HARTMANNS

g. 4. 8). A dosage of 300 ml per hour should not be exceeded. Elderly Care should be taken in the elderly to avoid circulatory overload, particularly in, patients with cardiac and renal insufficiency. 8). Monitoring of serum sodium is particularly important for hypotonic fluids.

Thrombosis of the chosen vein is always possible with intravenous infusion. 2. 5). Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product.

uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Although Hartmann's solution provides potassium, this is only enough to maintain the potassium content of extracellular fluid and would be quite inadequate for patients with severe potassium loss. Under these circumstances potassium supplements must be given.

Lactate overdose in, patients with heart disease may provoke arrhythmias and heart failure. ECG monitoring is recommended if Hartmann's solution is administered to such patients use with caution in, patients with cardiac failure, hypertension, impaired renal function, peripheral and pulmonary oedema and in toxaemia of pregnancy.

The label states:

Do not use unless the solution is clear and free from particles. High volume infusion must be used under specific monitoring in patients with cardiac or pulmonary failure, and in patients with non-osmotic vasopressin release (including SIADH), due to the risk of hospital-acquired hyponatraemia (see below).

g. 5) are at particular risk of acute hyponatraemia upon infusion of hypotonic fluids. Acute hyponatraemia can lead to acute hyponatraemic encephalopathy (cerebral oedema) characterized by headache, nausea, seizures, lethargy and vomiting.

Patients with cerebral oedema are at particular risk of severe, irreversible and life-threatening brain injury. g. meningitis, intracranial bleeding, cerebral contusion and brain oedema) are at particular risk of the severe and life-threatening brain swelling caused by acute hyponatraemia.

1 Patients with sodium overload. This may occur with myocardial and renal damage but also in the first five or six days after surgery or severe trauma when there may be an inability to excrete unwanted sodium. Hartmann's solution should not be given to patients with cardiac arrhythmias.

Lactate containing solutions are contraindicated in, patients with severe liver disease who are unable to convert lactate to bicarbonate.