Sodium Acetate 2meq/mlinj, 50ml
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
Pharmacologic Class
Sodium salt; Alkalinizing agent (via acetate metabolism)
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium Acetate is an intravenous medication used to provide your body with sodium, an important salt, and to help correct imbalances in your body's acid-base levels. It's often given as part of a larger IV fluid mixture, especially for patients who can't eat or drink normally.
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's essential to follow the instructions carefully. This medication is administered as an infusion into a vein over a period of time, 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 for guidance on proper storage.
Missing a Dose
If you miss a dose, contact your doctor to determine the best course of action.
To use this medication correctly, follow your doctor's instructions and read all the information provided. It's essential to follow the instructions carefully. This medication is administered as an infusion into a vein over a period of time, 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 for guidance on proper storage.
Missing a Dose
If you miss a dose, contact your doctor to determine the best course of action.
Lifestyle & Tips
- Report any unusual swelling, shortness of breath, or changes in alertness to your healthcare provider immediately.
- Your healthcare team will closely monitor your blood tests and fluid levels while you are receiving this medication.
Available Forms & Alternatives
Dosing & Administration
Adult Dosing
Standard Dose:
Highly individualized based on patient's electrolyte status, fluid balance, and metabolic needs. Typically administered as an additive to large volume parenteral fluids (e.g., TPN).
Dose Range:
20 - 160 mg
Condition-Specific Dosing:
sodium_deficiency:
Dose determined by severity of hyponatremia and fluid status. Often 20-160 mEq/day, adjusted to achieve desired serum sodium concentration.
metabolic_acidosis:
Dose determined by severity of acidosis and patient's bicarbonate deficit. Acetate is metabolized to bicarbonate.
Pediatric Dosing
Neonatal:
Highly individualized based on weight, gestational age, and electrolyte/fluid needs. Typically 2-4 mEq/kg/day, adjusted based on serum electrolytes.
Infant:
Highly individualized based on weight and electrolyte/fluid needs. Typically 2-4 mEq/kg/day, adjusted based on serum electrolytes.
Child:
Highly individualized based on weight and electrolyte/fluid needs. Typically 2-4 mEq/kg/day, adjusted based on serum electrolytes.
Adolescent:
Highly individualized based on weight and electrolyte/fluid needs. Typically 2-4 mEq/kg/day, adjusted based on serum electrolytes, similar to adult dosing for larger adolescents.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor serum sodium and fluid status closely.
Moderate:
Reduced dose and/or extended intervals; monitor serum sodium, fluid status, and acid-base balance frequently.
Severe:
Contraindicated or use with extreme caution and significant dose reduction; monitor serum sodium, fluid status, and acid-base balance very closely. Risk of hypernatremia and fluid overload is high.
Dialysis:
Dose must be carefully adjusted based on dialysis regimen and post-dialysis electrolyte levels. Sodium removal occurs during dialysis.
Hepatic Impairment:
Mild:
No specific dose adjustment typically required, but monitor for signs of fluid overload.
Moderate:
No specific dose adjustment typically required, but monitor for signs of fluid overload. Acetate metabolism to bicarbonate may be slightly impaired in severe liver failure, but usually not clinically significant for sodium acetate.
Severe:
No specific dose adjustment typically required, but monitor for signs of fluid overload. Acetate metabolism to bicarbonate may be slightly impaired, but usually not clinically significant for sodium acetate.
Pharmacology
Mechanism of Action
Sodium acetate provides sodium ions (Na+), an essential cation of the extracellular fluid, and acetate ions (CH3COO-). The acetate ion is a bicarbonate precursor; it is metabolized by various tissues (e.g., liver, muscle, kidney) to carbon dioxide and water, consuming hydrogen ions in the process, thereby generating bicarbonate (HCO3-). This contributes to the body's buffer system and helps correct metabolic acidosis.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous)
Tmax:
Not applicable (IV administration, immediate effect)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.2 L/kg (extracellular fluid volume for sodium)
ProteinBinding:
Not protein bound (sodium and acetate ions)
CnssPenetration:
Limited (sodium ions do not readily cross intact blood-brain barrier)
Elimination:
HalfLife:
Sodium: Regulated by renal excretion and hormonal control; Acetate: Rapidly metabolized, half-life is minutes.
Clearance:
Sodium: Primarily renal; Acetate: Metabolic clearance is rapid.
ExcretionRoute:
Sodium: Renal; Acetate: Metabolized to CO2 and H2O, excreted via lungs and kidneys.
Unchanged:
Sodium: Varies based on renal function and body needs; Acetate: Negligible amount excreted unchanged.
Pharmacodynamics
OnsetOfAction:
Immediate (upon IV administration)
PeakEffect:
Minutes (for acetate metabolism to bicarbonate); hours (for sodium repletion depending on deficit)
DurationOfAction:
Dependent on patient's metabolic needs, renal function, and ongoing losses.
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
As with any medication, you may experience side effects. While many people have no side effects or only mild ones, it's essential to discuss any concerns with your doctor. If you experience any side effects that bother you or persist, contact your doctor for guidance.
Reporting Side Effects
If you have questions or concerns about side effects, don't hesitate to reach out 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.
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
As with any medication, you may experience side effects. While many people have no side effects or only mild ones, it's essential to discuss any concerns with your doctor. If you experience any side effects that bother you or persist, contact your doctor for guidance.
