Sodium Acetate 2meq/mlinj, 100ml
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 replenisher; pH modifier
Pharmacologic Class
Sodium salt; Acetate source; Alkalinizing agent precursor
Pregnancy Category
C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium acetate is a medicine given through a vein (IV) to help balance the salt and acid levels in your body. It provides sodium, which is an important body salt, and also helps your body make a substance called bicarbonate, which keeps your blood from becoming too acidic.
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 intravenous infusion, which means it is given into a vein over a period of time after being mixed with other 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 best way to store it.
Missing a Dose
If you miss a dose, contact your doctor to find out 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 intravenous infusion, which means it is given into a vein over a period of time after being mixed with other 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 best way to store it.
Missing a Dose
If you miss a dose, contact your doctor to find out what to do next.
Lifestyle & Tips
- This medication is administered in a hospital or clinical setting by healthcare professionals.
- No specific lifestyle modifications are typically required by the patient related to this medication, as it's used to correct imbalances.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Individualized based on patient's clinical condition, serum electrolyte levels, acid-base balance, and fluid requirements. Typically administered as part of a parenteral nutrition regimen or for correction of metabolic acidosis.
Condition-Specific Dosing:
metabolicAcidosis:
Dose calculated based on base deficit and body weight, administered slowly via IV infusion.
parenteralNutrition:
Typically 1-2 mEq/kg/day of sodium, with acetate providing a portion of the anion requirement.
Pediatric Dosing
Neonatal:
Individualized based on weight, clinical condition, and electrolyte status. Careful monitoring required.
Infant:
Individualized based on weight, clinical condition, and electrolyte status. Careful monitoring required.
Child:
Individualized based on weight, clinical condition, and electrolyte status. Careful monitoring required.
Adolescent:
Individualized based on weight, clinical condition, and electrolyte status. Careful monitoring required.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor serum sodium and fluid balance.
Moderate:
Use with caution; monitor serum sodium and fluid balance closely. May require dose reduction.
Severe:
Contraindicated in severe renal impairment with oliguria or anuria due to risk of sodium accumulation and fluid overload. If used, extreme caution and frequent monitoring are essential.
Dialysis:
Use with extreme caution; dose must be carefully adjusted based on dialysis regimen and post-dialysis electrolyte levels. Risk of hypernatremia and fluid overload.
Hepatic Impairment:
Mild:
No specific adjustment typically needed, but monitor for signs of fluid retention.
Moderate:
No specific adjustment typically needed, but monitor for signs of fluid retention and electrolyte imbalances.
Severe:
Use with caution in severe hepatic impairment, as acetate metabolism to bicarbonate may be impaired, potentially leading to metabolic acidosis or exacerbating existing fluid retention. Monitor acid-base status.
Pharmacology
Mechanism of Action
Sodium acetate provides sodium ions, an essential electrolyte for maintaining fluid and electrolyte balance, nerve impulse transmission, and muscle contraction. The acetate ion is a bicarbonate precursor; it is metabolized by various tissues (e.g., muscle, liver, kidney) to carbon dioxide and water, generating bicarbonate in the process. This contributes to the body's buffer system and helps correct metabolic acidosis.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Not applicable (IV infusion, immediate effect)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.2 L/kg (extracellular fluid volume)
ProteinBinding:
Not applicable (ions)
CnssPenetration:
Limited (ions do not readily cross intact blood-brain barrier)
Elimination:
HalfLife:
Sodium: Regulated by renal excretion; Acetate: Rapidly metabolized (minutes)
Clearance:
Sodium: Renal; Acetate: Metabolic clearance
ExcretionRoute:
Sodium: Renal; Acetate: Metabolized to CO2 and H2O, then excreted via lungs and kidneys
Unchanged:
Sodium: Variable (depends on body needs); Acetate: Negligible
Pharmacodynamics
OnsetOfAction:
Immediate (upon IV administration)
PeakEffect:
Dependent on infusion rate and patient's metabolic status
DurationOfAction:
Dependent on patient's metabolic needs and renal function
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when 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
+ Trouble 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
+ Change in balance
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe upset stomach 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
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, contact your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
While rare, some people may experience severe and potentially life-threatening side effects when 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
+ Trouble 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
+ Change in balance
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe upset stomach 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
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns about side effects, contact 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:
- Unusual thirst or dry mouth (may indicate high sodium)
- Swelling in your ankles, feet, or hands (fluid retention)
- Shortness of breath or difficulty breathing (fluid in lungs)
- Confusion, extreme tiredness, or muscle weakness
- 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.
