Sodium Acetate 2meq/ml Inj, 20ml
It is used to treat or prevent low sodium levels.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Electrolyte Supplement; Alkalinizing Agent
Pharmacologic Class
Sodium Salt; Acetate Salt
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium Acetate is a medicine given through an IV (into a vein) to help balance the salt levels in your body and to correct the body's acid-base balance. It provides sodium, an important electrolyte, and a substance called acetate, which your body converts into bicarbonate to help neutralize excess acid.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to follow the instructions carefully. This medication is administered as an infusion into a vein over a period of time, after being mixed with fluids.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
Missing a Dose
If you miss a dose, contact your doctor to receive guidance on what to do next.
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to follow the instructions carefully. This medication is administered as an infusion into a vein over a period of time, after being mixed with fluids.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
Missing a Dose
If you miss a dose, contact your doctor to receive guidance on what to do next.
Lifestyle & Tips
- Report any unusual symptoms immediately, such as swelling, shortness of breath, confusion, or muscle weakness.
- Adhere to fluid restrictions or recommendations given by your healthcare provider.
- Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Highly individualized based on patient's sodium and acid-base status, fluid balance, and clinical condition. Typically administered as an additive to large volume parenteral fluids.
Condition-Specific Dosing:
sodium_deficiency:
Dose calculated based on sodium deficit (e.g., mEq sodium needed = (desired Na - current Na) x 0.6 x body weight (kg)). Administer slowly.
metabolic_acidosis:
Dose calculated based on bicarbonate deficit, as acetate is metabolized to bicarbonate. Administer slowly.
Pediatric Dosing
Neonatal:
Dosing highly individualized based on weight, gestational age, and electrolyte/acid-base status. Close monitoring required.
Infant:
Dosing highly individualized based on weight and electrolyte/acid-base status. Close monitoring required.
Child:
Dosing highly individualized based on weight and electrolyte/acid-base status. Close monitoring required.
Adolescent:
Dosing highly individualized based on weight and electrolyte/acid-base status. Close monitoring required.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor electrolytes and fluid balance closely.
Moderate:
Use with caution; monitor electrolytes and fluid balance closely. May require dose reduction or slower infusion rates to prevent hypernatremia or fluid overload.
Severe:
Contraindicated in severe renal impairment or anuria due to risk of hypernatremia, fluid overload, and metabolic alkalosis. If absolutely necessary, use extreme caution and continuous monitoring.
Dialysis:
Use with extreme caution; sodium and fluid balance are critical. Dosing should be guided by frequent electrolyte monitoring and dialysis parameters.
Hepatic Impairment:
Mild:
No specific adjustment typically needed, but monitor for signs of metabolic alkalosis as acetate metabolism may be impaired in severe liver disease.
Moderate:
Use with caution; monitor acid-base status closely. Acetate metabolism to bicarbonate may be impaired, potentially reducing its alkalinizing effect or leading to acetate accumulation.
Severe:
Use with caution; monitor acid-base status closely. Significant impairment of acetate metabolism may occur, potentially leading to acetate accumulation or reduced alkalinizing effect.
Pharmacology
Mechanism of Action
Sodium acetate provides sodium ions (Na+) which are essential for maintaining fluid and electrolyte balance, nerve impulse transmission, and muscle contraction. The acetate ion (CH3COO-) is metabolized by various tissues (e.g., liver, muscle) to bicarbonate (HCO3-), thereby serving as a precursor to bicarbonate and contributing to the body's buffer system, helping to correct metabolic acidosis.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous)
Tmax:
Not applicable (IV administration, immediate distribution)
FoodEffect:
Not applicable
Distribution:
Vd:
Sodium distributes primarily in the extracellular fluid (approx. 0.2 L/kg). Acetate is rapidly distributed throughout body water.
ProteinBinding:
Sodium: Not protein-bound. Acetate: Not significantly protein-bound.
CnssPenetration:
Limited for sodium under normal conditions; rapid changes in serum sodium can affect CNS. Acetate readily crosses cell membranes.
