1DESCRIPTION
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) is a sterile, nonpyrogenic solution for fluid and electrolyte replenishment and caloric supply in a single dose container for intravenous administration. Each 100 mL contains 5 g Dextrose Hydrous, USP*, 234 mg Sodium Chloride, USP (NaCl); 128 mg Potassium Acetate, USP (C2H3KO2); and 32 mg Magnesium Acetate, Tetrahydrate (C4H6MgO4•4H2O). It contains no antimicrobial agents. pH 5.0 (4.0 to 6.5). The pH is adjusted with hydrochloric acid.
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) administered intravenously has value as a source of water, electrolytes, and calories. One liter has an ionic concentration of 40 mEq sodium, 13 mEq potassium, 3 mEq magnesium, 40 mEq chloride, and 16 mEq acetate. The osmolarity is 363 mOsmol/L (calc). Normal physiologic osmolarity range is approximately 280 to 310 mOsmol/L. Administration of substantially hypertonic solutions (≥ 600 mOsmol/L) may cause vein damage. The caloric content is 170 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 may leach out certain chemical components from the plastic in very small amounts; however, biological testing was supportive of the safety of the plastic container materials.
2CLINICAL PHARMACOLOGY
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) has value as a source of water, electrolytes, and calories. It is capable of inducing diuresis depending on the clinical condition of the patient.
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) produces a metabolic alkalinizing effect. Acetate ions are metabolized ultimately to carbon dioxide and water, which requires the consumption of hydrogen cations.
3INDICATIONS AND USAGE
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) is indicated as a source of water, electrolytes, and calories or as an alkalinizing agent.
4CONTRAINDICATIONS
Solutions containing dextrose may be contraindicated in patients with known allergy to corn or corn products.
5WARNINGS
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) should be used with great care, if at all, in patients with congestive heart failure, severe renal insufficiency, and in clinical states in which there exists edema with sodium retention.
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) should be used with great care, if at all, in patients with hyperkalemia, severe renal failure, and in conditions in which potassium retention is present.
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) should be used with great care in patients with metabolic or respiratory alkalosis. The administration of acetate ions should be done with great care in those conditions in which there is an increased level or an impaired utilization of these ions, such as severe hepatic insufficiency.
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) should not be administered simultaneously with blood through the same administration set because of the possibility of pseudoagglutination or hemolysis.
The intravenous administration of Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration, congested states, or pulmonary edema. The risk of dilutional states is inversely proportional to the electrolyte concentrations of the injection. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentrations of the injection.
In patients with diminished renal function, administration of Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) may result in sodium or potassium retention.
6PRECAUTIONS
Clinical eva luation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such eva luation.
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) should be used with caution. Excess administration may result in metabolic alkalosis.
Caution must be exercised in the administration of Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) to patients receiving corticosteroids or corticotropin.
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) should be used with caution in patients with overt or subclinical diabetes mellitus.
6.1Pregnancy
6.1.1Teratogenic Effects
6.1.1.1Pregnancy Category C
Animal reproduction studies have not been conducted with Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP). It is also not known whether Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) should be given to a pregnant woman only if clearly needed.
6.2Pediatric Use
Safety and effectiveness of Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) in pediatric patients have not been established by adequate and well controlled trials, however, the use of plasmalyte and dextrose solutions in the pediatric population is referenced in the medical literature. The warnings, precautions and adverse reactions identified in the label copy should be observed in the pediatric population.
In very low birth weight infants, excessive or rapid administration of dextrose injection may result in increased serum osmolality and possible hemorrhage.
6.3Carcinogenesis, Mutagenesis, Impairment of Fertility
Studies with Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) have not been performed to eva luate carcinogenic potential, mutagenic potential, or effects on fertility.
6.4Nursing Mothers
It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) is administered to a nursing mother.
6.5Geriatric Use
Clinical studies of Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, 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 drug therapy.
Do not administer unless solution is clear and seal is intact.
7ADVERSE REACTIONS
Reactions which may occur because of the solution or the technique of administration include febrile response, infection at the site of injection, venous thrombosis or phlebitis extending from the site of injection, extravasation, and hypervolemia.
