Lactated Ringer's Solution vs. Normal Saline

Uses and How They Differ

If you've ever had surgery or been sick or injured enough to require hospitalization, there's a good chance you were given something called lactated Ringer's solution. This oddly named fluid is delivered via IV (intravenously, which means into a vein) to treat dehydration, deliver medication, and restore fluid balance following an injury.

Medical saline drip bags with doctor's preforming surgery in background
Owen Franken / Photographer's Choice / Getty Images

Lactated Ringer’s is a sterile solution composed of water, sodium chloride (salt), sodium lactate, potassium chloride, and calcium chloride.

It's often used in place of saline solution (water and 0.9% sodium chloride) because it is less likely to cause fluid to build up in the body.

Also Known As

Other names include:

  • Ringer's lactate solution
  • Ringer's saline solution
  • Ringer's solution
  • RL
  • Hartman's solution
  • Sodium lactate solution

Background

Lactated Ringer's solution was developed in the late 1800s by a British physician named Sydney Ringer for keeping organs hydrated during live animal research. This was around the same time saline solution, which physicians injected into the veins of patients with severe dehydration due to cholera, was created.

In the 1930s, a physician named Alexis Hartmann modified Ringer's original formula by adding lactate, which he found lowered the risk of acidosis (the abnormal buildup of acid in the blood).

Other variations of Ringer's solution exist, such as one that includes acetate which may be better for people with liver disease (since lactate tends to increase as the liver function decreases).

What Lactated Ringer's Solution Is Used For

Lactated Ringer's can be given intravenously to treat low blood volume or low blood pressure. It is also used in people with severe blood loss or burns. It contains water and electrolytes to restore lost fluids.

Lactated Ringer's can be used to:

  • Treat dehydration
  • Maintain hydration in hospitalized patients unable to keep fluids down
  • Restore body fluids after significant blood loss or a severe burn
  • Keep an IV catheter open
  • Aid in the transport of IV medications into a vein

Lactated Ringer's solution also is ideal for people with sepsis, kidney failure, or respiratory acidosis whose acid-base balance is characteristically thrown off.

The solution can also be used for non-intravenous purposes, such as flushing wounds and irrigating tissues during open surgery. It should not be swallowed, however.

Lactated Ringer's solution and saline solution are often used interchangeably in IVs.

Why Lactated Ringer's Is Better Than Saline

Lactated Ringer's is often recommended over saline solution for fluid resuscitation.

Normal saline dilates blood vessels, raises blood potassium levels, and can increase the risk of metabolic acidosis.

The lactate in lactated Ringer's solution reduces acidity as it is converted into bicarbonate, a base element that helps regulate the body's pH balance and avoid acidosis.

As lactated Ringer's doesn't remain in the body as long as saline does, it is less likely to cause a complication known as hypervolemia (fluid overload).

Side Effects and Risks

Lactated Ringer's solution is generally safe and well-tolerated but may cause swelling and edema (fluid buildup in tissue) if overused. Injection site pain is the most common side effect. Very rarely a person will have an allergic reaction to Ringer's.

Lactated Ringer's solution may also be a problem for people who are unable to effectively clear fluids from the body, such as those with congestive heart failure, chronic kidney disease, cirrhosis, and hypoalbuminemia (a common cause of hypovolemia).

There is no outright contraindication for using lactated Ringer's solution, but it should not be given to someone with severe liver dysfunction. Careful consideration should also be made for people with heart or kidney disease.

Other Considerations

Lactated Ringer's solution doesn't mix well with certain drugs intended for intravenous use. These include:

  • Ceftriaxone (an IV antibiotic)
  • Mannitol (a diuretic)
  • Methylprednisone (a corticosteroid)
  • Nitroglycerin (used to control blood pressure during surgery)
  • Nitroprusside (a vasodilator)
  • Norepinephrine (used to control low blood pressure and shock)
  • Procainamide (used to treat abnormal heart rhythms)
  • Propanolol (used to treat rapid heart rhythms)

For these medications, a normal saline solution is safer.

Frequently Asked Questions

  • What ingredients are in lactated Ringer's solution?

    Lactated Ringer’s contains water, sodium chloride (salt), sodium lactate, potassium chloride, and calcium chloride.

  • Does lactated Ringer's solution contain sugar?

    No, there is no sugar or glucose in lactated Ringer's solution.

  • Why would you use lactated Ringer's instead of normal saline?

    Ringer’s lactate solution is used instead of saline to treat blood loss and burn injuries. It can also be used interchangeably with saline to treat any condition, including sepsis and acute pancreatitis.

Was this page helpful?
6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Singh S, Davis D. Ringer's lactate. In: StatPearls.

  2. Severs D, Hoorn EJ, Rookmaaker MB. A critical appraisal of intravenous fluids: from the physiological basis to clinical evidence. Nephrol Dial Transplant. 2015;30(2):178-87. doi:10.1093/ndt/gfu005

  3. Rajan S, Srikumar S, Tosh P, Kumar L. Effect of lactate versus acetate-based intravenous fluids on acid-base balance in patients undergoing free flap reconstructive surgeries. J Anaesthesiol Clin Pharmacol. 2017;33:514-9. doi:10.4103/joacp.JOACP_18_17

  4. Mane AS. Fluid resuscitation: Ringer lactate versus normal saline—a clinical study. IJCMR. 2017. 4(11):2290–3. 

  5. Galvango SM. (2003) Emergency Pathophysiology: Clinical Applications for Prehospital Care (1st Edition). Jackson, WY: Teton NewsMedia.

  6. Singh S, Kerndt CC, Davis D. Ringer's Lactate. [Updated 2022 May 6]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-.