Nebusal Sod Chloride 3% Soln 60x4ml
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; Osmotic agent
Pharmacologic Class
Electrolyte solution; Osmotic agent
Pregnancy Category
Category A
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medicine is a 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, which can help you breathe better.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, 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 properly.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry place, away from bathrooms and heat sources. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications by throwing them away. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of medications, consult your pharmacist. You may also have access to drug take-back programs in your area.
Missing a Dose
If you take this medication regularly, use 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 resume your normal 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 correctly, 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 properly.
Storing and Disposing of Your Medication
Store this medication at room temperature in a dry place, away from bathrooms and heat sources. Keep all medications in a safe location, out of the reach of children and pets. Dispose of unused or expired medications by throwing them away. Do not flush them down the toilet or pour them down the drain unless instructed to do so. If you have questions about disposing of medications, consult your pharmacist. You may also have access to drug take-back programs in your area.
Missing a Dose
If you take this medication regularly, use 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 resume your normal 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 can also help thin mucus.
- Follow proper nebulizer cleaning and maintenance instructions.
- Do not mix with other medications in the nebulizer unless directed by your doctor or pharmacist.
Available Forms & Alternatives
Available Strengths:
Dosing & Administration
Adult Dosing
Standard Dose:
4 mL of 3% solution via nebulizer 2 to 4 times daily
Dose Range:
4 - 16 mg
Condition-Specific Dosing:
cysticFibrosis:
4 mL of 3% to 7% solution via nebulizer 2 to 4 times daily, or as directed by physician.
bronchiolitis:
4 mL of 3% solution via nebulizer 2 to 4 times daily, often after bronchodilator.
Pediatric Dosing
Neonatal:
Not established (use with caution and under strict medical supervision)
Infant:
4 mL of 3% solution via nebulizer 2 to 4 times daily, often used for bronchiolitis. Pre-treatment with bronchodilator may be considered.
Child:
4 mL of 3% solution via nebulizer 2 to 4 times daily, often used for cystic fibrosis or acute bronchiolitis.
Adolescent:
4 mL of 3% 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, minimal systemic absorption.
Hepatic Impairment:
Mild:
No adjustment
Moderate:
No adjustment
Severe:
No adjustment
Pharmacology
Mechanism of Action
Hypertonic saline (3% sodium chloride) creates an osmotic gradient across the airway surface, drawing water from the submucosa and cells into the airway lumen. This rehydrates the airway surface liquid, thins tenacious mucus, and facilitates mucociliary clearance and cough expectoration. It may also induce a cough reflex and improve lung function.
Pharmacokinetics
Absorption:
Bioavailability:
Minimal systemic absorption (primarily local action)
Tmax:
Not applicable (local action)
FoodEffect:
Not applicable
Distribution:
Vd:
Not applicable (local action)
ProteinBinding:
Not applicable
CnssPenetration:
No
Elimination:
HalfLife:
Not applicable (local action)
Clearance:
Cleared locally by mucociliary action and expectoration
ExcretionRoute:
Not applicable (minimal systemic absorption)
Unchanged:
Not applicable
Pharmacodynamics
OnsetOfAction:
Within minutes (e.g., 5-10 minutes)
PeakEffect:
Variable, typically within 15-30 minutes post-nebulization
DurationOfAction:
Variable, typically 1-4 hours depending on patient's condition and mucociliary clearance
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Attention Immediately
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 medical help right away:
- 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, or 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 is available to provide medical advice about 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 medical help right away:
- 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, or 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 is available to provide medical advice about side effects.
Seek Immediate Medical Attention If You Experience:
- Worsening shortness of breath or difficulty breathing immediately after use.
- Severe or uncontrollable coughing.
- New or increased wheezing.
- Chest pain or severe chest tightness.
- Signs of an allergic reaction (rare): rash, itching, swelling (especially of face/tongue/throat), severe dizziness.
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, any of its components, or other substances, such as foods or other medications. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) medications, natural products, and vitamins. This is not an exhaustive list, and it is crucial to disclose all your medications and health conditions to your doctor and pharmacist.
Any health problems you have, as they may interact with this medication. Your doctor and pharmacist need to be aware of your complete medical history to ensure safe treatment.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication in conjunction with your other medications and health conditions.