If an adverse reaction does occur, discontinue the infusion, eva luate the patient, institute appropriate therapeutic countermeasures, and save the remainder of the fluid for examination if deemed necessary.
8DOSAGE AND ADMINISTRATION
As directed by a physician. Dosage is dependent upon the age, weight and clinical condition of the patient as well as laboratory determinations.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration whenever solution and container permit.
All injections in Viaflex® plastic containers are intended for intravenous administration using sterile equipment.
As reported in the literature, the dosage and constant infusion rate of intravenous dextrose must be selected with caution in pediatric patients, particularly neonates and low weight infants, because of the increased risk of hyperglycemia/hypoglycemia.
Additives may be incompatible. Complete information is not available. Those additives known to be incompatible should not be used. Consult with 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. Do not store solutions containing additives.
9HOW SUPPLIED
Plasma-Lyte® 56 and 5% Dextrose Injection (Multiple Electrolytes and Dextrose Injection, Type 1, USP) in Viaflex® plastic containers is available as shown below:
|
Code |
Size (mL) |
NDC |
|
2B2573 |
500 |
NDC 0338-0147-03 |
|
2B2574 |
1000 |
NDC 0338-0147-04 |
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.
10DIRECTIONS FOR USE OF VIAFLEX® PLASTIC CONTAINER
Warning: Do not use plastic containers in series connections. Such use could result in air embolism due to residual air being drawn from the primary container before administration of the fluid from the secondary container is completed.
10.1To Open
Tear overwrap down side at slit and remove solution container. 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.
10.2Preparation for Administration
-
Suspend container from eyelet support.
-
Remove plastic protector from outlet port at bottom of container.
-
Attach administration set. Refer to complete directions accompanying set.
10.3To Add Medication
Warning: Additives may be incompatible.
10.3.1To add medication before solution administration
-
Prepare medication site.
-
Using syringe with 19 to 22 gauge needle, puncture medication port and inject.
-
Mix solution and medication thoroughly. For high density medication such as potassium chloride, squeeze ports while ports are upright and mix thoroughly.
10.3.2To add medication during solution administration
-
Close clamp on the set.
-
Prepare medication site.
-
Using syringe with 19 to 22 gauge needle, puncture resealable medication port and inject.
-
Remove container from IV pole and/or turn to an upright position.
-
Evacuate both ports by squeezing them while container is in the upright position.
-
Mix solution and medication thoroughly.
-
Return container to in use position and continue administration.
Baxter Healthcare Corporation
Deerfield, IL 60015 USA
Printed in USA
*BAR CODE POSITION ONLY
071922966
©Copyright 1982, 1983, 1984, 1989, 1994, Baxter Healthcare Corporation.
All rights reserved.
7-19-22-966
Rev. March 2000
12PRINCIPAL DISPLAY PANEL - PACKAGING LABELING
LOT
EXP
2B2574
NDC 0338-0147-04
PLASMA-LYTE 56
and 5% Dextrose
Injection
(Multiple Electrolytes and
Dextrose Injection Type 1 USP)
1000 mL
Each 100 mL contains 5 g Dextrose Hydrous USP 234 mg
Sodium Chloride USP 128 mg Potassium Acetate USP
32 mg Magnesium Acetate Tetrahydrate pH adjusted with
Hydrochloric Acid pH 5.0 (4.0 to 6.5) mEq/L
Sodium 40 Potassium 13 Magnesium 3 Chloride 40
Acetate 16 Osmolarity 363 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
administer simultaneously with blood 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
1, 2, 3, 4, 5, 6, 7, 8, 9
2B2574X
14-1000 ML
VIAFLEX® container
PLASMA-LYTE® 56 & 5% DEX. INJ. (MULTIPLE
ELECTROLYTES AND DEX. INJ., TYPE 1, USP)
EXP
XXXXX
SECONDARY BAR CODE
(17) YYMMOO (10) XXXXX
LOT
XXXXX
PRIMARY BAR CODE
(01) 50303380147040
