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Sod Chloride 0.45% Inj, 100ml

Manufacturer FRESENIUS KABI USA Active Ingredient Intravenous (IV) Fluids(in truh VEE nuhs FLOO ids) Pronunciation SO-dee-um KLOR-ide
It is used to give fluids to the body when more fluids and electrolytes are needed.It is used as a way to give other drugs as a shot.It may be given to you for other reasons. Talk with the doctor.
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Drug Class
Fluid and Electrolyte Replenisher
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Pharmacologic Class
Hypotonic Crystalloid Solution
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Pregnancy Category
Category C
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FDA Approved
Jan 1970
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DEA Schedule
Not Controlled

Overview

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What is this medicine?

This medication is a sterile salt water solution given through a vein (IV) to help your body get enough fluids and keep your body's salts (electrolytes) balanced. It's often used when you're dehydrated or need extra fluids.
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How to Use This Medicine

Proper Use of This Medication

To use this medication correctly, follow your doctor's instructions and read all the information provided. This medication is administered as an infusion into a vein over a period of time. Your doctor may instruct you on how to self-administer this medication.

Before and after handling the medication, wash your hands thoroughly. Do not use the medication if the solution appears cloudy, is leaking, or contains particles. Additionally, do not use the solution if it has changed color.

To dispose of used needles and sharp objects, use a designated needle/sharp disposal box. Never reuse needles or other items. When the disposal box is full, follow local regulations for proper disposal. If you have any questions or concerns, consult your doctor or pharmacist.

Storage and Disposal

Typically, this medication is administered in a hospital or doctor's office. If you need to store it at home, follow the storage instructions provided by your doctor.

Missed Dose

If you miss a dose, contact your doctor to determine the best course of action.
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Lifestyle & Tips

  • Maintain adequate oral fluid intake if able, as advised by your doctor.
  • Report any unusual swelling, difficulty breathing, or changes in how you feel.
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Available Forms & Alternatives

Available Strengths:

Dosing & Administration

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Adult Dosing

Standard Dose: Highly individualized based on patient's fluid and electrolyte needs. Typically administered at rates of 75-150 mL/hour for maintenance, or higher rates for rehydration.
Dose Range: 75 - 500 mg

Condition-Specific Dosing:

maintenance_fluid: 75-150 mL/hour
rehydration: Variable, up to 500 mL/hour or more depending on deficit and clinical status
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Pediatric Dosing

Neonatal: Highly individualized based on weight, gestational age, and clinical condition. Typically 2-4 mL/kg/hour for maintenance, adjusted for specific needs.
Infant: Highly individualized based on weight and clinical condition. Typically 2-4 mL/kg/hour for maintenance, adjusted for specific needs.
Child: Highly individualized based on weight and clinical condition. Typically 2-4 mL/kg/hour for maintenance, adjusted for specific needs.
Adolescent: Similar to adult dosing, highly individualized based on weight and clinical condition.
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Dose Adjustments

Renal Impairment:

Mild: Use with caution; monitor fluid balance and electrolytes closely.
Moderate: Use with caution; monitor fluid balance and electrolytes closely. May require reduced rates or volumes to prevent fluid overload.
Severe: Use with extreme caution; monitor fluid balance and electrolytes very closely. Often contraindicated or requires significant reduction in volume/rate due to risk of fluid overload and electrolyte imbalance.
Dialysis: Administer with extreme caution and only under strict medical supervision, typically to replace fluid removed during dialysis or to address specific electrolyte deficits. Avoid routine use due to risk of fluid overload.

Hepatic Impairment:

Mild: Generally no specific adjustment, but monitor for fluid retention.
Moderate: Generally no specific adjustment, but monitor for fluid retention and electrolyte imbalances (e.g., hyponatremia in cirrhosis).
Severe: Use with caution; monitor for fluid retention, ascites, and electrolyte imbalances. May require reduced rates or volumes.

Pharmacology

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Mechanism of Action

0.45% Sodium Chloride Injection is a hypotonic solution relative to plasma, providing both water and electrolytes (sodium and chloride). It is primarily used to provide free water for hydration and to replace hypotonic fluid losses. The sodium and chloride ions are essential for maintaining fluid and electrolyte balance, osmotic pressure, and normal cellular function. The hypotonicity allows for the movement of water from the extracellular space into the intracellular space, aiding in cellular rehydration.
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Pharmacokinetics

Absorption:

Bioavailability: 100% (intravenous administration)
Tmax: Immediate
FoodEffect: Not applicable (IV administration)

Distribution:

Vd: Distributes primarily into the extracellular fluid compartment (interstitial and intravascular spaces). Free water component distributes throughout total body water.
ProteinBinding: Not applicable (ions)
CnssPenetration: Yes (ions cross blood-brain barrier, water freely crosses)

Elimination:

HalfLife: Not applicable (ions are continuously regulated)
Clearance: Primarily renal excretion; regulated by kidneys to maintain fluid and electrolyte homeostasis.
ExcretionRoute: Renal (urine)
Unchanged: 100% (ions are not chemically altered)
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Pharmacodynamics

OnsetOfAction: Immediate
PeakEffect: Within minutes of administration, as fluid and electrolytes distribute.
DurationOfAction: Dependent on patient's fluid and electrolyte status, renal function, and ongoing losses. Effects are transient as the body continuously regulates fluid and electrolytes.

