Sod Chloride 0.9% Excel 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
Crystalloid Solution; Isotonic Solution
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium Chloride 0.9% Injection, often called 'normal saline' or 'salt water IV,' is a clear liquid given through a vein (intravenously). It's used to replace fluids and salts that your body might be missing, or to help deliver other medicines.
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 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 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 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 swelling, difficulty breathing, or unusual symptoms to your healthcare provider immediately.
- Maintain good oral hygiene if you are on fluid restrictions or have a dry mouth.
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 clinical condition, fluid and electrolyte status, and concomitant therapy.
Condition-Specific Dosing:
hydration:
Typically 500 mL to 3 L per 24 hours, adjusted to patient's needs.
drugDilution:
Volume as required for specific drug dilution and administration rate.
hypovolemia:
Rapid infusion (e.g., 500-1000 mL over 15-60 minutes) for acute volume expansion, then adjusted.
Pediatric Dosing
Neonatal:
Highly individualized; typically 10-20 mL/kg bolus for volume expansion, then maintenance rates (e.g., 60-100 mL/kg/day) adjusted for clinical status.
Infant:
Highly individualized; typically 10-20 mL/kg bolus for volume expansion, then maintenance rates (e.g., 60-100 mL/kg/day) adjusted for clinical status.
Child:
Highly individualized; typically 10-20 mL/kg bolus for volume expansion, then maintenance rates (e.g., 60-100 mL/kg/day) adjusted for clinical status.
Adolescent:
Highly individualized; typically 10-20 mL/kg bolus for volume expansion, then maintenance rates (e.g., 60-100 mL/kg/day) adjusted for clinical status.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor fluid balance and electrolytes.
Moderate:
Use with caution; monitor fluid balance and electrolytes closely to avoid fluid overload and hypernatremia.
Severe:
Use with extreme caution; monitor fluid balance and electrolytes closely. May require fluid restriction or alternative solutions.
Dialysis:
Considerations: Administer post-dialysis or as directed by nephrologist to manage fluid status and avoid interdialytic weight gain.
Hepatic Impairment:
Mild:
Adjustment: Monitor fluid balance and electrolytes.
Moderate:
Adjustment: Monitor fluid balance and electrolytes closely, especially in conditions with ascites or edema.
Severe:
Adjustment: Use with caution; monitor fluid balance and electrolytes closely due to increased risk of fluid retention and electrolyte disturbances.
Pharmacology
Mechanism of Action
Sodium Chloride 0.9% Injection is an isotonic solution that provides water and electrolytes (sodium and chloride) to maintain osmotic pressure and expand the extracellular fluid volume. It is primarily used for hydration, to restore fluid and sodium losses, and as a vehicle for the intravenous administration of other compatible drugs.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous administration)
Tmax:
Not applicable (continuous infusion)
FoodEffect:
Not applicable
Distribution:
Vd:
Approximately 0.28 L/kg (distributes primarily to the extracellular fluid compartment)
ProteinBinding:
Not protein-bound
CnssPenetration:
Yes, freely crosses the blood-brain barrier
Elimination:
HalfLife:
Not applicable for ions; fluid half-life is short (minutes to hours) depending on hydration status and renal function.
Clearance:
Primarily renal excretion, regulated by kidneys to maintain fluid and electrolyte balance.
ExcretionRoute:
Renal
Unchanged:
100% (ions are excreted as such)
Pharmacodynamics
OnsetOfAction:
Immediate (upon intravenous administration)
PeakEffect:
Immediate
DurationOfAction:
Short, dependent on patient's hydration status, renal function, and ongoing fluid losses.
