Sodium Acetate

Sodium Acetate may be found in some form under the following brand names:

• BSS Ophthalmic Solution

• Dextrose 5% and Plasma-Lyte 148

• Freamine III 3

• Isolyte H

• Isolyte M

• Isolyte P

• Isolyte S

• Isolyte S and 5% Dextrose

• Isoplate

• Normosol-R

• Normosol-R and 5% Dextrose

• Physiolyte

• Physiosol

• Plasma-lyte 148

• Plasma-Lyte M in 5 % Dextrose

• Plasma-Lyte R

• Plasma-Lyte R in 5 % Dextrose

• Plasmalyte A

• ProcalAmine 3

• TPN Electrolytes

• Travasol 2.75

• Travasol 3.5

• Travasol 4.25/10

• Travasol 4.25/25

• Travasol 4.25/5

• Travasol 8.5 Electrolytes

• Trophamine

• Trophamine 10 %

• Trophamine 6 %

Sodium Acetate is available in the following forms:

• Injectable Solution
• Irrigation Solution
• Ophthalmic Solution

• If you need to store sodium acetate at home, talk with your doctor, nurse, or pharmacist about how to store it.

Sodium is the principal cation of extracellular fluid. It comprises more than 90% of total cations at its normal plasma concentration of approximately 140 mEq/liter. The sodium ion exerts a primary role in controlling total body water and its distribution.

Acetate (CH3COO− ), a source of hydrogen ion acceptors, is an alternate source of bicarbonate (HCO3−) by metabolic conversion in the liver. This has been shown to proceed readily, even in the presence of severe liver disease.

Do not administer unless solution is clear and seal is intact. Discard unused portion.

Sodium replacement therapy should be guided primarily by the serum sodium level.

Caution should be exercised in administering sodium-containing solutions to patients with severe renal function impairment, cirrhosis, cardiac failure, or other edematous or sodium-retaining states, as well as in patients with oliguria or anuria.

Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ions, to patients receiving corticosteroids or corticotropin.

Solutions containing acetate ions should be used with caution as excess administration may result in metabolic alkalosis.

Pregnancy Category C. Animal reproduction studies have not been conducted with Sodium Acetate. It is also not known whether Sodium Acetate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Sodium Acetate should be given to a pregnant woman only if clearly needed.

Pediatric Use: Safety and effectiveness have been established in the age groups infant to adolescent.

Geriatric Use: An evaluation of current literature revealed no clinical experience identifying differences in response between 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 other drug therapy.

Sodium ions are known to be substantially excreted by the kidney, and the risk of toxic reactions may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.

Excipient information presented when available (limited, particularly for generics); consult specific product labeling.

Solution, Intravenous, as anhydrous:

Generic: 2 mEq/mL (20 mL, 50 mL, 100 mL); 4 mEq/mL (50 mL, 100 mL)

Hypernatremia and fluid retention

No dosage adjustment provided in manufacturer’s labeling. Use with caution.

Concerns related to adverse effects:

• Hypernatremia: Close monitoring of serum sodium concentrations is needed to avoid hypernatremia.

Disease-related concerns:

• Acid/base disorders: Use with caution in patients with acid/base alterations; contains acetate, monitor closely during acid/base correction.

• Edema: Use with caution in edematous patients.

• Heart failure (HF): Use extreme caution in patients with HF; monitor closely for edema.

• Hepatic impairment: Use with caution in patients with severe hepatic impairment.

• Renal impairment: Use with caution in patients with renal impairment; monitor serum sodium concentrations closely.

Dosage form specific issues:

• Aluminum: The parenteral product may contain aluminum; toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources. Parenteral aluminum exposure of >4 to 5 mcg/kg/day is associated with CNS and bone toxicity; tissue loading may occur at lower doses (Federal Register, 2002). See manufacturer’s labeling.

Other warnings/precautions:

• Extravasation: Avoid extravasation.

• Discuss specific use of drug and side effects with patient as it relates to treatment. (HCAHPS: During this hospital stay, were you given any medicine that you had not taken before? Before giving you any new medicine, how often did hospital staff tell you what the medicine was for? How often did hospital staff describe possible side effects in a way you could understand?)

• Have patient report immediately to prescriber signs of fluid and electrolyte problems (mood changes, confusion, muscle pain or weakness, abnormal heartbeat, very bad dizziness or passing out, fast heartbeat, more thirst, seizures, feeling very tired or weak, not hungry, unable to pass urine or change in the amount of urine produced, dry mouth, dry eyes, or nausea or vomiting (HCAHPS).

• Educate patient about signs of a significant reaction (eg, wheezing; chest tightness; fever; itching; bad cough; blue skin color; seizures; or swelling of face, lips, tongue, or throat). Note: This is not a comprehensive list of all side effects. Patient should consult prescriber for additional questions.

Intended Use and Disclaimer: Should not be printed and given to patients. This information is intended to serve as a concise initial reference for health care professionals to use when discussing medications with a patient. You must ultimately rely on your own discretion, experience, and judgment in diagnosing, treating, and advising patients.

Sodium acetate has been assigned to pregnancy category C by the FDA. Animal studies have not been reported. There are no controlled data in human pregnancy. Sodium acetate is only recommended for use during pregnancy when benefit outweighs risk.