Elimination:
HalfLife:
Sodium: Not applicable (homeostatically regulated). Acetate: Rapidly metabolized, half-life typically minutes (e.g., 20-30 minutes).
Clearance:
Sodium: Renal clearance, highly variable based on hydration and renal function. Acetate: Metabolic clearance, rapid.
ExcretionRoute:
Sodium: Primarily renal. Acetate: Metabolized, with end products (CO2, H2O) excreted via lungs and kidneys.
Unchanged:
Sodium: Varies based on homeostatic needs. Acetate: Negligible amount excreted unchanged.
Pharmacodynamics
OnsetOfAction:
Immediate (upon IV administration for sodium effect); alkalinizing effect of acetate begins as it is metabolized, typically within minutes.
PeakEffect:
Within minutes to hours, depending on infusion rate and metabolic conversion.
DurationOfAction:
Dependent on the patient's metabolic needs and renal function; effects persist as long as infusion continues and acetate is metabolized.
Confidence:
Medium
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain, cramps, or spasms
+ Weakness
+ Shakiness
+ Balance changes
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe nausea or vomiting
Shortness of breath
Sudden significant weight gain
* Swelling in the arms or legs
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
Not all possible side effects are listed here. If you have questions or concerns about side effects, talk to your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice any of the following symptoms, contact your doctor or seek immediate medical attention:
Signs of an allergic reaction, such as:
+ Rash
+ Hives
+ Itching
+ Red, swollen, blistered, or peeling skin (with or without fever)
+ Wheezing
+ Tightness in the chest or throat
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain, cramps, or spasms
+ Weakness
+ Shakiness
+ Balance changes
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe nausea or vomiting
Shortness of breath
Sudden significant weight gain
* Swelling in the arms or legs
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
Not all possible side effects are listed here. If you have questions or concerns about side effects, talk to your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
Seek Immediate Medical Attention If You Experience:
- Excessive thirst
- Unusual tiredness or weakness
- Confusion or disorientation
- Muscle twitching or cramps
- Swelling in ankles, feet, or hands
- Shortness of breath
- Rapid weight gain
- Irregular heartbeat
Before Using This Medicine
Before Taking This Medication: Important Information to Share with Your Doctor
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you have elevated sodium levels or swelling, as these conditions may be relevant to your treatment.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. Additionally, share any existing health problems, as they may interact with this medication.
To ensure your safety, always verify with your doctor before starting, stopping, or modifying the dose of any medication, including this one. This will help prevent potential interactions and ensure that it is safe for you to take this medication in conjunction with your other treatments and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, its components, or other substances, such as foods or drugs. Be sure to describe the symptoms you experienced as a result of the allergy.
If you have elevated sodium levels or swelling, as these conditions may be relevant to your treatment.
This list is not exhaustive, and it is crucial to discuss all your medications, including prescription and over-the-counter drugs, natural products, and vitamins, with your doctor and pharmacist. Additionally, share any existing health problems, as they may interact with this medication.
To ensure your safety, always verify with your doctor before starting, stopping, or modifying the dose of any medication, including this one. This will help prevent potential interactions and ensure that it is safe for you to take this medication in conjunction with your other treatments and health conditions.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. Regular blood tests will be necessary, as directed by your doctor, to monitor your condition. Discuss any concerns or questions you have with your doctor.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. It is crucial to discuss this potential risk with your doctor.
If you are pregnant, planning to become pregnant, or are breast-feeding, you must notify your doctor. You and your doctor will need to weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. It is crucial to discuss this potential risk with your doctor.
If you are pregnant, planning to become pregnant, or are breast-feeding, you must notify your doctor. You and your doctor will need to weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Hypernatremia (excessively high sodium levels): thirst, lethargy, confusion, seizures, coma, hyperreflexia, muscle rigidity.
- Fluid Overload: edema, pulmonary congestion, dyspnea, hypertension, tachycardia, jugular venous distension.
