) in glucose 5% solution for infusion

Package leaflet: Information for the user

Introduction

Package leaflet: information for the user

Viaflo Hartmann (Ringer lactate) in 5% glucose solution for infusion

Glucose, sodium chloride, potassium chloride, calcium chloride dihydrate and sodium lactate

Read the entire leaflet carefully before you start using this medicine, because it contains important information for you.

• Keep this leaflet, as you may need to read it again.
• If you have any questions, consult your doctor or nurse.
• If you experience any adverse reactions, consult your doctor or nurse, even if they are not listed in this leaflet. See section 4.

Leaflet contents:

1. What Viaflo Hartmann (Ringer lactate) in 5% glucose is and what it is used for
2. What you need to know before you are given Viaflo Hartmann (Ringer lactate) in 5% glucose
3. How Viaflo Hartmann (Ringer lactate) in 5% glucose will be administered to you
4. Possible side effects
5. How to store Viaflo Hartmann (Ringer lactate) in 5% glucose
6. Contents of the pack and other information

This medicine is called "Viaflo Hartmann (Ringer lactate) in 5% glucose solution for infusion", but will be referred to as "Viaflo Hartmann (Ringer lactate) in 5% glucose" throughout the rest of this leaflet.

1. What Viaflo Hartmann (Ringer lactate) in 5% glucose is and what it is used for

Viaflo Hartmann (Ringer lactate) in 5% glucose is a solution containing the following substances in water:

• Sugar (glucose)
• Sodium chloride
• Potassium chloride
• Calcium chloride dihydrate
• Sodium lactate

Glucose is one of the body's sources of energy. This solution provides 200 kilocalories per liter. Sodium, potassium, calcium, chlorides, and lactate are chemicals (electrolytes) normally present in the blood.

Viaflo Hartmann (Ringer lactate) in 5% glucose is used as a source of carbohydrates (sugar) in the following situations:

• To treat loss of body water and chemicals (e.g., due to excessive sweating, kidney disorders)
• To treat you if the volume of blood in your blood vessels is low (hypovolemia) or if you have low blood pressure (hypotension)
• In metabolic acidosis (when the blood becomes too acidic)

2. What you need to know before Viaflo Hartmann (Ringer lactate) in 5% glucose is administered to you

Do NOT be given Viaflo Hartmann (Ringer lactate) in 5% glucose if you have any of the following clinical conditions

• in a newborn (less than 28 days) receiving ceftriaxone (an antibiotic)

• if you are allergic to sodium lactate or any of the components of Viaflo Hartmann (Ringer lactate) in 5% glucose

• when there is excess fluid in the body's extracellular spaces (extracellular hyperhydration)

• when there is a higher than normal blood volume in the blood vessels (hypervolemia)

• severe renal failure (when your kidneys are not functioning properly and you require dialysis)

• if you have uncompensated heart failure. This is heart failure that is not receiving adequate treatment and causes symptoms such as:

  • difficulty breathing
  • swelling of the ankles.

• if your blood potassium concentration is higher than normal (hyperkalemia)

• if your blood calcium concentration is higher than normal (hypercalcemia)

• if you have a condition in which the blood becomes too alkaline (metabolic alkalosis)

• if you have liver disease causing fluid accumulation in the abdomen (ascitic cirrhosis)

• your blood is too acidic with life-threatening risk (severe metabolic acidosis)

• in a particular type of metabolic acidosis (lactic acidosis)

• severe liver disease (when the liver is not functioning properly and requires intensive treatment)

• impaired lactate metabolism (this occurs in severe liver disease, as lactate is eliminated by the liver)

• if you are receiving cardiac glycosides (cardiotonics) used to treat heart failure, such as digitalis or digoxin. (See "Other medicines and Viaflo Hartmann (Ringer lactate) in 5% glucose")

• diabetes that is not adequately treated, allowing your blood sugar levels to be higher than normal (uncompensated diabetes)

• glucose intolerance states, for example:

  • metabolic stress (when the body's metabolism is not functioning properly, e.g., due to a serious illness)
  • hyperosmolar coma (loss of consciousness). This is a type of coma that may occur if you have diabetes and do not receive enough medication.

• abnormally high blood sugar (hyperglycemia)

• abnormally high blood lactate (hyperlactatemia)

Warnings and precautions

Viaflo Hartmann (Ringer lactate) in 5% glucose is a hypertonic (concentrated) solution. Your doctor will take this into account when calculating the amount of solution to be administered.

