Sod Chloride 0.45% Inj, 50ml
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
Electrolyte and Fluid Replacement
Pharmacologic Class
Crystalloid Solution; Hypotonic
Pregnancy Category
Not available
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium Chloride 0.45% Injection is a sterile salt water solution given through a vein (intravenously). It's used to help your body stay hydrated and to maintain the right balance of salts (electrolytes) in your blood, especially when you can't drink enough fluids or have lost a lot of body fluids.
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
- This medication is administered by healthcare professionals in a clinical setting.
- Report any discomfort at the injection site (pain, swelling, redness) immediately.
- Report any new or worsening symptoms such as swelling in your hands, feet, or ankles, difficulty breathing, or unusual thirst.
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:
Highly individualized based on patient's fluid and electrolyte status, clinical condition, and concomitant therapy. Typically administered as a continuous intravenous infusion.
Condition-Specific Dosing:
maintenanceFluid:
Typically 75-150 mL/hour, adjusted based on patient's needs and output.
dehydration:
Variable, depending on severity and type of dehydration, often used after initial resuscitation with isotonic fluids.
Pediatric Dosing
Neonatal:
Highly individualized, often 2-4 mL/kg/hour for maintenance, with careful monitoring of electrolytes and fluid balance.
Infant:
Highly individualized, often 2-4 mL/kg/hour for maintenance, with careful monitoring of electrolytes and fluid balance.
Child:
Highly individualized, often 2-4 mL/kg/hour for maintenance, with careful monitoring of electrolytes and fluid balance.
Adolescent:
Highly individualized, often 75-150 mL/hour for maintenance, with careful monitoring of electrolytes and fluid balance.
Dose Adjustments
Renal Impairment:
Mild:
Adjust dose based on fluid and electrolyte status; monitor closely.
Moderate:
Adjust dose based on fluid and electrolyte status; monitor closely, may require reduced rates to prevent fluid overload.
Severe:
Use with extreme caution; significant dose reduction or avoidance may be necessary; monitor fluid balance, electrolytes, and renal function closely. May contribute to fluid overload.
Dialysis:
Use with extreme caution; fluid and electrolyte balance must be precisely managed in consultation with nephrology.
Hepatic Impairment:
Mild:
Adjust dose based on fluid and electrolyte status; monitor closely.
Moderate:
Adjust dose based on fluid and electrolyte status; monitor closely, especially for fluid retention and electrolyte imbalances.
Severe:
Adjust dose based on fluid and electrolyte status; monitor closely, especially for fluid retention, ascites, and electrolyte imbalances. May require reduced rates.
Pharmacology
Mechanism of Action
0.45% Sodium Chloride Injection (half-normal saline) is a hypotonic crystalloid solution relative to plasma. It provides water, sodium, and chloride ions. When administered intravenously, it expands the extracellular fluid compartment, including the interstitial and intravascular spaces. Due to its hypotonicity, it provides more free water than 0.9% Sodium Chloride, allowing water to shift from the extracellular space into the intracellular space, aiding in cellular rehydration and excretion of solutes.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Immediate
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.2 L/kg (extracellular fluid volume)
ProteinBinding:
Not applicable (ions)
CnssPenetration:
Limited (ions can cross blood-brain barrier, but regulated)
Elimination:
HalfLife:
Not applicable (ions are continuously regulated)
Clearance:
Primarily renal excretion, regulated by kidneys based on fluid and electrolyte balance.
ExcretionRoute:
Renal
Unchanged:
Not applicable (ions are regulated)
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Within minutes of infusion completion, depending on volume and rate.
DurationOfAction:
Variable, depends on patient's fluid and electrolyte status, renal function, and ongoing losses. Effects on fluid compartments are transient as water and electrolytes are continuously regulated.
