Sod Chloride 0.45% Inj, 250ml
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.
Drug Class
Fluid and Electrolyte Replenisher
Pharmacologic Class
Hypotonic Crystalloid Solution
Pregnancy Category
Not available
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
This medication is a type of intravenous (IV) fluid, sometimes called 'half-normal saline'. It's given through a vein to help your body get enough water and salt, especially if you're dehydrated or need to balance your body's fluids. It's designed to help rehydrate your cells.
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 solution if it appears cloudy, is leaking, or contains particles. Additionally, do not use the solution if it has changed color.
To dispose of used needles and other sharp objects, use a 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.
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 solution if it appears cloudy, is leaking, or contains particles. Additionally, do not use the solution if it has changed color.
To dispose of used needles and other sharp objects, use a 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.
Lifestyle & Tips
- Report any unusual swelling, shortness of breath, or changes in how much you urinate.
- Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
Available Forms & Alternatives
Available Strengths:
- Sod Chloride 0.9% Inj, 1000ml
- Sod Chloride 0.9% Inj, 250ml
- Sod Chloride 0.45% Inj, 1000ml
- Sod Chloride 0.9% Inj, 100ml
- Sod Chloride 0.9% Inj, 50ml
- Sodium Chloride 1gm Tablets
- Sodium Chloride 0.9% Inj, 10ml
- Sodium Chloride 0.9% Inj, 50ml
- Sodium Chloride 0.9% Inj, 20ml
- Sod Chloride 0.45%/20meqkcl
- Sod Chloride 0.9% Inj, 500ml
- Sod Chloride 0.9% W/ 20meq Kcl
- Sodium Chloride 4meq/ml (23.4%) Inj
- Sod Chloride 0.9% Excel Inj 250ml
- Sodium Chloride 0.9% Neb Sol 30x3ml
- Sod Chloride 0.9% Inj, 100ml
- Sod Chloride 0.9% Inj, 50ml
- Sod Chloride 23.4% Inj, 100ml
- Sod Chloride 0.45% Inj, 500ml
- Sod Chloride 0.45% Inj, 1000ml
- Sod Chloride 0.9% Inj, 500ml
- Sodium Chloride 2.5meq/ml Inj, 40ml
- Sodium Chloride 3% Neb Sol 15ml
- Sod Chloride 0.9% Neb Sol 100 X 5ml
- Sodium Chloride 10% Neb Soln, 15ml
- Sod Chloride 0.9% Inj, 5ml
- Sodium Chloride 5% Ophth Oint 3.5gm
- Sod Chloride 0.9% Inj, 10ml
- Sodium Chloride 7% Neb Sol 60x4ml
- Sodium Chloride 3% Inj, 500ml
- Sod Chloride 23.4% Inj, 200ml
- Sod Chloride 0.9% Neb Sol 25 X 5ml
- Sod Chloride 0.9% Neb Sol 100 X 3ml
- Sod Chloride 0.9% Neb Sol 50 X 15ml
- Sodium Chloride 10% Neb Sol 60x4ml
- Sodium Chloride 0.9% Inj, 2ml
- Sodium Chloride 2.5meq/ml Inj, 20ml
- Sodium Chloride 2.5meq/ml Inj, 40ml
- Sod Chloride 4meq/ml Inj, 25x30ml
- Sod Chloride 5% Ophth Soln 15ml
- Sod Chloride 0.9% Inj, 1000ml
- Sodium Chloride 3% Neb Sol 30x4ml
- Sodium Chloride 7% Neb Sol 30x4ml
- Sodium Chloride 3% Neb Sol 60x4ml
- Sod Chloride 0.9% Inj, 250ml
- Sod Chloride 0.9% Inj, 150ml
- Sodium Chloride 0.9% Inj,100ml
- Sod Chloride 0.9% Inj, 25ml
- Sod Chloride 0.9% Inj, 125ml
- Sod Chloride 0.45% Inj, 250ml
- Sod Chloride 0.45% Inj, 50ml
- Sod Chloride 0.45% Inj, 100ml
- Sod Chloride 5% Inj, 500ml
- Sod Chloride 0.45%/20meq Kcl
Dosing & Administration
Adult Dosing
Standard Dose:
Individualized based on patient's fluid and electrolyte status, clinical condition, and hydration needs. Typical infusion rates vary from 75 mL/hour to 200 mL/hour for maintenance, or higher for rehydration.