Consult your doctor or nurse before starting to use Viaflo Hartmann (Ringer lactate) in 5% glucose if you have or have had any of the following clinical conditions:

• if you are receiving ceftriaxone (an antibiotic) (see also "Other medicines and Viaflo Hartmann (Ringer lactate) in 5% glucose")

• heart failure

• respiratory failure (lung disease) (in the above cases, special monitoring may be required)

• renal failure

• if your blood chloride concentration is higher than normal (hyperchloremia)

• high blood pressure (hypertension)

• fluid accumulation under the skin affecting the whole body (generalized edema)

• fluid accumulation under the skin, particularly under the ankles (peripheral edema)

• fluid accumulation in the lungs (pulmonary edema)

• high blood pressure during pregnancy (pre-eclampsia)

• diseases causing high levels of the hormone aldosterone (aldosteronism)

• if your blood sodium concentration is higher than normal (hypernatremia) or any other condition associated with sodium retention (when the body retains too much sodium), such as treatment with steroids (see also "Other medicines and Viaflo Hartmann (Ringer lactate) in 5% glucose")

• diabetes (your blood sugar level will be carefully monitored and your insulin treatment may need to be adjusted)

• any type of heart disease

• any condition that increases your risk of having high blood potassium levels (hyperkalemia), such as:

  • kidney failure
  • adrenocortical insufficiency (this adrenal gland disease affects hormones that regulate chemical concentrations in the body)
  • acute dehydration (loss of water from the body, e.g., due to vomiting or diarrhea)
  • extensive tissue damage (as occurs in severe burns)

Intensive monitoring of potassium levels in your blood is required.

• diseases associated with high levels of vitamin D (e.g., sarcoidosis, a disease affecting the skin and internal organs)

• kidney stones

• impaired liver function

• increased pressure inside the skull (intracranial hypertension)

• stroke due to a blood clot in a blood vessel (cerebral infarction)

• if you have had a head injury less than one day ago

• If you have a condition that could cause elevated levels of vasopressin, a hormone that regulates your body's fluid. You may have too much vasopressin in your body, for example, because:

  • you have had a sudden and serious illness
  • you have pain
  • you have undergone surgery
  • you have infections, burns, or brain injury
  • you have diseases affecting your heart, liver, kidneys, or central nervous system
  • you are taking certain medicines (see "Other medicines and Viaflo Hartmann (Ringer lactate) in 5% glucose")

This may increase the risk of low sodium levels in the blood and may cause headache, nausea, seizures, lethargy, coma, brain swelling, and death. Brain swelling increases the risk of death and brain damage. People at higher risk of brain swelling are:

• children
• women (particularly if of childbearing age)
• people who have problems with their cerebral fluid levels, for example, due to meningitis, bleeding in the skull, or brain injury.

While you are receiving this solution, your doctor may take blood and urine samples to monitor:

• the levels of chemicals such as sodium and potassium in your blood (your plasma electrolytes)
• the level of sugar (glucose)
• the acidity of your blood and urine (your acid-base balance)

Although Viaflo Hartmann (Ringer lactate) in 5% glucose contains potassium, it does not contain enough to treat very low plasma potassium levels (severe potassium deficiency).

Calcium chloride can be harmful if injected into tissues. Therefore, Viaflo Hartmann (Ringer lactate) in 5% glucose must not be administered by intramuscular injection. Your doctor will take this into account to prevent the solution from leaking into the tissues around the veins.

Viaflo Hartmann (Ringer lactate) in 5% glucose must not be administered through the same needle used for blood transfusion. This could damage red blood cells or cause them to clump.

As Viaflo Hartmann (Ringer lactate) in 5% glucose contains lactate (a substance naturally present in the body), it may make the blood too alkaline (metabolic alkalosis).

Viaflo Hartmann (Ringer lactate) in 5% glucose contains sugar (glucose) and may cause high blood sugar (hyperglycemia). If this occurs, your doctor may:

• adjust the infusion rate
• administer insulin to reduce blood sugar levels

This is particularly important if you have diabetes.

Children

Viaflo Hartmann in 5% glucose should be administered with caution in children. Newborns, especially premature infants and those with low birth weight, are at higher risk of developing abnormally high or low blood sugar levels (hyperglycemia or hypoglycemia), which may lead to complications.