If you have elevated sodium levels or swelling.
This list is not exhaustive, and it is crucial to discuss all your medications (including prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health issues.
Remember, do not start, stop, or adjust the dosage of any medication without first consulting 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.
If you have elevated sodium levels or swelling.
This list is not exhaustive, and it is crucial to discuss all your medications (including prescription, over-the-counter, natural products, and vitamins) and health conditions with your doctor and pharmacist. They will help determine if it is safe to take this medication with your other medications and health issues.
Remember, do not start, stop, or adjust the dosage of any medication without first consulting your doctor.
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. Be sure to discuss any concerns or questions with your doctor.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. Individuals with kidney problems and premature infants are at a higher risk. It is crucial to consult with your doctor about this potential risk.
If you are pregnant, planning to become pregnant, or are breastfeeding, you must notify your doctor. Your doctor will help you 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. Individuals with kidney problems and premature infants are at a higher risk. It is crucial to consult with your doctor about this potential risk.
If you are pregnant, planning to become pregnant, or are breastfeeding, you must notify your doctor. Your doctor will help you 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 (excess sodium): thirst, lethargy, confusion, seizures, coma
- Fluid Overload: edema, pulmonary congestion, dyspnea, hypertension, heart failure
- Metabolic Alkalosis (excess bicarbonate): muscle weakness, cramps, tetany, hypoventilation, confusion
What to Do:
Immediate medical attention is required. Treatment involves discontinuing the infusion, administering diuretics to promote sodium and fluid excretion, and in severe cases, dialysis may be necessary. Management of metabolic alkalosis may involve administration of acidifying agents (e.g., ammonium chloride, hydrochloric acid) or potassium chloride if hypokalemia is present. Call 1-800-222-1222 (Poison Control).
Drug Interactions
Major Interactions
- Corticosteroids (e.g., Prednisone, Hydrocortisone): May increase sodium retention and fluid overload risk.
- Drugs that cause sodium retention (e.g., NSAIDs): Increased risk of hypernatremia and fluid overload.
Moderate Interactions
- Diuretics (e.g., Furosemide, Hydrochlorothiazide): May alter sodium balance; dose adjustment of sodium acetate may be needed.
- Lithium: Sodium levels can affect lithium excretion; monitor lithium levels closely.
Monitoring
Baseline Monitoring
Serum Electrolytes (Sodium, Potassium, Chloride, Bicarbonate)
Rationale: To establish baseline electrolyte status and guide initial dosing.
Timing: Prior to initiation of therapy
Renal Function (BUN, Creatinine)
Rationale: To assess kidney's ability to excrete sodium and manage fluid balance.
Timing: Prior to initiation of therapy
Fluid Status (Weight, Intake/Output, Edema)
Rationale: To assess baseline hydration and risk of fluid overload.
Timing: Prior to initiation of therapy
Acid-Base Status (Arterial Blood Gases if indicated)
Rationale: To assess baseline pH and bicarbonate levels, especially if treating acidosis.
