Hypersal 7% Nebulizer Solution
It is used to thin mucus so it can be taken from the body by coughing.It is used to mix with other drugs for use in a special machine (nebulizer).It may be given to you for other reasons. Talk with the doctor.
Drug Class
Mucolytic agent
Pharmacologic Class
Osmotic agent; Electrolyte solution
Pregnancy Category
Category A
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Hypersal 7% is a strong salt water solution that you breathe in using a nebulizer. It helps to thin the thick mucus in your lungs, making it easier to cough up and clear your airways. This can help you breathe more easily.
How to Use This Medicine
Taking Your Medication Correctly
To use this medication properly, follow your doctor's instructions and read all the information provided. You will inhale this medication through your mouth using a special machine called a nebulizer. Your doctor will show you how to use the nebulizer correctly.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry place, avoiding the bathroom. Protect it from heat and keep it out of reach of children and pets. When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless instructed to do so. Instead, ask your pharmacist about the best way to dispose of it, or check if there are any drug take-back programs in your area.
Missing a Dose
If you take this medication regularly, take a missed dose as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time or take extra doses. If you use this medication as needed, do not use it more frequently than directed by your doctor.
To use this medication properly, follow your doctor's instructions and read all the information provided. You will inhale this medication through your mouth using a special machine called a nebulizer. Your doctor will show you how to use the nebulizer correctly.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry place, avoiding the bathroom. Protect it from heat and keep it out of reach of children and pets. When disposing of unused or expired medication, do not flush it down the toilet or pour it down the drain unless instructed to do so. Instead, ask your pharmacist about the best way to dispose of it, or check if there are any drug take-back programs in your area.
Missing a Dose
If you take this medication regularly, take a missed dose as soon as you remember. However, if it's close to the time for your next dose, skip the missed dose and continue with your regular schedule. Do not take two doses at the same time or take extra doses. If you use this medication as needed, do not use it more frequently than directed by your doctor.
Lifestyle & Tips
- Maintain good hydration by drinking plenty of fluids, as this also helps to thin mucus.
- Practice airway clearance techniques as instructed by your healthcare provider (e.g., chest physiotherapy, vest therapy).
- Clean your nebulizer equipment regularly as per manufacturer instructions to prevent infections.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
4 mL of 7% hypertonic saline solution via nebulizer, 2 to 4 times daily
Dose Range:
4 - 4 mg
Condition-Specific Dosing:
Cystic Fibrosis:
4 mL of 7% hypertonic saline solution via nebulizer, 2 to 4 times daily
Bronchiectasis:
4 mL of 7% hypertonic saline solution via nebulizer, 2 to 4 times daily
Pediatric Dosing
Neonatal:
Not established (use with caution, often lower concentrations)
Infant:
4 mL of 7% hypertonic saline solution via nebulizer, 2 to 4 times daily (consider lower concentrations or pre-treatment with bronchodilator)
Child:
4 mL of 7% hypertonic saline solution via nebulizer, 2 to 4 times daily
Adolescent:
4 mL of 7% hypertonic saline solution via nebulizer, 2 to 4 times daily
Dose Adjustments
Renal Impairment:
Mild:
No adjustment needed
Moderate:
No adjustment needed
Severe:
No adjustment needed
Dialysis:
No adjustment needed
Hepatic Impairment:
Mild:
No adjustment
Moderate:
No adjustment
Severe:
No adjustment
Pharmacology
Mechanism of Action
Hypertonic saline (7% sodium chloride) is an osmotic agent that draws water into the airway lumen, increasing the hydration of the airway surface liquid. This rehydrates the mucus, reducing its viscosity and elasticity, thereby improving mucociliary clearance and facilitating expectoration of sputum. It may also induce a cough reflex, further aiding in mucus removal.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption (primarily local action)
Tmax:
Not applicable (local effect)
FoodEffect:
Not applicable
Distribution:
Vd:
Not applicable (local action)
ProteinBinding:
Not applicable (local action)
CnssPenetration:
No
Elimination:
HalfLife:
Not applicable (local action, not systemically eliminated as a drug)
Clearance:
Not applicable
ExcretionRoute:
Not applicable (primarily cleared from airways via mucociliary escalator and cough)
Unchanged:
Not applicable
Pharmacodynamics
OnsetOfAction:
Rapid (within minutes of inhalation)
PeakEffect:
Within 15-30 minutes
DurationOfAction:
Variable, typically 1-6 hours depending on individual patient factors and mucus burden
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience 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
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 side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical guidance on managing side effects.
Although rare, this medication can cause severe and potentially life-threatening side effects. If you experience 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
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 side effects that bother you or do not go away, contact your doctor for advice.
Reporting Side Effects
This list does not include all possible side effects. If you have questions or concerns about side effects, discuss them with your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can provide medical guidance on managing side effects.
Seek Immediate Medical Attention If You Experience:
- Sudden worsening of shortness of breath or difficulty breathing after inhalation
- Severe coughing fits that do not subside
- New or increased wheezing or chest tightness
- Chest pain or discomfort
- Signs of infection (e.g., fever, chills, increased discolored sputum)
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.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.
Remember, this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to consult with your doctor and pharmacist about all your medications and health issues before starting, stopping, or changing the dose of any medication, including this one. Always check with your doctor before making any changes to your treatment regimen.