Safety & Warnings
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 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
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of fluid and electrolyte problems, such as:
+ 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 may only have mild side effects. If you experience any of the following side effects or any other side effects that bother you or do not go away, contact your doctor or seek medical help:
Irritation or swelling at the injection site
* Pain at the injection site
Reporting Side Effects
This is not a complete list of possible side effects. If you have questions about side effects, contact 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 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
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of fluid and electrolyte problems, such as:
+ 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 may only have mild side effects. If you experience any of the following side effects or any other side effects that bother you or do not go away, contact your doctor or seek medical help:
Irritation or swelling at the injection site
* Pain at the injection site
Reporting Side Effects
This is not a complete list of possible side effects. If you have questions about side effects, contact 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
- Difficulty breathing or shortness of breath
- Sudden weight gain
- Headache
- Confusion or dizziness
- Nausea or vomiting
- Muscle weakness or cramps
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.
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.
* Any existing health problems, as this medication may interact with other medical conditions.
To ensure your safety, carefully review all your medications and health issues with your doctor and pharmacist. Do not start, stop, or modify 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 symptoms you experienced.
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.
* Any existing health problems, as this medication may interact with other medical conditions.
To ensure your safety, carefully review all your medications and health issues with your doctor and pharmacist. Do not start, stop, or modify 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 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, to monitor your health. Be sure to follow your doctor's instructions and discuss any concerns or questions you may have.
When administering this medication to newborns, exercise caution, as they may have a higher risk of experiencing side effects.
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, to monitor your health. Be sure to follow your doctor's instructions and discuss any concerns or questions you may have.
When administering this medication to newborns, exercise caution, as they may have a higher risk of experiencing side effects.
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 (e.g., pulmonary edema, peripheral edema, hypertension, tachycardia)
- Hypernatremia (e.g., thirst, lethargy, confusion, seizures, coma)
- Hyperchloremia (e.g., metabolic acidosis)
What to Do:
Discontinue infusion immediately. Management is supportive and includes diuretics to promote fluid excretion, correction of electrolyte imbalances, and respiratory support if pulmonary edema is severe. Call 1-800-222-1222 (Poison Control) or seek immediate medical attention.
Drug Interactions
Major Interactions
- Corticosteroids (e.g., Prednisone, Dexamethasone): May enhance sodium retention, increasing risk of edema and hypernatremia.
- Lithium: Sodium depletion can decrease renal clearance of lithium, leading to increased lithium levels and toxicity. Conversely, sodium loading can increase lithium excretion.
Moderate Interactions
- Drugs causing sodium retention (e.g., NSAIDs, some antihypertensives): Increased risk of fluid overload and hypernatremia.
- Diuretics (e.g., Furosemide, Hydrochlorothiazide): May alter fluid and electrolyte balance, requiring careful monitoring to avoid hypo- or hypernatremia depending on the diuretic type and patient's condition.
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl)
Rationale: To establish baseline electrolyte status and identify pre-existing imbalances.
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 risk of fluid overload.
Timing: Prior to initiation of therapy.
Routine Monitoring
Fluid Balance (Intake and Output)
Frequency: Every 4-8 hours or as clinically indicated.
Target: Balanced or as per physician orders.
Action Threshold: Significant positive or negative balance; signs of fluid overload or dehydration.
Vital Signs (BP, HR, RR)
Frequency: Every 4-8 hours or as clinically indicated.
Target: Within patient's normal limits.
Action Threshold: Significant changes indicating fluid overload (e.g., elevated BP, tachycardia) or dehydration (e.g., orthostatic hypotension, tachycardia).
Serum Electrolytes (Na, K, Cl)
Frequency: Daily or as clinically indicated, especially with large volumes or renal impairment.
Target: Na: 135-145 mEq/L; K: 3.5-5.0 mEq/L; Cl: 98-106 mEq/L.
Action Threshold: Values outside normal range, particularly hypernatremia or significant shifts.
Physical Assessment (Edema, Lung Sounds, Skin Turgor)
Frequency: Daily or as clinically indicated.
Target: No new or worsening edema, clear lung sounds, normal skin turgor.
Action Threshold: Development of peripheral or pulmonary edema, crackles, decreased skin turgor.