Timing: Prior to initiation of therapy
Routine Monitoring
Serum Electrolytes (Sodium, Potassium, Chloride, Bicarbonate)
Frequency: Daily or more frequently as clinically indicated (e.g., every 4-6 hours during acute correction)
Target: Sodium: 135-145 mEq/L; Bicarbonate: 22-28 mEq/L
Action Threshold: Sodium > 145 mEq/L (hypernatremia), Bicarbonate > 30 mEq/L (metabolic alkalosis), or significant deviations from target range
Fluid Balance (Intake/Output, Daily Weight)
Frequency: Daily
Target: Stable weight, balanced I/O
Action Threshold: Significant weight gain, positive fluid balance, or signs of fluid overload (e.g., edema, dyspnea)
Vital Signs (Blood Pressure, Heart Rate)
Frequency: Regularly, as per institutional protocol
Target: Within normal limits for patient
Action Threshold: Signs of fluid overload (e.g., hypertension, tachycardia) or dehydration
Symptom Monitoring
- Signs and symptoms of hypernatremia (e.g., thirst, lethargy, confusion, seizures, coma)
- Signs and symptoms of fluid overload (e.g., peripheral edema, pulmonary edema, dyspnea, weight gain, elevated blood pressure)
- Signs and symptoms of metabolic alkalosis (e.g., muscle weakness, cramps, tetany, hypoventilation, confusion)
Special Patient Groups
Pregnancy
Sodium acetate is an essential electrolyte. When indicated for the correction of electrolyte or acid-base imbalances, its use is generally considered safe during pregnancy, as the benefits of correcting severe imbalances outweigh potential risks. Close monitoring of maternal fluid and electrolyte status is crucial.
Trimester-Specific Risks:
First Trimester:
No known specific risks beyond general electrolyte management.
Second Trimester:
No known specific risks beyond general electrolyte management.
Third Trimester:
No known specific risks beyond general electrolyte management. Careful monitoring of fluid balance is important to avoid fluid overload, which can be more pronounced in late pregnancy.
Lactation
Sodium acetate is an endogenous substance and essential electrolyte. It is compatible with breastfeeding when administered to correct maternal electrolyte or acid-base imbalances. The amount transferred into breast milk is not expected to be harmful to the infant.
Infant Risk:
Low risk. No adverse effects on breastfed infants are expected.
Pediatric Use
Dosing must be carefully individualized based on weight, age, clinical condition, and precise electrolyte and acid-base deficits. Neonates and infants have immature renal function and are more susceptible to fluid and electrolyte imbalances, requiring meticulous monitoring and slower infusion rates.
Geriatric Use
Elderly patients may have age-related decreases in renal function and cardiac reserve, making them more susceptible to hypernatremia, fluid overload, and electrolyte imbalances. Dosing should be initiated at the lower end of the range and titrated slowly with close monitoring of fluid status, renal function, and serum electrolytes.
Clinical Information
Clinical Pearls
- Sodium acetate is often preferred over sodium chloride in parenteral nutrition formulations to provide a portion of the sodium requirement while also serving as a bicarbonate precursor, helping to prevent or correct metabolic acidosis.
- Rapid infusion of sodium acetate can lead to hypernatremia, fluid overload, and metabolic alkalosis. Always administer slowly via IV infusion.
- Careful calculation of the total sodium load from all sources (e.g., other IV fluids, medications) is essential to prevent hypernatremia.
- Monitor for signs of fluid overload, especially in patients with compromised cardiac or renal function.
- The acetate ion is metabolized to bicarbonate, so it contributes to the body's buffer system. This is a key difference from sodium chloride.
Alternative Therapies
- Oral sodium supplements (for mild deficiencies, if patient can tolerate oral intake)
- Other alkalinizing agents (e.g., tromethamine, for severe acidosis, but with different mechanisms and side effect profiles)
Cost & Coverage
Average Cost:
Low to moderate per 100ml vial
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Preferred Generic) or Tier 2 (Generic) for hospital/institutional use; generally covered by most insurance plans when medically necessary.
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for someone else. Store all medications in a secure location, out of reach of children and pets, to prevent accidental ingestion. Dispose of unused or expired medications properly; do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional patient information leaflet, which your pharmacist can provide. If you have any questions or concerns about your medication, 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 information about the medication taken, the quantity, and the time of ingestion.