- Metabolic Alkalosis: muscle weakness, cramps, tetany, hypoventilation, arrhythmias, irritability.
What to Do:
Discontinue infusion immediately. Management is supportive and depends on the specific symptoms and severity. May involve administration of diuretics for fluid overload, correction of electrolyte imbalances (e.g., potassium, calcium), and in severe cases, dialysis. Call 1-800-222-1222 (Poison Control Center) for advice.
Drug Interactions
Major Interactions
- Corticosteroids (e.g., Prednisone, Hydrocortisone): May increase sodium retention, leading to hypernatremia and fluid overload when co-administered with sodium acetate.
- Lithium: Sodium levels can affect lithium excretion. Increased sodium intake may increase lithium excretion, potentially decreasing lithium levels and efficacy.
Moderate Interactions
- Diuretics (e.g., Thiazides, Loop Diuretics): May alter sodium and fluid balance, requiring careful monitoring of electrolyte levels.
- Drugs that cause sodium retention (e.g., NSAIDs): May increase risk of hypernatremia and fluid overload.
Monitoring
Baseline Monitoring
Serum Electrolytes (Sodium, Potassium, Chloride, Bicarbonate)
Rationale: To establish baseline sodium and acid-base status before initiating therapy.
Timing: Prior to first dose
Renal Function (BUN, Creatinine)
Rationale: To assess kidney's ability to excrete sodium and manage fluid balance.
Timing: Prior to first dose
Fluid Balance (Intake/Output, Daily Weight)
Rationale: To assess hydration status and risk of fluid overload.
Timing: Prior to first dose
Arterial Blood Gases (ABGs) or Venous Blood Gases (VBGs)
Rationale: To assess baseline acid-base status (pH, pCO2, bicarbonate).
Timing: Prior to first dose, if indicated
Routine Monitoring
Serum Electrolytes (Sodium, Potassium, Chloride, Bicarbonate)
Frequency: Every 4-6 hours initially, then daily or as clinically indicated based on patient stability and infusion rate.
Target: Sodium: 135-145 mEq/L; Bicarbonate: 22-28 mEq/L
Action Threshold: Sodium >145 mEq/L or rapid increase; Bicarbonate >30 mEq/L or rapid increase; significant deviation from target ranges.
Fluid Balance (Intake/Output, Daily Weight)
Frequency: Every 8-12 hours or daily.
Target: Appropriate fluid balance for clinical condition.
Action Threshold: Significant positive fluid balance, rapid weight gain, or signs of edema.
Renal Function (BUN, Creatinine)
Frequency: Daily or every other day, especially in patients with impaired renal function.
Target: Stable within patient's baseline.
Action Threshold: Significant increase in BUN/Creatinine.
Vital Signs (Blood Pressure, Heart Rate)
Frequency: Regularly, as per institutional protocol.
Target: Within normal limits for patient.
Action Threshold: Signs of fluid overload (hypertension, tachycardia).
Symptom Monitoring
- Signs of hypernatremia (thirst, lethargy, confusion, seizures, coma)
- Signs of fluid overload (edema, dyspnea, crackles, weight gain, elevated blood pressure)
- Signs of metabolic alkalosis (muscle weakness, cramps, tetany, hypoventilation, arrhythmias)
- Signs of hypokalemia (muscle weakness, fatigue, cardiac arrhythmias) - can occur with metabolic alkalosis
Special Patient Groups
Pregnancy
Sodium acetate is a normal constituent of the body and is generally considered safe for use in pregnancy when clinically indicated to correct electrolyte or acid-base imbalances. Use with caution and monitor maternal and fetal electrolyte status closely.
Trimester-Specific Risks:
First Trimester:
No specific increased risk identified beyond general electrolyte management.
Second Trimester:
No specific increased risk identified beyond general electrolyte management.
Third Trimester:
No specific increased risk identified beyond general electrolyte management. Careful monitoring for fluid overload is important.