Condition-Specific Dosing:
maintenance_fluid:
Typically 75-125 mL/hour
dehydration:
Higher rates as clinically indicated, with careful monitoring
Pediatric Dosing
Neonatal:
Individualized based on weight, age, and clinical status. Careful monitoring of fluid balance and electrolytes is crucial due to immature renal function.
Infant:
Individualized based on weight, age, and clinical status. Careful monitoring of fluid balance and electrolytes is crucial.
Child:
Individualized based on weight, age, and clinical status. Careful monitoring of fluid balance and electrolytes is crucial.
Adolescent:
Individualized based on weight, age, and clinical status, similar to adult dosing but adjusted for body surface area/weight.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor fluid balance and electrolytes closely.
Moderate:
Use with caution; monitor fluid balance and electrolytes closely. Reduced infusion rates may be necessary to prevent fluid overload.
Severe:
Contraindicated or used with extreme caution and close monitoring due to high risk of fluid overload, pulmonary edema, and electrolyte disturbances.
Dialysis:
Generally avoided or used in very small, carefully calculated volumes to prevent interdialytic weight gain and fluid overload. Consult nephrology.
Hepatic Impairment:
Mild:
No specific adjustment, but monitor for fluid retention if ascites or edema are present.
Moderate:
Monitor closely for fluid retention and electrolyte imbalances, especially if associated with renal dysfunction.
Severe:
Use with extreme caution due to increased risk of fluid overload, ascites, and electrolyte disturbances. May exacerbate cerebral edema in hepatic encephalopathy.
Pharmacology
Mechanism of Action
0.45% Sodium Chloride Injection is a hypotonic crystalloid solution. It provides water and electrolytes (sodium and chloride) to the extracellular fluid compartment. Due to its hypotonicity relative to plasma, it causes a net shift of water from the extracellular space into the intracellular space, effectively rehydrating cells. It helps maintain osmotic pressure, expand extracellular fluid volume, and replenish lost water and electrolytes.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Immediate (upon intravenous administration)
FoodEffect:
Not applicable
Distribution:
Vd:
Distributes throughout the total body water, with initial distribution primarily to the extracellular fluid compartment.
ProteinBinding:
Not applicable (ions do not bind to plasma proteins in a significant manner)
CnssPenetration:
Yes (water and ions readily cross the blood-brain barrier)
Elimination:
HalfLife:
Variable (depends on fluid balance, renal function, and clinical need)
Clearance:
Primarily renal excretion of excess water and electrolytes.
ExcretionRoute:
Renal
Unchanged:
100% (ions are excreted as ions)
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Within minutes of infusion completion, depending on volume administered and patient's fluid status.
DurationOfAction:
Variable, depends on patient's hydration status, renal function, and ongoing fluid losses.
Note:
The primary effect is expansion of extracellular and intracellular fluid volume and provision of free water.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
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 immediately or seek emergency 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
Signs of fluid and electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or fainting
+ Increased thirst
+ Seizures
+ Feeling extremely tired or weak
+ Decreased appetite
+ Difficulty urinating or changes in urine output
+ Dry mouth
+ Dry eyes
+ Severe nausea or vomiting
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
Swelling, warmth, numbness, color changes, 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. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Irritation or swelling at the injection site
* Pain at the injection site
Reporting Side Effects
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.
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 immediately or seek emergency 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
Signs of fluid and electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain or weakness
+ Fast or abnormal heartbeat
+ Severe dizziness or fainting
+ Increased thirst
+ Seizures
+ Feeling extremely tired or weak
+ Decreased appetite
+ Difficulty urinating or changes in urine output
+ Dry mouth
+ Dry eyes
+ Severe nausea or vomiting
Signs of skin infection, such as:
+ Oozing
+ Heat
+ Swelling
+ Redness
+ Pain
Swelling, warmth, numbness, color changes, 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. While many people may not experience any side effects or only minor ones, it's essential to discuss any concerns with your doctor. If you experience any of the following side effects or any other unusual symptoms, contact your doctor for advice:
Irritation or swelling at the injection site
* Pain at the injection site
Reporting Side Effects
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.