Safety & Warnings

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Side Effects

Serious Side Effects: Seek Medical Attention Immediately

Although rare, some people may experience severe and potentially life-threatening side effects while taking this medication. If you notice 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
+ Swelling of the mouth, face, lips, tongue, or throat
 Signs of fluid and electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or passing out
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or change in the amount of urine produced
+ Dry mouth
+ Dry eyes
+ Severe upset stomach or vomiting
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
 Swelling, warmth, numbness, change of color, or pain in a leg or arm
Chest pain or pressure
 Fever
Shortness of breath
 Sudden weight gain
Swelling in the arms or legs

Other Possible Side Effects

Like all medications, this drug can cause side effects. Many people may not experience any side effects or only minor ones. If you notice any of the following side effects or any other unusual symptoms, contact your doctor or seek medical help:

 Irritation or swelling at the injection site
* Pain at the injection site

This is not an exhaustive list of possible side effects. If you have questions or concerns about side effects, consult your doctor. You can also report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch.
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Seek Immediate Medical Attention If You Experience:

  • Swelling in your hands, feet, or ankles (edema)
  • Difficulty breathing or shortness of breath
  • Sudden weight gain
  • Confusion, dizziness, or unusual tiredness
  • Muscle weakness or cramps
  • Headache
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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 and pharmacist assess potential interactions between this medication and other substances you are taking.
* Any existing health problems, as this medication may interact with certain conditions.

To ensure your safety, it is crucial to verify that this medication can be taken with all your current medications and health conditions. Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor.
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Precautions & Cautions

It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication.

If your medication contains potassium, consult your doctor before using a salt substitute or any product that also contains potassium.

If your medication contains dextrose and you have diabetes (high blood sugar), discuss this with your doctor to ensure safe management of your condition.

Regular blood tests are crucial while taking this medication. Follow your doctor's instructions regarding the frequency and timing of these tests, and discuss the results with your doctor.

When administering this medication to newborns, exercise caution due to the potential for increased risk of side effects in this age group.

If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to discuss the benefits and risks of this medication with your doctor to make an informed decision regarding its use and potential impact on you and your baby.
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Overdose Information

Overdose Symptoms:

  • Fluid overload (e.g., pulmonary edema, peripheral edema, hypertension, heart failure)
  • Hypernatremia (if excessive sodium is given relative to water loss, though less common with 0.45% NaCl)
  • Electrolyte imbalances (e.g., hypokalemia, hyperchloremic acidosis if large volumes are given without other electrolytes)
  • Cerebral edema (if rapid correction of chronic hyponatremia occurs, though 0.45% NaCl is used to *prevent* this in some cases)

What to Do:

Discontinue infusion immediately. Administer diuretics to promote fluid excretion. Correct electrolyte imbalances as needed. Provide supportive care. In severe cases, dialysis may be considered. Call 911 or Poison Control (1-800-222-1222) for immediate medical attention.

Drug Interactions

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Major Interactions

  • Corticosteroids (e.g., Prednisone, Hydrocortisone): May cause sodium and fluid retention, increasing risk of hypernatremia and fluid overload when co-administered with sodium chloride solutions.
  • Drugs causing sodium retention (e.g., NSAIDs): Increased risk of fluid overload and hypernatremia.
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Moderate Interactions

  • Lithium: Sodium intake can affect renal lithium excretion. Increased sodium intake may lead to decreased lithium levels, while sodium restriction or excessive sodium loss can lead to increased lithium levels and toxicity. Monitor lithium levels.
  • Diuretics (e.g., Furosemide, Hydrochlorothiazide): May alter fluid and electrolyte balance, requiring careful monitoring when administering sodium chloride solutions.

Monitoring

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Baseline Monitoring

Serum Electrolytes (Na, K, Cl)

Rationale: To assess baseline electrolyte status and guide fluid therapy.

Timing: Prior to initiation of therapy

Renal Function (BUN, Creatinine)

Rationale: To assess kidney's ability to excrete fluid and electrolytes.

Timing: Prior to initiation of therapy

Fluid Status (Vital Signs, Edema, Lung Sounds)

Rationale: To assess baseline hydration status and identify signs of fluid overload or deficit.