Your doctor must consider whether you are receiving parenteral nutrition (nutrition delivered by infusion through a vein). During prolonged treatment with Viaflo Hartmann (Ringer lactate) in 5% glucose, you will require additional nutrition.

Other medicines and Viaflo Hartmann (Ringer lactate) in 5% glucose

Inform your doctor or nurse if you are using, have recently used, or might need to use any other medicines.

It is particularly important that you inform your doctor if you are taking:

• ceftriaxone (an antibiotic), which must not be administered through the same infusion line unless it is properly flushed.
• cardiac glycosides (cardiotonics) such as digitalis or digoxin, used to treat heart failure, as they must not be used together with Viaflo Hartmann (Ringer lactate) in 5% glucose (see section "Do NOT be given Viaflo Hartmann (Ringer lactate) in 5% glucose if you have..."). The effects of these medicines may be increased by calcium, which could lead to life-threatening heart rhythm disturbances.
• corticosteroids (anti-inflammatory medicines)

These medicines may cause the body to retain sodium and water, leading to:

• tissue swelling due to fluid accumulation under the skin (edema)
• high blood pressure (hypertension)

The following medicines may increase blood potassium concentration. This effect may be life-threatening. You are more likely to experience increased blood potassium if you have kidney disease.

• potassium-sparing diuretics (some water tablets, e.g., amiloride, spironolactone, triamterene)

(Note that these drugs may be included in some combination medicines)

• angiotensin-converting enzyme inhibitors (ACE inhibitors) used to treat high blood pressure
• angiotensin II receptor antagonists (used to treat high blood pressure)
• tacrolimus (used to prevent transplant rejection and treat skin disorders)
• cyclosporines (used to prevent transplant rejection)

Some medicines affect the hormone vasopressin. These may include:

• antidiabetic medicines (chlorpropamide)
• cholesterol-lowering medicines (clofibrate)
• some cancer medicines (vincristine, ifosfamide, cyclophosphamide)
• selective serotonin reuptake inhibitors (used to treat depression)
• antipsychotics
• opioids for severe pain relief
• pain and/or anti-inflammatory medicines (also known as NSAIDs)
• medicines that mimic or enhance the effects of vasopressin, such as desmopressin (used to treat excessive thirst and urination), terlipressin (used to treat esophageal bleeding), and oxytocin (used to induce labor)
• antiepileptic medicines (carbamazepine and oxcarbazepine)
• diuretics

Other medicines that may affect or be affected by Viaflo Hartmann (Ringer lactate) in 5% glucose are:

• thiazide diuretics such as hydrochlorothiazide or chlorthalidone
• vitamin D
• bisphosphonates (used to treat bone diseases such as osteoporosis)
• fluoride (for teeth and bones)
• fluoroquinolones (a type of antibiotic, such as ciprofloxacin, norfloxacin, ofloxacin)
• tetracyclines (a type of antibiotic, including tetracycline)
• acidic medicines, for example:
  • salicylates used to treat inflammation (aspirin)
  • barbiturates (sleeping tablets)
  • lithium (used to treat psychiatric disorders)
• alkaline (basic) medicines, for example:
  • sympathomimetics (stimulants such as ephedrine and pseudoephedrine, used in cough and cold preparations)
  • other stimulants (e.g., dexamphetamine, fenfluramine)

Use of Viaflo Hartmann (Ringer lactate) in 5% glucose with food and drinks

Ask your doctor or nurse about what you may eat or drink.

Pregnancy, breastfeeding, and fertility

If you are pregnant or breastfeeding, think you may be pregnant, or plan to become pregnant, consult your doctor or nurse before using this medicine.

Viaflo Hartmann (Ringer lactate) in 5% glucose can be safely used during pregnancy and breastfeeding. Your doctor will monitor your blood electrolyte levels and fluid balance.

Calcium may pass to the fetus through the placenta and, after birth, through breast milk.

However, if another medicine is added to the infusion solution during pregnancy or breastfeeding, you should:

• consult your doctor or nurse
• read the package leaflet of the medicine to be added

Driving and using machines

Ask your doctor or pharmacist before driving or operating machinery.

3. How Viaflo Hartmann (Ringer lactate) in 5% glucose will be administered to you

Viaflo Hartmann (Ringer lactate) in 5% glucose will be administered to you by a doctor or nurse.

Your doctor will decide how much you need and when it should be given. This will depend on your age, weight, physical condition, and the reason for treatment. The amount you receive may also be influenced by other treatments you are receiving.

