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Sodium Acetate (Sodium Acetate Injection): Side Effects, Uses, Dosage, Interactions, Warnings

Sodium Acetate

Medical Editor: John P. Cunha, DO, FACOEP Last updated on RxList: 7/26/2022

Drug Summary

What Is Sodium Acetate?

Sodium Acetate is an electrolyte replenisher used as a source of sodium, for addition to intravenous (IV) fluids to prevent or correct low levels of sodium in the blood (hyponatremia). Sodium acetate is available in generic form.

What Are Side Effects of Sodium Acetate?

Common side effects of sodium acetate include:

  • sodium overload
  • excessive hydration
  • dilution of other serum electrolyte concentrations
  • fluid in the lungs, or
  • low levels of blood potassium (hypokalemia)

Sodium Acetate may cause serious side effects including:

  • hives,
  • difficulty breathing,
  • swelling of your face, lips, tongue, or throat,
  • severe dizziness,
  • severe sweating,
  • fever,
  • vomiting,
  • diarrhea,
  • nausea,
  • shortness of breath,
  • chest pain, and
  • cough

Get medical help right away, if you have any of the symptoms listed above.

Seek medical care or call 911 at once if you have the following serious side effects:

  • Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
  • Serious heart symptoms such as fast, irregular, or pounding heartbeats; fluttering in your chest; shortness of breath; and sudden dizziness, lightheartedness, or passing out;
  • Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors.

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

Dosage for Sodium Acetate

Sodium Acetate Injection is administered intravenously only after dilution in a larger volume of fluid. The dose and rate of administration depends on the individual needs of the patient.

What Drugs, Substances, or Supplements Interact with Sodium Acetate?

Sodium Acetate may interact with other drugs. Tell your doctor all medications and supplements you use.

Sodium Acetate During Pregnancy or Breastfeeding

During pregnancy, Sodium Acetate should be used only if prescribed. Consult your doctor before breastfeeding.

Additional Information

Our Sodium Acetate Side Effects Drug Center provides a comprehensive view of available drug information on the potential side effects when taking this medication.

40 mEq (2 mEq/mL)
FOR ADDITIVE USE ONLY AFTER DILUTION IN I.V. FLUIDS.
Plastic Vial

Description for Sodium Acetate

Sodium Acetate (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) Injection, USP 40 mEq (2 mEq/mL) is a sterile, nonpyrogenic, concentrated solution of sodium acetate (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) in water for injection. The solution is administered, after dilution, by the intravenous route as an electrolyte replenisher. It must not be administered undiluted. Each 20 mL contains 3.28 g of sodium acetate (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) (anhydrous) which provides 40 mEq each of sodium (Na+) and acetate (CH3COO-). The solution contains no bacteriostat, antimicrobial agent or added buffer. May contain acetic acid for pH adjustment; the pH is 6.5 (6.0 to 7.0). The osmolar concentration is 4 mOsmol/mL (calc).

The solution is intended as an alternative to sodium chloride to provide sodium ion (Na+) for addition to large volume infusion fluids for intravenous use.

Sodium Acetate (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) , USP (anhydrous) is chemically designated CH3COONa, a hygroscopic powder very soluble in water. The semi-rigid container is fabricated from a specially formulated polyolefin. It is a copolymer of ethylene and propylene. The safety of the plastic has been confirmed by tests in animals according to USP biological standards for plastic containers. The container requires no vapor barrier to maintain the proper drug concentration.

Uses for Sodium Acetate

Sodium Acetate Injection, USP 40 mEq is indicated as a source of sodium, for addition to large volume intravenous fluids to prevent or correct hyponatremia in patients with restricted or no oral intake. It is also useful as an additive for preparing specific intravenous fluid formulas when the needs of the patient cannot be met by standard electrolyte or nutrient solutions.

Dosage for Sodium Acetate

Sodium Acetate (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) Injection, USP 40 mEq is administered intravenously only after dilution in a larger volume of fluid. The dose and rate of administration are dependent upon the individual needs of the patient. Serum sodium should be monitored as a guide to dosage. Using aseptic technique, all or part of the contents of one or more vials may be added to other intravenous fluids to provide any desired number of milliequivalents (mEq) of sodium (Na+) with an equal number of acetate (CH3COO-).

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration. See PRECAUTIONS.

HOW SUPPLIED

Sodium Acetate (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) Injection, USP 40 mEq (2 mEq/mL) is supplied in a 20 mL partial-fill single-dose Plastic Vial (List No. 7299). Each vial is partially filled to provide air space for complete vacuum withdrawal of the contents into the I.V. container. Store at 20° to 25°C (68° to 77°F). [See USP Controlled Room Temperature.]

Rev: October, 2004. HOSPIRA, INC., LAKE FOREST, IL 60045 USA

Side Effects for Sodium Acetate

Sodium overload can occur with intravenous infusion of excessive amounts of sodium-containing solutions. See WARNINGS and PRECAUTIONS.

Drug Interactions for Sodium Acetate

No information provided.

Warnings for Sodium Acetate

Sodium Acetate Injection, USP 40 mEq must be diluted before use.

To avoid sodium overload and water retention, infuse sodium-containing solutions slowly.

Solutions containing sodium ions 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.

In patients with diminished renal function, administration of solutions containing sodium ions may result in sodium retention. Solutions containing acetate ions should be used with great care in patients with metabolic or respiratory alkalosis. Acetate should be administered with great care in those conditions in which there is an increased level or an impaired utilization of this ion, such as severe hepatic insufficiency.

The intravenous administration of this solution (after appropriate dilution) can cause fluid and/or solute overloading resulting in dilution of other serum electrolyte concentrations, overhydration, congested states or pulmonary edema. Excessive administration of potassium free solutions may result in significant hypokalemia.

WARNING: This product contains aluminum that may be toxic. Aluminum may reach toxic levels with prolonged parenteral administration if kidney function is impaired. Premature neonates are particularly at risk because their kidneys are immature, and they require large amounts of calcium and phosphate solutions, which contain aluminum.

Research indicates that patients with impaired kidney function, including premature neonates, who receive parenteral levels of aluminum at greater than 4 to 5 mcg/kg/day accumulate aluminum at levels associated with central nervous system and bone toxicity. Tissue loading may occur at even lower rates of administration.

Precautions for Sodium Acetate

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 (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Sodium acetate (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) 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.

Overdose Information for Sodium Acetate

In the event of overdosage, discontinue infusion containing sodium acetate immediately and institute corrective therapy as indicated to reduce elevated serum sodium levels, and restore acid-base balance if necessary. See WARNINGS, PRECAUTIONS and ADVERSE REACTIONS.

Contraindications for Sodium Acetate

Sodium Acetate (sodium acetate (sodium acetate (sodium acetate injection) injection) injection) Injection, USP 40 mEq is contraindicated in patients with hypernatremia or fluid retention.

Clinical Pharmacology for Sodium Acetate

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.

Patient Information for Sodium Acetate

No information provided. Please refer to the WARNINGS and PRECAUTIONS sections.

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