Reporting Side Effects
If you have questions or concerns about side effects, don't hesitate to reach out 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
- Swelling in ankles, feet, or hands
- Shortness of breath
- Rapid weight gain
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. 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. Individuals with kidney problems and premature infants are at a higher risk of developing aluminum toxicity. Consult your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or are breast-feeding, it is crucial to inform 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. Individuals with kidney problems and premature infants are at a higher risk of developing aluminum toxicity. Consult your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or are breast-feeding, it is crucial to inform 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
- Fluid overload: edema, pulmonary edema, hypertension, heart failure
- Metabolic alkalosis: muscle weakness, cramps, irritability, confusion, arrhythmias
What to Do:
Discontinue infusion, administer diuretics, provide supportive care, correct electrolyte and fluid imbalances. 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 causing sodium retention (e.g., NSAIDs): Increased risk of hypernatremia and fluid overload.
Moderate Interactions
- Lithium: Sodium levels can affect lithium excretion; changes in sodium intake/administration may alter lithium levels.
- Diuretics (e.g., Thiazides, Loop diuretics): May alter sodium and fluid balance, requiring careful monitoring.
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl, HCO3)
Rationale: To assess baseline sodium status, acid-base balance, and identify other electrolyte imbalances.
Timing: Prior to initiation of therapy.
Renal Function (BUN, Creatinine)
Rationale: To assess kidney's ability to excrete sodium and fluid.
Timing: Prior to initiation of therapy.
Fluid Status (Weight, I&O, vital signs, physical exam)
Rationale: To assess baseline hydration and risk of fluid overload.
Timing: Prior to initiation of therapy.
Routine Monitoring
Serum Electrolytes (Na, K, Cl, HCO3)
Frequency: Daily or more frequently as clinically indicated, especially during initial therapy or dose adjustments.
Target: Sodium: 135-145 mEq/L; Bicarbonate: 22-28 mEq/L
Action Threshold: Sodium outside target range, significant changes in other electrolytes, or worsening acid-base status.
Fluid Status (Weight, I&O, vital signs, physical exam)
Frequency: Daily or more frequently as clinically indicated.
Target: Stable weight, balanced I&O, no signs of edema or dehydration.
Action Threshold: Significant weight gain/loss, positive/negative fluid balance, signs of fluid overload (e.g., edema, dyspnea) or dehydration.
Acid-Base Status (Arterial Blood Gases if indicated)
Frequency: As clinically indicated, especially in patients with metabolic acidosis.
Target: pH 7.35-7.45
Action Threshold: Persistent acidosis or development of metabolic alkalosis.
Symptom Monitoring
- Signs of hypernatremia (thirst, lethargy, confusion, seizures, coma)
- Signs of fluid overload (edema, weight gain, dyspnea, crackles, elevated blood pressure)
- Signs of metabolic alkalosis (muscle weakness, cramps, irritability, confusion, arrhythmias)
Special Patient Groups
Pregnancy
Sodium is an essential electrolyte. When administered appropriately to correct a deficiency or maintain electrolyte balance, sodium acetate is generally considered safe during pregnancy. Dosing should be carefully managed to avoid hypernatremia or fluid overload.
Trimester-Specific Risks:
First Trimester:
No known specific risks when used appropriately.
Second Trimester:
No known specific risks when used appropriately.
Third Trimester:
No known specific risks when used appropriately.
Lactation
Sodium is a normal component of breast milk. When administered appropriately to the mother, sodium acetate is not expected to cause adverse effects in breastfed infants. Dosing should be carefully managed to avoid maternal hypernatremia or fluid overload.
Infant Risk:
Low risk (L1)
Pediatric Use
Dosing must be highly individualized based on weight, age, and specific electrolyte/fluid requirements. Neonates and infants have immature renal function and are more susceptible to fluid and electrolyte imbalances, requiring very careful monitoring.
Geriatric Use
Elderly patients may have age-related decline in renal function and comorbidities (e.g., heart failure), increasing their susceptibility to hypernatremia and fluid overload. Dosing should be initiated at the lower end of the range and adjusted with careful monitoring of electrolytes and fluid status.
Clinical Information
Clinical Pearls
- Sodium Acetate is primarily used as an additive to large volume parenteral solutions (e.g., TPN, maintenance IV fluids) and is NOT for direct intravenous push.
- The acetate component is a bicarbonate precursor, making it useful in patients with metabolic acidosis or those who cannot tolerate chloride (e.g., in TPN where chloride load needs to be managed).
- Careful monitoring of serum sodium, other electrolytes, fluid balance, and acid-base status is crucial due to the highly individualized dosing and potential for imbalances.
- Not interchangeable with sodium chloride for all uses, especially when acid-base balance is a concern.
Alternative Therapies
- Sodium Chloride (for sodium repletion, but does not provide bicarbonate precursor)
- Sodium Bicarbonate (for direct bicarbonate supplementation, but may contribute to higher CO2 production and is less stable in some IV mixtures)
- Sodium Phosphate (for sodium and phosphate repletion)
Cost & Coverage
Average Cost:
Low per vial
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Generic)
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. Unless instructed otherwise, do not flush medications down the toilet or drain. If you are unsure about the proper 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 the incident.