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
+ Unable to pass urine or changes in urine output
+ Dry mouth
+ Dry eyes
+ Severe stomach upset 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
This is not an exhaustive list of possible side effects. If you have questions or concerns, don't hesitate to reach out to 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
+ Unable to pass urine or changes in urine output
+ Dry mouth
+ Dry eyes
+ Severe stomach upset 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
This is not an exhaustive list of possible side effects. If you have questions or concerns, don't hesitate to reach out to 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 hands, feet, or ankles (edema)
- Shortness of breath or difficulty breathing
- Headache
- Nausea or vomiting
- Confusion or disorientation
- Muscle weakness or cramps
- Unusual thirst
- Dizziness or lightheadedness
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 allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to ensure safe use and avoid potential interactions.
* Any existing health problems, as this medication may interact with other medical conditions or drugs.
To guarantee your safety, carefully review all your medications and health issues with your doctor and pharmacist. Never start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm it is safe to do so.
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 allergic reaction you experienced, including any symptoms that occurred.
All medications you are currently taking, including prescription and over-the-counter (OTC) drugs, natural products, and vitamins. This is crucial to ensure safe use and avoid potential interactions.
* Any existing health problems, as this medication may interact with other medical conditions or drugs.
To guarantee your safety, carefully review all your medications and health issues with your doctor and pharmacist. Never start, stop, or adjust the dosage of any medication without first consulting your doctor to confirm it is safe to do so.
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 will be necessary as directed by your doctor. Be sure to follow their instructions and discuss any concerns or questions you may have.
When administering this medication to a newborn, exercise caution due to the potential for a higher risk of side effects in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to consult your doctor. They will help you weigh the benefits and risks of taking this medication to ensure the best outcome for both you and your baby.
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 will be necessary as directed by your doctor. Be sure to follow their instructions and discuss any concerns or questions you may have.
When administering this medication to a newborn, exercise caution due to the potential for a higher risk of side effects in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to consult your doctor. They will help you weigh the benefits and risks of taking this medication to ensure the best outcome for both you and your baby.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., pulmonary edema, peripheral edema, hypertension, heart failure)
- Hypernatremia (high sodium levels: thirst, lethargy, confusion, seizures, coma)
- Electrolyte imbalances (e.g., hyperchloremia, hypokalemia due to dilution)
What to Do:
Overdose requires immediate medical attention. Treatment involves discontinuing the infusion, administering diuretics to promote fluid and electrolyte excretion, and correcting severe electrolyte imbalances. In severe cases, dialysis may be necessary. Call 911 or your local emergency number immediately.
Drug Interactions
Major Interactions
- Drugs causing sodium retention (e.g., corticosteroids, NSAIDs): May increase risk of fluid overload and hypernatremia.
- Drugs causing potassium depletion (e.g., loop diuretics, thiazide diuretics): May exacerbate electrolyte imbalances if not carefully monitored.
Moderate Interactions
- Lithium: Changes in sodium intake or excretion can affect lithium levels. Increased sodium intake may decrease lithium levels.
- Drugs affecting ADH secretion (e.g., desmopressin, carbamazepine): May alter water balance and increase risk of hyponatremia or hypernatremia.
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 (Weight, Vital Signs, Edema)
Rationale: To assess baseline hydration status and risk of fluid overload.
Timing: Prior to initiation of therapy.
Routine Monitoring
Fluid Intake and Output (I&O)
Frequency: Every 4-8 hours or continuously, depending on clinical status.
Target: Balanced I&O or as clinically indicated.
Action Threshold: Significant positive or negative fluid balance; notify prescriber.
Serum Electrolytes (Na+, K+, Cl-)
Frequency: Daily or more frequently (e.g., every 6-12 hours) in critically ill patients or those with significant fluid shifts.
Target: Sodium: 135-145 mEq/L; Potassium: 3.5-5.0 mEq/L; Chloride: 98-107 mEq/L.
Action Threshold: Sodium <130 mEq/L or >150 mEq/L; Potassium <3.0 mEq/L or >5.5 mEq/L; notify prescriber.
Vital Signs (BP, HR, RR, Temp)
Frequency: Every 4 hours or more frequently as clinically indicated.
Target: Within patient's normal limits.
Action Threshold: Significant changes indicating fluid overload (e.g., hypertension, tachycardia, tachypnea) or dehydration (e.g., hypotension, tachycardia); notify prescriber.
