Normal saline is sodium and chloride, 154 mEq/L each. Lactated Ringer's adds potassium, calcium, and lactate, and that calcium is why it can't run with ceftriaxone or citrated blood. Here's what's on the labels and how to stock both.
· 3 min read
Written and clinically reviewed by Jacob Fuchs, PharmD
Reviewed on
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In stockNormal saline (0.9% sodium chloride) is sodium and chloride, 154 mEq/L each, at about 308 mOsmol/L. Lactated Ringer's has less sodium and chloride (130 and 110 mEq/L) and adds potassium (4), calcium (3), and lactate (28 mEq/L), at about 275 mOsmol/L. Those numbers are from B. Braun's labels (LR label; NS product page).
Which fluid a patient gets is your clinicians' call. What purchasing needs to understand is the calcium. It's the reason LR has compatibility rules that saline doesn't.
From B. Braun's labeling:
| 0.9% Sodium Chloride (normal saline) | Lactated Ringer's | |
|---|---|---|
| Sodium | 154 mEq/L | 130 mEq/L |
| Chloride | 154 mEq/L | 110 mEq/L |
| Potassium | — | 4 mEq/L |
| Calcium | — | 3 mEq/L |
| Lactate | — | 28 mEq/L |
| Osmolarity (calculated) | 308 mOsmol/L | 275 mOsmol/L |
| pH | 5.6 (4.5–7.0) | 6.2 (6.0–7.5) |
Sources: B. Braun NS; B. Braun LR.
Two label warnings come straight from it (LR label):
LR also isn't for every metabolic situation. The label says it's "NOT FOR USE IN THE TREATMENT OF LACTIC ACIDOSIS" (LR label).
None of that is a reason not to stock LR. It's a reason to stock both, so nobody has to improvise.
B. Braun's LR comes in EXCEL containers in 1000, 500, and 250 mL sizes. The label states they're not made with natural rubber latex, PVC, or DEHP (LR label). Its normal saline is in the same family of containers, 12 bags per case for the 1 L size (B. Braun NS).
If your practice cares about PVC- or DEHP-free containers, that's worth confirming on whatever brand you buy. It isn't true of every IV bag.
LR: 20°C to 25°C (68°F to 77°F), excursions allowed from 15°C to 30°C, minimize heat exposure, and protect from freezing (LR label). Treat saline the same way, and check your specific label.
Two practical points:
Premier Pharma supplies licensed surgery centers, clinics, and pharmacies, and every invoice lists the lot number and expiration date for each item. We carry B. Braun Lactated Ringer's, 12 × 1000 mL and 0.9% Sodium Chloride, 12 × 1000 mL. For the rest of a procedure area, see our anesthesia supplies purchasing guide. Open a free account. Credential review typically takes 1–2 business days.
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