DO NOT receive Viaflo Hartmann (Ringer lactate) in 5% glucose if there are particles floating in the solution or if the container is damaged in any way.

Viaflo Hartmann (Ringer lactate) in 5% glucose is usually administered through a plastic tube connected to a needle inserted into a vein. A vein in the arm is typically used for the infusion. However, your doctor may administer the medicine in another way.

Before and during the infusion, your doctor will monitor:

• the amount of fluid in your body
• the acidity of your blood and urine
• the levels of electrolytes in your body (particularly sodium, in patients with high levels of vasopressin, or those taking other medicines that enhance the effect of vasopressin).

Any unused portion of the solution must be discarded. DO NOT receive Viaflo Hartmann (Ringer lactate) in 5% glucose from a bag that has been partially used.

If you receive more Viaflo Hartmann (Ringer lactate) in 5% glucose than you should

If you receive too much Viaflo Hartmann (Ringer lactate) in 5% glucose solution or if it is administered too quickly, you may experience the following symptoms:

• water or sodium (salt) overload and fluid accumulation in tissues (edema), causing swelling
• abnormally high blood potassium concentration (hyperkalemia), especially in patients with renal failure, leading to symptoms such as:
• tingling in arms and legs (paresthesia)
• muscle weakness
• inability to move (paralysis)
• irregular heartbeats (cardiac arrhythmias)
• heart block (very slow heartbeats)
• cardiac arrest (heart stops beating, life-threatening)
• confusion
• abnormally high blood calcium concentration (hypercalcemia), causing symptoms such as:
• decreased appetite (anorexia)
• discomfort (nausea)
• vomiting
• constipation
• abdominal pain
• mental disturbances, such as irritability or depression
• excessive thirst (polidipsia)
• increased urine production (polyuria)
• kidney disease caused by calcium buildup in the kidneys (nephrocalcinosis)
• kidney stones
• coma (loss of consciousness)
• chalky taste
• redness (flushing)
• dilation of blood vessels in the skin (peripheral vasodilation)
• abnormally low blood potassium concentration (hypokalemia) and metabolic alkalosis (blood becomes too alkaline), particularly in patients with renal failure, causing symptoms such as:
• changes in mood
• fatigue
• difficulty breathing
• muscle stiffness
• muscle twitching
• muscle contractions
• excessive blood concentration (hyperosmolality)
• loss of water from your body (dehydration)
• higher blood sugar levels (hyperglycemia)
• presence of glucose in the urine (glucosuria)
• increased urine output (osmotic diuresis)

If you notice any of these symptoms, inform your doctor immediately. The infusion will be stopped, and you will receive treatment depending on your symptoms.

If any medicine has been added to Viaflo Hartmann (Ringer lactate) in 5% glucose before the overdose, that medicine may also cause symptoms. You should read the list of possible side effects in the leaflet of the added medicine.

If the infusion of Viaflo Hartmann (Ringer lactate) in 5% glucose is interrupted

Your doctor will decide when you should stop receiving this infusion.

If you have any further questions about the use of this product, ask your doctor or nurse.

4. Possible adverse effects

Like all medicines, Viaflo Hartmann (Ringer lactate) with 5% glucose may cause adverse effects, although not everyone experiences them.

If you experience any of the following symptoms, inform your doctor or nurse immediately.

The following symptoms may be signs of a very severe, potentially life-threatening allergic reaction known as anaphylactic shock:

• hives (urticaria), which may be localized in one area of the body or widespread
• skin rash
• redness of the skin (erythema)
• itching (pruritus)
• swelling of the skin (angioedema)
• narrowing of the airways causing breathing difficulty (bronchospasm)
• chest discomfort or chest pain
• shortness of breath (dyspnea)
• fever (pyrexia)
• nausea
• cough

Low levels of sodium in the blood that may occur during hospitalization (nosocomial hyponatremia) and associated neurological disorder (acute hyponatremic encephalopathy). Hyponatremia may lead to irreversible brain damage and death due to cerebral edema/inflammation (see also section 2 “Warnings and precautions”).