Seek Immediate Medical Attention If You Experience:
- Swelling in your ankles, feet, or hands (edema)
- Shortness of breath or difficulty breathing
- Sudden weight gain
- Headache
- Nausea or vomiting
- Confusion or dizziness
- Muscle cramps or weakness
- Seizures (rare, but serious sign of severe electrolyte imbalance)
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.
Potential interactions with other medications or health conditions. This medication may affect or be affected by other drugs or health problems, so it is crucial to disclose all relevant information.
To ensure your safety, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are currently taking
Any natural products or vitamins you are using
* Existing health problems or conditions
Carefully review your medication regimen and health status with your doctor to confirm that it is safe to take this medication in conjunction with your other drugs and health conditions. Do not initiate, discontinue, or modify the dosage of any medication without first consulting 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.
Potential interactions with other medications or health conditions. This medication may affect or be affected by other drugs or health problems, so it is crucial to disclose all relevant information.
To ensure your safety, provide your doctor and pharmacist with a comprehensive list of:
All prescription and over-the-counter (OTC) medications you are currently taking
Any natural products or vitamins you are using
* Existing health problems or conditions
Carefully review your medication regimen and health status with your doctor to confirm that it is safe to take this medication in conjunction with your other drugs and health conditions. Do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor.
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 any salt substitutes or products that also contain 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 will be necessary as directed by your doctor. Be sure to discuss any concerns or questions you have with your doctor.
When administering this medication to newborns, exercise caution, as the risk of side effects may be increased in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
If your medication contains potassium, consult your doctor before using any salt substitutes or products that also contain 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 will be necessary as directed by your doctor. Be sure to discuss any concerns or questions you have with your doctor.
When administering this medication to newborns, exercise caution, as the risk of side effects may be increased in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Fluid overload (pulmonary edema, peripheral edema, hypertension, heart failure)
- Hyponatremia (headache, nausea, vomiting, lethargy, confusion, seizures, coma)
- Hypernatremia (if excessive free water loss occurs concurrently, or if patient is unable to excrete excess sodium)
- Electrolyte imbalances (e.g., hypokalemia, hyperchloremic acidosis)
What to Do:
Discontinue infusion immediately. Management is supportive and depends on the specific symptoms and electrolyte imbalances. May involve diuretics for fluid overload, or hypertonic saline for severe symptomatic hyponatremia. Call 1-800-222-1222 (Poison Control) or seek immediate medical attention.
Drug Interactions
Contraindicated Interactions
- Patients with cerebral edema or conditions where increased intracranial pressure is a concern (e.g., acute stroke, head trauma) due to risk of exacerbating edema.
- Patients with severe hyponatremia (unless carefully managed to avoid rapid correction).
Major Interactions
- Corticosteroids (e.g., Prednisone, Dexamethasone): May increase sodium and fluid retention, leading to fluid overload and edema.
- Drugs causing sodium retention (e.g., NSAIDs): Increased risk of fluid overload.
Moderate Interactions
- Diuretics (e.g., Furosemide, Hydrochlorothiazide): May alter electrolyte balance; monitor serum electrolytes closely.
- Lithium: Changes in sodium balance can affect lithium excretion, potentially leading to lithium toxicity or subtherapeutic levels. Monitor lithium levels.
Monitoring
Baseline Monitoring
Serum Electrolytes (Na+, K+, Cl-)
Rationale: To establish 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, I&O, Weight, Edema)
Rationale: To assess baseline hydration status and identify signs of fluid overload or deficit.