Lactation
Sodium and acetate are normal components of breast milk. Administration of sodium acetate to the mother is unlikely to cause adverse effects in a breastfed infant when used appropriately to correct maternal electrolyte or acid-base imbalances. Use with caution and monitor infant for any signs of electrolyte imbalance.
Infant Risk:
Low risk (L3 - Moderately safe, but data limited).
Pediatric Use
Dosing must be highly individualized based on weight, age, and specific electrolyte/acid-base deficits. Neonates and infants are particularly vulnerable to fluid and electrolyte imbalances, requiring meticulous calculation and close monitoring of serum electrolytes, fluid balance, and renal function. Rapid correction of sodium levels can be dangerous.
Geriatric Use
Elderly patients may have age-related decreases in renal function, pre-existing cardiovascular disease, or be on medications that affect fluid and electrolyte balance. This increases their susceptibility to hypernatremia, fluid overload, and metabolic alkalosis. Use with caution, start with lower doses, and monitor electrolytes and fluid status frequently.
Clinical Information
Clinical Pearls
- Sodium acetate is a valuable source of sodium and bicarbonate precursor, particularly useful when chloride load needs to be minimized (e.g., in patients with hyperchloremic acidosis or those receiving large volumes of saline).
- Always administer sodium acetate as a diluted solution, typically added to larger volumes of IV fluids, and infuse slowly to prevent rapid shifts in serum sodium or pH.
- Never administer undiluted sodium acetate directly as a bolus, as it can cause severe hypernatremia, hyperosmolarity, and metabolic alkalosis.
- Careful monitoring of serum electrolytes (especially sodium and bicarbonate), fluid balance, and renal function is paramount during therapy.
- Consider the total sodium load from all IV fluids and medications when calculating sodium acetate dosage to avoid hypernatremia.
Alternative Therapies
- Sodium Chloride Injection (for sodium replacement without alkalinizing effect)
- Sodium Bicarbonate Injection (for direct bicarbonate replacement and alkalinizing effect)
- Lactated Ringer's Solution (contains sodium, chloride, potassium, calcium, and lactate which is metabolized to bicarbonate)
- Other electrolyte solutions tailored to specific deficits
Cost & Coverage
Average Cost:
Price range varies widely by supplier and volume (e.g., $5 - $50 per 20ml vial) per 20ml vial
Generic Available:
Yes
Insurance Coverage:
Typically covered by most insurance plans as a generic injectable, often under medical benefit for inpatient use.
General Drug Facts
If your symptoms or health problems do not improve or worsen over time, it is essential to contact your doctor for further evaluation and guidance.
To ensure safe use, do not share your medication with others, and never take someone else's medication. Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion.
Proper disposal of unused or expired medications is crucial. Do not flush them down the toilet or pour them down the drain unless specifically instructed to do so by your pharmacist or healthcare provider. If you are unsure about the best method for disposing of your medication, consult with your pharmacist, who can provide guidance on safe disposal practices and inform you about potential drug take-back programs in your area.
Some medications may have additional patient information leaflets available. Your pharmacist can provide you with more information on this. If you have any questions or concerns about your medication, it is recommended that you discuss them with your doctor, nurse, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide detailed information about the medication, including the amount taken and the time it was ingested, to ensure prompt and effective treatment.
To ensure safe use, do not share your medication with others, and never take someone else's medication. Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion.
Proper disposal of unused or expired medications is crucial. Do not flush them down the toilet or pour them down the drain unless specifically instructed to do so by your pharmacist or healthcare provider. If you are unsure about the best method for disposing of your medication, consult with your pharmacist, who can provide guidance on safe disposal practices and inform you about potential drug take-back programs in your area.
Some medications may have additional patient information leaflets available. Your pharmacist can provide you with more information on this. If you have any questions or concerns about your medication, it is recommended that you discuss them with your doctor, nurse, pharmacist, or other healthcare provider.
In the event of a suspected overdose, immediately contact your local poison control center or seek emergency medical attention. Be prepared to provide detailed information about the medication, including the amount taken and the time it was ingested, to ensure prompt and effective treatment.