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.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This information will help your doctor assess potential interactions between this medication and other substances you are taking.
* Any health problems you have, as they may affect the safety and efficacy of this medication.
Remember, this is not an exhaustive list of potential interactions. To ensure your safety, it is crucial to consult with your doctor and pharmacist about all your medications and health issues before starting, stopping, or changing the dose of any medication, including this one. Always check with your doctor before making any changes to your treatment regimen.
Precautions & Cautions
It is essential to inform all of your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. If you are pregnant, planning to become pregnant, or are currently breast-feeding, be sure to discuss this with your doctor. You and your doctor will need to carefully weigh the benefits and risks of using this medication during pregnancy or breast-feeding to make an informed decision about its use.
Overdose Information
Overdose Symptoms:
- Severe bronchospasm (tightening of airways)
- Persistent, uncontrollable cough
- Significant shortness of breath
- Chest pain
What to Do:
Discontinue use immediately. If symptoms are severe or persistent, seek immediate medical attention or call 911. For advice, call a poison control center at 1-800-222-1222.
Drug Interactions
Monitoring
Baseline Monitoring
Respiratory assessment (lung sounds, cough, sputum characteristics)
Rationale: To establish baseline respiratory status and assess the need for therapy
Timing: Prior to initiation of therapy
Spirometry (FEV1)
Rationale: To assess baseline lung function, especially in patients with obstructive lung disease
Timing: Prior to initiation of therapy (optional, but recommended for CF/bronchiectasis)
Routine Monitoring
Respiratory symptoms (cough, sputum production, dyspnea)
Frequency: Daily or with each dose
Target: Improvement in symptoms, easier expectoration
Action Threshold: Worsening cough, increased dyspnea, wheezing, or chest tightness may indicate bronchospasm; consider pre-treatment with bronchodilator or discontinuation.
Lung sounds
Frequency: Periodically, or if symptoms worsen
Target: Clearer lung sounds, decreased crackles/wheezes
Action Threshold: Increased wheezing or new adventitious sounds
Sputum characteristics (volume, viscosity, color)
Frequency: Daily
Target: Increased volume, decreased viscosity, easier to clear
Action Threshold: No change or worsening sputum characteristics
Symptom Monitoring
- Cough (frequency, severity, productivity)
- Shortness of breath (dyspnea)
- Wheezing
- Chest tightness or discomfort
- Sputum production (amount, color, consistency)
Special Patient Groups
Pregnancy
Sodium chloride is a naturally occurring electrolyte and is generally considered safe for use during pregnancy. Minimal systemic absorption is expected with nebulized administration.
Trimester-Specific Risks:
First Trimester:
No known risks.
Second Trimester:
No known risks.
Third Trimester:
No known risks.
Lactation
Sodium chloride is considered safe for use during lactation. Minimal systemic absorption means negligible transfer into breast milk.
Infant Risk:
No known risk to the breastfed infant.
Pediatric Use
Commonly used in pediatric patients, particularly those with cystic fibrosis or bronchiectasis. However, younger children or those prone to bronchospasm may require pre-treatment with a bronchodilator or may tolerate lower concentrations (e.g., 3%) better. Monitor closely for signs of bronchospasm.
Geriatric Use
Generally safe for use in geriatric patients. No specific dose adjustments are typically required. Monitor for tolerance and potential for bronchospasm, especially if underlying cardiac or pulmonary conditions are present.
Clinical Information
Clinical Pearls
- Always consider pre-treating patients with a short-acting bronchodilator (e.g., albuterol) 10-15 minutes before administering hypertonic saline, especially for the first dose or in patients prone to bronchospasm.
- Patients should be instructed on proper nebulizer technique to ensure effective delivery of the medication.
- Hypertonic saline can induce a strong cough; this is often a desired effect to help clear mucus. Encourage patients to cough productively.
- If patients experience significant bronchospasm or discomfort, consider reducing the concentration (e.g., to 3%) or frequency of administration.
- Regular use of hypertonic saline has been shown to improve lung function and reduce exacerbations in patients with cystic fibrosis and bronchiectasis.
Alternative Therapies
- Dornase alfa (Pulmozyme) - another mucolytic agent, often used in cystic fibrosis.
- N-acetylcysteine (NAC) - a mucolytic, though less commonly used via nebulization for chronic conditions.
- Isotonic saline (0.9% NaCl) - less effective for mucolysis but can be used for airway hydration.
- Mannitol dry powder for inhalation (Bronchitol) - another osmotic agent for mucociliary clearance.
Cost & Coverage
Average Cost:
$10 - $50 per 30 x 4mL vials
Generic Available:
Yes
Insurance Coverage:
Tier 1 or Tier 2 (often covered by most insurance plans)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety, never share your medication with others or take someone else's medication. Some medications may come with an additional patient information leaflet, so it's a good idea to check with your pharmacist for more information. If you have any questions or concerns about this medication, don't hesitate to discuss them with your doctor, nurse, pharmacist, or other healthcare provider. In the event of a suspected overdose, immediately call your local poison control center or seek emergency medical attention. When seeking help, be prepared to provide details about the overdose, including the medication taken, the amount, and the time it occurred.