It is essential to inform your doctor about the following:
Any allergies you have, including allergies to this medication, any of its components, or other substances, such as foods or other medications. Be sure to describe the allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) medications, natural products, and vitamins. This is not an exhaustive list, and it is crucial to disclose all your medications and health conditions to your doctor and pharmacist.
Any health problems you have, as they may interact with this medication. Your doctor and pharmacist need to be aware of your complete medical history to ensure safe treatment.
Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor. It is vital to verify that it is safe to take this medication in conjunction with your other medications and health conditions.
Precautions & Cautions
It is essential to inform all 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 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 to ensure the best possible outcome for both you and your baby.
Overdose Information
Overdose Symptoms:
- Severe bronchospasm (tightening of airways)
- Excessive coughing
- Respiratory distress
What to Do:
Discontinue use immediately. If symptoms are severe, administer a rescue bronchodilator if available and seek immediate medical attention. Call 911 or your local emergency number. For non-emergency advice, call Poison Control at 1-800-222-1222.
Drug Interactions
Monitoring
Baseline Monitoring
Respiratory assessment (e.g., breath sounds, respiratory rate, oxygen saturation)
Rationale: To establish baseline respiratory status before initiating therapy.
Timing: Prior to first dose
Routine Monitoring
Respiratory status (e.g., cough, sputum production, signs of bronchospasm)
Frequency: During and after each nebulization, or as clinically indicated
Target: Improvement in cough effectiveness, thinning of secretions, absence of increased wheezing or shortness of breath.
Action Threshold: If significant bronchospasm, increased wheezing, or respiratory distress occurs, discontinue treatment and administer bronchodilator if not already given.
Patient comfort and tolerance
Frequency: During and after each nebulization
Target: Patient tolerates treatment without excessive coughing or discomfort.
Action Threshold: If severe coughing, chest tightness, or discomfort, consider pre-treatment with bronchodilator or reducing frequency/concentration.
Symptom Monitoring
- Increased cough (especially initially)
- Sputum production
- Wheezing
- Shortness of breath
- Chest tightness
- Throat irritation
Special Patient Groups
Pregnancy
Sodium chloride is a naturally occurring and essential electrolyte. Nebulized hypertonic saline has minimal systemic absorption. It is generally considered safe for use during pregnancy.
Trimester-Specific Risks:
First Trimester:
Low risk
Second Trimester:
Low risk
Third Trimester:
Low risk
Lactation
Sodium chloride is naturally present in breast milk. Nebulized hypertonic saline has minimal systemic absorption, making it highly unlikely to pose a risk to a nursing infant.
Infant Risk:
Very low risk (L1)
Pediatric Use
Commonly used in pediatric populations, particularly for infants with bronchiolitis and children with cystic fibrosis. Close monitoring for bronchospasm is recommended, especially in younger children. Pre-treatment with a bronchodilator may be considered.
Geriatric Use
Generally safe for use in geriatric patients. No specific dose adjustments are typically required. Monitor for tolerance and potential for increased cough or bronchospasm, as with other age groups.
Clinical Information
Clinical Pearls
- Hypertonic saline can induce bronchospasm in some patients, especially those with reactive airway disease. Consider pre-treating with a short-acting bronchodilator (e.g., albuterol) 10-15 minutes before nebulization, particularly for the first few doses or if the patient has a history of airway hyperreactivity.
- Patients should be instructed on proper nebulizer technique and hygiene to prevent contamination.
- The 3% concentration is a common starting point; higher concentrations (e.g., 7%) may be used in specific conditions like cystic fibrosis under medical supervision.
- Encourage patients to cough effectively after treatment to clear loosened secretions.
Alternative Therapies
- Normal saline (0.9% sodium chloride) nebulizer solution (less effective for mucolysis)
- Dornase alfa (Pulmozyme) - for cystic fibrosis patients to break down DNA in sputum
- N-acetylcysteine (Mucomyst) - another mucolytic agent
- Mannitol inhalation powder (Bronchitol) - another osmotic agent for mucolysis
Cost & Coverage
Average Cost:
$10 - $50 per 60 x 4mL vials
Generic Available:
Yes
Insurance Coverage:
Tier 1 or 2 (preferred generic)
General Drug Facts
If your symptoms or health issues persist or worsen, it is essential to contact your doctor promptly. To ensure safe and effective treatment, 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. 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 detailed information about the overdose, including the medication taken, the amount, and the time it occurred.