Symptom Monitoring
- Signs of fluid overload (e.g., peripheral edema, pulmonary edema, dyspnea, crackles, weight gain, elevated blood pressure, jugular venous distension)
- Signs of electrolyte imbalance (e.g., hypernatremia: thirst, lethargy, confusion, seizures; hyponatremia: headache, nausea, vomiting, confusion, seizures)
- Headache
- Nausea
- Vomiting
- Confusion
- Muscle weakness or cramps
Special Patient Groups
Pregnancy
Generally considered safe for use during pregnancy when clinically indicated for fluid and electrolyte replacement. However, careful monitoring of fluid balance and electrolytes is essential to avoid fluid overload or electrolyte disturbances in both mother and fetus.
Trimester-Specific Risks:
First Trimester:
No known specific risks, but careful monitoring is always advised.
Second Trimester:
No known specific risks, but careful monitoring is always advised.
Third Trimester:
No known specific risks, but careful monitoring is always advised. Risk of fluid overload may be slightly higher due to physiological changes.
Lactation
Sodium chloride is a natural component of breast milk. Administration of 0.9% Sodium Chloride Injection is generally considered safe during lactation and is not expected to harm the breastfed infant.
Infant Risk:
L1 (Safest - compatible with breastfeeding)
Pediatric Use
Dosing must be highly individualized based on weight, age, clinical condition, and fluid/electrolyte status. Pediatric patients, especially neonates and infants, have immature renal function and are more susceptible to fluid overload and electrolyte imbalances. Close monitoring of fluid intake/output, weight, and serum electrolytes is crucial.
Geriatric Use
Elderly patients are at increased risk of fluid overload, hypernatremia, and electrolyte imbalances due to age-related decreases in renal function, cardiac reserve, and thirst perception. Use with caution, initiate at lower rates, and monitor fluid balance and electrolytes closely.
Clinical Information
Clinical Pearls
- 0.9% Sodium Chloride is an isotonic solution, meaning it has a similar osmolality to human plasma, making it ideal for intravascular volume expansion without significant fluid shifts into or out of cells.
- It is the most commonly used intravenous fluid for hydration, resuscitation, and as a diluent for medications.
- While generally safe, excessive administration can lead to fluid overload (hypervolemia), hypernatremia, and hyperchloremic metabolic acidosis.
- Always assess patient's fluid status, renal function, and electrolyte levels before and during administration.
- Not suitable for patients with severe heart failure, renal failure, or conditions requiring free water (e.g., hypernatremia with dehydration).
Alternative Therapies
- Dextrose 5% in Water (D5W): Provides free water and some calories, but is hypotonic once dextrose is metabolized.
- Dextrose 5% in 0.45% Sodium Chloride (D5 1/2 NS): Hypotonic solution used for maintenance fluids.
- Colloid solutions (e.g., Albumin, Hetastarch): Used for more rapid and sustained intravascular volume expansion, but carry different risks and are more expensive.
Cost & Coverage
Average Cost:
$5 - $20 per 250ml bag
Generic Available:
Yes
Insurance Coverage:
Typically covered by most health insurance plans as it is a fundamental hospital supply and medication diluent.
General Drug Facts
If your symptoms or health problems do not improve or worsen over time, 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.
Proper disposal of unused or expired medications is crucial. Do not dispose of them by flushing down the toilet or pouring down the drain unless specifically instructed to do so. If you are unsure about the correct disposal method, consult your pharmacist for advice. Many communities have drug take-back programs, which your pharmacist can help you locate.
Some medications may come with an additional patient information leaflet. Your pharmacist can provide this information if available. If you have any questions or concerns about your medication, it is best to 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 detailed information about the overdose, including the name of the medication, the amount taken, and the time it occurred, to ensure prompt and effective treatment.
Proper disposal of unused or expired medications is crucial. Do not dispose of them by flushing down the toilet or pouring down the drain unless specifically instructed to do so. If you are unsure about the correct disposal method, consult your pharmacist for advice. Many communities have drug take-back programs, which your pharmacist can help you locate.
Some medications may come with an additional patient information leaflet. Your pharmacist can provide this information if available. If you have any questions or concerns about your medication, it is best to 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 detailed information about the overdose, including the name of the medication, the amount taken, and the time it occurred, to ensure prompt and effective treatment.