Some reactions may be due to the administration technique:

• skin rash or itching (pruritus) at the infusion site
• pain or local reaction (redness or swelling at the infusion site)
• numbness at the infusion site

Other adverse effects reported with similar products (other solutions containing sodium lactate) include:

• other manifestations of hypersensitivity/reactions due to infusion: laryngeal edema (Quincke's edema), slow heart rate (bradycardia), rapid heart rate (tachycardia), decreased blood pressure, breathing difficulty, flushing, throat irritation, skin inflammation, tingling and prickling sensations (paresthesias), reduced mouth sensitivity (oral hypoesthesia), altered taste (dysgeusia), anxiety, headache, nasal congestion, sneezing
• disturbances in blood concentrations of chemical substances (electrolyte disorders)
• higher-than-normal potassium levels in the blood (hyperkalemia)
• increased blood volume in blood vessels (hypervolemia)
• panic attacks
• other reactions due to the administration technique: infection at the infusion site, phlebitis, extravasation, inflammation, swelling, rash, pain or burning at the infusion site

If a medicine has been added to the infusion solution, it may also cause adverse effects. These adverse effects will depend on the added medicine. You should read the list of possible symptoms in the leaflet of the added medicine.

If you experience any adverse effects, consult your doctor or nurse, even if they are adverse effects not listed in this leaflet.

Reporting of adverse effects

If you experience any type of adverse effect, talk to your doctor or pharmacist, even if they are possible adverse effects not listed in this leaflet. You may also report them directly via the Spanish Pharmacovigilance System for Human Medicines: https://www.notificaram.es.

By reporting adverse effects, you can help provide more information on the safety of this medicine.

5. Storage of Viaflo Hartmann (Lactated Ringer's) in 5% Glucose

Keep this medicine out of the sight and reach of children.

This medicine does not require any special storage conditions.

DO NOT use this medicine after the expiry date stated on the bag after EXP. The expiry date is the last day of the month indicated.

Do not use Viaflo Hartmann (Lactated Ringer's) in 5% Glucose if there are particles floating in the solution or if the container is damaged in any way.

6. Package contents and additional information

Composition of Viaflo Hartmann (Ringer's lactate) in 5% glucose

The active substances are:

• Sugar (glucose): 50.00 g per litre
• Sodium chloride: 6.00 g per litre
• Potassium chloride: 0.40 g per litre
• Calcium chloride dihydrate: 0.27 g per litre
• Sodium lactate: 3.20 g per litre

The only excipient is water for injections.

Appearance of the product and contents of the container

Viaflo Hartmann (Ringer's lactate) in 5% glucose is a clear solution, free from visible particles. It is supplied in plastic bags made of polyolefin/polyamide (Viaflo). Each bag is contained within a sealed protective overpouch made of plastic.

Bag sizes are:

• 250 ml
• 500 ml
• 1000 ml

The bags are packed in cardboard boxes. Each cardboard box contains one of the following quantities:

• 30 bags of 250 ml
• 20 bags of 500 ml
• 10 bags of 1000 ml
• 12 bags of 1000 ml

Not all pack sizes may be marketed.

Marketing Authorization Holder and Manufacturer

Holder:

Baxter S.L.
Pouet de Camilo 2, 46394 Ribarroja del Turia (Valencia)
Spain

Manufacturer:

Bieffe Medital S.A.
Ctra. de Biescas, Senegüé
22666 Sabiñanigo (Huesca)
Spain

Baxter SA
Boulevard René Branquart, 80
7860 Lessines
Belgium

Date of latest revision of this leaflet: April 2018

Detailed and up-to-date information on this medicinal product is available on the website of the Spanish Agency of Medicines and Health Products (AEMPS) http://www.aemps.gob.es/

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This information is intended for healthcare professionals only

Handling and preparation

Parenteral solutions should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. Do not administer unless the solution is clear and the container is intact.

Do not remove the bag from its overpouch until ready for use. The inner bag maintains the sterility of the product. Administer immediately after connecting the infusion set.

Do not connect plastic containers in series. Such use may result in air embolism due to residual air being entrained from the primary container before completion of fluid administration from the secondary container. Pressurizing intravenous solutions in flexible plastic containers to increase flow rates may lead to air embolism if residual air in the container is not completely evacuated prior to administration. Using an intravenous administration set with a vented filter in the open position could cause air embolism. Intravenous administration sets with vented filters in the open position must not be used with flexible plastic containers.

The solution is intended for intravenous administration using a sterile administration set and aseptic technique. The administration set should be primed with the solution to prevent air from entering the system.

Medications may be added before or during infusion through the injection site.