Timing: Prior to initiation of therapy

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Routine Monitoring

Serum Electrolytes (Na, K, Cl)

Frequency: Every 12-24 hours, or more frequently as clinically indicated (e.g., every 4-6 hours in critical patients)

Target: Sodium: 135-145 mEq/L; Potassium: 3.5-5.0 mEq/L; Chloride: 98-107 mEq/L

Action Threshold: Significant deviations from normal range (e.g., Na <130 or >150 mEq/L, K <3.0 or >5.5 mEq/L) require immediate medical evaluation and adjustment of therapy.

Fluid Balance (Intake and Output)

Frequency: Every 4-8 hours, or continuous monitoring in critical care

Target: Positive or negative balance as clinically desired for patient's condition

Action Threshold: Significant positive balance (e.g., >1-2 L/day) or negative balance (e.g., >1-2 L/day) may indicate fluid overload or dehydration, requiring intervention.

Vital Signs (BP, HR, RR)

Frequency: Every 4-8 hours, or more frequently as clinically indicated

Target: Within patient's normal limits

Action Threshold: Significant changes (e.g., hypotension, tachycardia, tachypnea) may indicate fluid imbalance or other complications.

Physical Assessment (Edema, Lung Sounds, Skin Turgor, Mucous Membranes)

Frequency: Daily, or more frequently as clinically indicated

Target: Absence of significant edema, clear lung sounds, normal skin turgor and moist mucous membranes

Action Threshold: Development of new or worsening edema, crackles/rales in lungs, or signs of dehydration (e.g., poor skin turgor, dry mucous membranes) require intervention.

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Symptom Monitoring

  • Signs of fluid overload (e.g., peripheral edema, pulmonary edema, dyspnea, crackles in lungs, weight gain)
  • Signs of electrolyte imbalance (e.g., confusion, lethargy, muscle weakness, seizures, arrhythmias)
  • Signs of dehydration (e.g., thirst, dry mucous membranes, decreased urine output, poor skin turgor, dizziness)

Special Patient Groups

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Pregnancy

Generally considered safe and commonly used for hydration and fluid management during pregnancy. Close monitoring of fluid and electrolyte balance is recommended.

Trimester-Specific Risks:

First Trimester: No known specific risks.
Second Trimester: No known specific risks.
Third Trimester: No known specific risks, commonly used for labor and delivery hydration.
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Lactation

Considered safe for use during lactation. Sodium and chloride are natural components of breast milk, and administration of 0.45% Sodium Chloride is unlikely to pose a risk to the nursing infant.

Infant Risk: Low risk.
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Pediatric Use

Use with extreme caution and precise calculation of fluid and electrolyte needs. Pediatric patients, especially neonates and infants, have a higher risk of fluid and electrolyte imbalances (e.g., hyponatremia, hypernatremia, fluid overload) due to immature renal function and higher body water content. Close monitoring of serum electrolytes, fluid balance, and clinical status is essential.

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Geriatric Use

Use with caution. Elderly patients may have impaired renal function, pre-existing cardiovascular disease, or other comorbidities that increase the risk of fluid overload, electrolyte imbalances, and adverse reactions. Start with lower infusion rates and monitor fluid status, electrolytes, and renal function closely.

Clinical Information

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Clinical Pearls

  • 0.45% Sodium Chloride (half-normal saline) is a hypotonic solution, meaning it provides more free water than sodium compared to normal saline. It is primarily used for maintenance hydration and to replace hypotonic fluid losses.
  • Not suitable for initial volume resuscitation in hypovolemic shock due to its hypotonicity, which can lead to fluid shifting out of the intravascular space.
  • Always monitor serum sodium levels closely, especially when administering large volumes or to patients at risk for hyponatremia or hypernatremia.
  • Risk of fluid overload is significant, particularly in patients with cardiac, renal, or hepatic impairment. Monitor for signs of pulmonary edema and peripheral edema.
  • Consider adding dextrose (e.g., D5 0.45% NaCl) if the patient requires calories or to prevent ketosis, especially in pediatric patients or those with prolonged NPO status.
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Alternative Therapies

  • Oral Rehydration Solutions (for mild to moderate dehydration)
  • Other intravenous crystalloid solutions (e.g., balanced salt solutions)
  • Colloid solutions (e.g., albumin, for specific indications like severe hypovolemia or hypoalbuminemia)
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Cost & Coverage

Average Cost: $5 - $20 per 100 mL bag
Generic Available: Yes
Insurance Coverage: Tier 1 (Preferred Generic) - Generally covered by most insurance plans as a standard medical supply.
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General Drug Facts

If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure safe use, never share your medication with others, and do not take medication prescribed to 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 correct disposal method, consult your pharmacist for advice. Many communities offer drug take-back programs, which your pharmacist can help you locate. Some medications may come with an additional patient information leaflet; check with your pharmacist for more information. 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 details about the medication taken, the amount, and the time it occurred.