Body Weight
Frequency: Daily, especially in patients at risk for fluid overload.
Target: Stable or as desired.
Action Threshold: Rapid weight gain (>1-2 kg/day) or loss; notify prescriber.
Signs of Fluid Overload (Edema, Crackles, JVD)
Frequency: Ongoing clinical assessment.
Target: Absence of signs.
Action Threshold: Presence or worsening of signs; notify prescriber.
Symptom Monitoring
- Signs of fluid overload: peripheral edema, pulmonary crackles/rales, dyspnea, jugular venous distension (JVD), hypertension, headache, nausea, vomiting.
- Signs of electrolyte imbalance (hyponatremia/hypernatremia): confusion, lethargy, seizures, muscle weakness, irritability, thirst, dry mucous membranes.
Special Patient Groups
Pregnancy
Sodium chloride is a naturally occurring and essential electrolyte. When administered appropriately to correct fluid and electrolyte imbalances, 0.45% Sodium Chloride Injection is generally considered safe for use during pregnancy. Close monitoring of fluid and electrolyte status is crucial to avoid complications for both mother and fetus.
Trimester-Specific Risks:
First Trimester:
No known specific risks when used appropriately.
Second Trimester:
No known specific risks when used appropriately.
Third Trimester:
No known specific risks when used appropriately. Careful monitoring for fluid overload is important, especially in pre-eclampsia or other conditions with fluid retention.
Lactation
Sodium chloride is a natural component of breast milk. Administration of 0.45% Sodium Chloride Injection to the mother is generally considered safe during lactation and is not expected to harm the breastfed infant or affect milk production.
Infant Risk:
Low risk. No adverse effects on breastfed infants are expected.
Pediatric Use
Pediatric patients, especially neonates and infants, are at higher risk for fluid and electrolyte imbalances due to their immature renal function and higher body water content. Dosing must be carefully calculated based on weight and clinical status, and fluid and electrolyte levels must be monitored frequently to prevent hyponatremia, hypernatremia, or fluid overload.
Geriatric Use
Geriatric patients may have age-related decreases in renal function, cardiac reserve, and altered fluid regulation, increasing their susceptibility to fluid overload and electrolyte disturbances. Use with caution, initiate at lower rates, and monitor fluid balance, electrolytes, and cardiovascular status closely.
Clinical Information
Clinical Pearls
- 0.45% Sodium Chloride is a hypotonic solution, meaning it has a lower solute concentration than plasma. It is primarily used as a maintenance fluid or for conditions where free water is needed (e.g., hypernatremia, cellular dehydration).
- Not suitable for initial volume resuscitation in hypovolemic shock, as it is hypotonic and will not remain in the intravascular space effectively.
- Always assess patient's fluid status, serum electrolytes, and renal function before and during administration.
- Risk of hyponatremia is lower than with D5W alone, but still present if administered excessively or in patients with impaired free water excretion (e.g., SIADH).
- Risk of fluid overload is present, especially in patients with cardiac or renal impairment.
- Often combined with dextrose (e.g., D5 0.45% NaCl) to provide calories and prevent ketosis during maintenance fluid therapy.
Alternative Therapies
- 0.9% Sodium Chloride Injection (Normal Saline - isotonic, for volume expansion)
- Lactated Ringer's Injection (Isotonic, balanced electrolyte solution, for volume expansion and electrolyte replacement)
- Dextrose 5% in Water (D5W - isotonic in bag, but physiologically hypotonic, provides free water)
- Oral rehydration solutions (for mild to moderate dehydration, if patient can tolerate oral intake)
Cost & Coverage
Average Cost:
Very low per 50mL bag
Generic Available:
Yes
Insurance Coverage:
Generally covered by most health insurance plans as a standard medical supply/medication when administered in a healthcare setting.
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 or take someone else's medication. 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; do not flush them down the toilet or pour them down the drain unless instructed to do so by a healthcare professional or pharmacist. If you are unsure about the correct disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Additionally, some medications may come with a separate patient information leaflet, which your pharmacist can provide. 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 information about the medication taken, the amount, and the time it occurred.