It is essential that mixing of products be performed under strict aseptic conditions. Solutions containing added medications should be used immediately and not stored.

The addition of other medications or the use of incorrect administration techniques may result in febrile reactions due to possible introduction of pyrogens. In case of an adverse reaction, infusion must be stopped immediately.

Discard after single use.

Discard partially used containers.

Do not reconnect partially used bags.

1. Opening

2. Remove the Viaflo bag from the protective overpouch immediately before use.

3. Check for small leaks by squeezing the inner bag firmly. If leaks are detected, discard the solution, as it may not be sterile.

4. Check the clarity of the solution and absence of foreign particles. Discard the solution if it is not clear or contains foreign particles.

5. Preparation for administration

Use sterile materials for preparation and administration.

1. Hang the container by the hanger loop.
2. Remove the plastic protector from the outlet port at the bottom of the container.

• Hold the small fin on the neck of the outlet tube with one hand.
• Hold the large fin on the closure cap with the other hand and twist.
• The cap will detach.
  1. Use aseptic technique for preparing the infusion.
  2. Connect the administration set. Refer to the instructions accompanying the administration set for connection, priming, and solution administration.

1. Techniques for adding medication

Warning: Added medications may be incompatible. Check compatibility of the added medication with both the solution and the container before use (see section 5 “Incompatibilities of added medications” below).

To add medication before administration

• Disinfect the injection site.
• Using a syringe with a needle gauge 19 (1.10 mm) to 22 (0.70 mm), puncture the resealable injection site and inject the medication.
• Mix the medication and solution thoroughly. For high-density medications such as potassium chloride, gently move the bags while in vertical position to ensure mixing.

Caution: Do not store bags with added medication.

To add medication during administration

• Close the clamp on the administration set.
• Disinfect the injection site.
• Using a syringe with a needle gauge 19 (1.10 mm) to 22 (0.70 mm), puncture the resealable injection site and inject the medication.
• Remove the container from the intravenous stand and/or turn it to place it in vertical position.
• Empty both tubes by gently tapping them while the container is in vertical position.
• Mix the solution and medication carefully.
• Return the container to the proper position, reopen the clamp, and continue administration.

1. In-use expiry (with added medications)

Prior to use, the physical and chemical stability of any added medication at the pH of Viaflo Hartmann (Ringer's lactate) in 5% glucose in the Viaflo container must be established.

From a microbiological standpoint, the diluted product should be used immediately unless the addition of medication has been carried out under controlled, validated aseptic conditions. If not used immediately, the conditions and duration of storage prior to use are the responsibility of the user.

1. Incompatibilities of added medications

Ceftriaxone must not be mixed with solutions containing calcium, including Viaflo Hartmann (Ringer's lactate) in 5% glucose.

As with all parenteral solutions, added medications may be incompatible; therefore, compatibility of medications added to Viaflo Hartmann (Ringer's lactate) in 5% glucose must be verified before addition.

After adding a medication, incompatibility with Viaflo Hartmann (Ringer's lactate) in 5% glucose should be evident by a change in color and/or precipitation, formation of insoluble complexes, or appearance of crystals. The package leaflet of the medication to be added or other relevant sources should be consulted.

Before adding a medication, verify that it is soluble and/or stable in water within the pH range of Viaflo Hartmann (Ringer's lactate) in 5% glucose (pH 4.0 – 6.5).

When adding medications to Viaflo Hartmann (Ringer's lactate) in 5% glucose, aseptic technique must be used. Mix the solution well after adding medications. Do not store solutions with added medications.

The following list provides guidance on medications incompatible with Viaflo Hartmann (Ringer's lactate) in 5% glucose (non-exhaustive list):

• Medications incompatible with Viaflo Hartmann (Ringer's lactate) in 5% glucose:

• Aminocaproic acid

• Amphotericin B

• Ceftriaxone

• Cortisone acetate

• Diethylstilbestrol

• Etamivan

• Ethyl alcohol

• Phosphate and carbonate solutions

• Oxytetracycline

• Sodium thiopental

• Disodium versenate

• Medications partially incompatible with Viaflo Hartmann (Ringer's lactate) in 5% glucose:

• Tetracycline – stable for 12 hours

• Sodium ampicillin

  • 2%-3% concentration stable for 4 hours
  • Concentration >3% must be administered within 1 hour

• Minocycline – stable for 12 hours

• Doxycycline – stable for 6 hours

Medications known to be incompatible must not be used.