Timing: Prior to initiation of therapy
Routine Monitoring
Fluid Intake and Output (I&O)
Frequency: Every 4-8 hours or as clinically indicated
Target: Balanced or as per clinical goal
Action Threshold: Significant positive or negative balance; signs of fluid overload/deficit
Vital Signs (BP, HR, RR)
Frequency: Every 4-8 hours or as clinically indicated
Target: Within normal limits for patient
Action Threshold: Significant changes indicating fluid overload (e.g., hypertension, tachycardia) or dehydration (e.g., hypotension, tachycardia)
Serum Electrolytes (Na+, K+, Cl-)
Frequency: Daily or more frequently if clinically indicated (e.g., every 6-12 hours in critically ill patients)
Target: Na+ 135-145 mEq/L, K+ 3.5-5.0 mEq/L, Cl- 98-106 mEq/L
Action Threshold: Hyponatremia (<135 mEq/L), hypernatremia (>145 mEq/L), or other significant electrolyte imbalances
Body Weight
Frequency: Daily
Target: Stable or as per clinical goal
Action Threshold: Rapid weight gain (>1-2 kg/day) indicating fluid retention
Signs of Fluid Overload (e.g., peripheral edema, crackles, dyspnea, JVD)
Frequency: Ongoing clinical assessment
Target: Absence of signs
Action Threshold: Presence or worsening of signs
Symptom Monitoring
- Headache
- Nausea
- Vomiting
- Confusion
- Lethargy
- Muscle weakness
- Cramps
- Seizures (signs of severe hyponatremia)
- Shortness of breath
- Cough
- Swelling (edema)
Special Patient Groups
Pregnancy
Generally considered safe and commonly used for hydration and fluid management during pregnancy. However, fluid and electrolyte status should be closely monitored to avoid complications like fluid overload or electrolyte imbalances.
Trimester-Specific Risks:
First Trimester:
No known specific risks.
Second Trimester:
No known specific risks.
Third Trimester:
No known specific risks, but careful monitoring for fluid overload is important, especially in pre-eclampsia or other conditions with fluid retention.
Lactation
Considered safe for use during lactation. Sodium chloride is a natural component of breast milk, and intravenous administration is unlikely to pose a risk to the nursing infant.
Infant Risk:
Low risk (L1)
Pediatric Use
Use with extreme caution and precise calculation of fluid volumes and rates due to the higher risk of fluid overload, hyponatremia, and cerebral edema in children, especially infants and neonates, who have less compensatory reserve and different body water distribution. Close monitoring of fluid balance, weight, and electrolytes is essential.
Geriatric Use
Use with caution due to increased risk of fluid overload, pulmonary edema, and electrolyte imbalances in elderly patients, who often have comorbidities such as cardiac, renal, or hepatic impairment. Reduced renal function and decreased compensatory mechanisms necessitate slower infusion rates and meticulous monitoring of fluid status and electrolytes.
Clinical Information
Clinical Pearls
- 0.45% NaCl is a hypotonic solution, meaning it provides more free water than 0.9% NaCl. This makes it useful for cellular rehydration but also increases the risk of hyponatremia.
- Not suitable for rapid volume expansion or resuscitation, as a significant portion of the fluid will shift intracellularly.
- Always monitor serum sodium levels closely, especially in patients at risk for hyponatremia (e.g., SIADH, post-operative patients, those with cerebral pathology).
- Avoid in patients with cerebral edema or conditions where increased intracranial pressure is a concern, as it can worsen brain swelling.
- Careful monitoring of fluid intake/output, daily weights, and clinical signs of fluid overload (e.g., crackles, edema, dyspnea) is paramount, particularly in patients with cardiac or renal dysfunction.
- Often used as a maintenance fluid when patients require free water and some electrolytes, or in hypernatremia to gradually lower serum sodium.
Alternative Therapies
- 0.9% Sodium Chloride Injection (Isotonic Saline): For volume expansion, resuscitation, and general fluid replacement.
- Lactated Ringer's Injection: For volume expansion, resuscitation, and electrolyte replacement, particularly when lactate metabolism is desired.
- Dextrose 5% in Water (D5W): Primarily provides free water for cellular rehydration and calories, but no electrolytes.
- Dextrose 5% in 0.45% Sodium Chloride (D5 1/2 NS): Provides both free water, some electrolytes, and calories.
Cost & Coverage
Average Cost:
$5 - $20 per 250ml bag
Generic Available:
Yes
Insurance Coverage:
Tier 1 (covered by most insurance plans as a medical supply/service)
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, never share your medication with others, and do not take medication prescribed for 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, avoid flushing medications down the toilet or pouring them down the drain. If you are unsure about the correct disposal method, consult your pharmacist for guidance. 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 medical attention. Be prepared to provide details about the medication taken, the amount, and the time it occurred.