Sod Chloride 0.9% Inj, 150ml
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; Plasma Volume Expander
Pharmacologic Class
Isotonic Crystalloid Solution; Electrolyte
Pregnancy Category
Category A
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium Chloride 0.9% Injection, also known as 'normal saline,' is a sterile salt water solution given through a vein (IV). It's used to replace fluids and salts your body needs, especially if you're dehydrated, have lost blood, or need a way to get other medicines into your body.
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 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 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 weight gain immediately.
- Inform healthcare providers of any pre-existing heart, kidney, or liver conditions.
- Maintain good oral hygiene if experiencing 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 variable, typically 500 mL to 3000 mL per 24 hours, adjusted based on patient's fluid and electrolyte status, clinical condition, and concomitant medications.
Dose Range:
500 - 3000 mg
Condition-Specific Dosing:
dehydration:
1000 mL over 1-2 hours, then adjusted
maintenance:
1000-2000 mL/day
drug_dilution:
Variable, as per drug specific instructions
Pediatric Dosing
Neonatal:
Highly individualized, typically 10-20 mL/kg/dose for bolus, then maintenance rates based on weight and clinical need (e.g., 60-100 mL/kg/day).
Infant:
Highly individualized, typically 10-20 mL/kg/dose for bolus, then maintenance rates based on weight and clinical need (e.g., 80-120 mL/kg/day).
Child:
Highly individualized, typically 10-20 mL/kg/dose for bolus, then maintenance rates based on weight and clinical need (e.g., 100-150 mL/kg/day).
Adolescent:
Similar to adult dosing, adjusted for weight and clinical need.
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment, monitor fluid and electrolyte balance closely.
Moderate:
Use with caution, monitor fluid and electrolyte balance (especially sodium and chloride) frequently to avoid fluid overload and hypernatremia/hyperchloremia.
Severe:
Use with extreme caution, often contraindicated or requires significant reduction in volume and rate, close monitoring of fluid balance, electrolytes, and renal function. Risk of fluid overload and electrolyte disturbances is high.
Dialysis:
Administer post-dialysis or with extreme caution during dialysis, as fluid and electrolyte balance are tightly controlled by dialysis. Consult nephrologist.
Hepatic Impairment:
Mild:
No specific adjustment.
Moderate:
Use with caution in patients with significant ascites or edema due to potential for fluid retention; monitor fluid balance.
Severe:
Use with caution, monitor for fluid overload and electrolyte disturbances, especially in patients with cirrhosis and portal hypertension.
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 of the extracellular fluid. It expands the extracellular fluid volume, including the interstitial and intravascular fluid compartments. Sodium is the principal cation of the extracellular fluid and plays a large part in fluid and electrolyte balance. Chloride is the major extracellular anion.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous administration)
Tmax:
Immediate (upon infusion completion)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.2 L/kg (extracellular fluid volume)
ProteinBinding:
Not applicable (ions)
CnssPenetration:
Limited (ions do not readily cross intact blood-brain barrier, but can affect CNS fluid balance)
Elimination:
HalfLife:
Variable, depends on fluid status, renal function, and rate of administration. Sodium and chloride are continuously exchanged and excreted.
Clearance:
Primarily renal, regulated by kidneys to maintain fluid and electrolyte homeostasis.
ExcretionRoute:
Renal (urine), also small amounts via sweat and feces.
Unchanged:
100% (as ions)
Pharmacodynamics
OnsetOfAction:
Immediate (upon infusion)
PeakEffect:
Immediate (upon infusion completion, then sustained as long as infusion continues or until renal excretion/redistribution)
DurationOfAction:
Variable, depends on patient's hydration status, renal function, and ongoing fluid losses. Typically hours, until excreted or redistributed.
Safety & Warnings
Side Effects
Serious Side Effects: Seek Medical Help 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 attention 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 fainting
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or changes in urine production
+ 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. Many people may not experience any side effects or may only have mild ones. If you notice any of the following side effects or any other symptoms that concern you, contact your doctor:
Irritation or swelling at the injection site
* Pain at the injection site
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns 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 notice any of the following symptoms, contact your doctor or seek medical attention 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 fainting
+ Increased thirst
+ Seizures
+ Feeling very tired or weak
+ Decreased appetite
+ Unable to pass urine or changes in urine production
+ 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. Many people may not experience any side effects or may only have mild ones. If you notice any of the following side effects or any other symptoms that concern you, contact your doctor:
Irritation or swelling at the injection site
* Pain at the injection site
Reporting Side Effects
This list is not exhaustive, and you may experience other side effects. If you have questions or concerns 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 ankles, feet, or hands (edema)
- Shortness of breath or difficulty breathing
- Sudden weight gain
- Headache, dizziness, or confusion
- Muscle weakness or cramps
- Increased thirst or dry mouth
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.
* 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. Never start, stop, or adjust 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.
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.
* 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. Never start, stop, or adjust 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, to monitor your health. Be sure to follow your doctor's instructions and discuss any concerns with them.
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. They will help you weigh the benefits and risks of this medication to both you and your baby, ensuring you make an informed decision about your care.
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 with them.
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. They will help you weigh the benefits and risks of this medication to both you and your baby, ensuring you make an informed decision about your care.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., pulmonary edema, peripheral edema, hypertension, tachycardia)
- Hypernatremia (e.g., thirst, lethargy, confusion, seizures, coma)
- Hyperchloremic acidosis (e.g., hyperventilation, lethargy)
- Electrolyte imbalances
What to Do:
Discontinue infusion, administer diuretics if fluid overload is present, correct electrolyte imbalances, provide supportive care. Call 1-800-222-1222 (Poison Control) or seek immediate medical attention.
Drug Interactions
Moderate Interactions
- Corticosteroids (e.g., prednisone, hydrocortisone): May increase sodium and fluid retention, leading to edema and hypertension.
- Lithium: Increased sodium intake can increase renal excretion of lithium, potentially decreasing lithium levels and efficacy. Monitor lithium levels.
- Diuretics (e.g., furosemide, hydrochlorothiazide): Concurrent use may alter fluid and electrolyte balance, requiring careful monitoring.
Monitoring
Baseline Monitoring
Serum Electrolytes (Na+, K+, Cl-)
Rationale: To establish baseline 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 (Weight, Blood Pressure, Heart Rate, Edema assessment)
Rationale: To assess baseline hydration and identify signs of fluid overload or deficit.
Timing: Prior to initiation of therapy
Routine Monitoring
Fluid Balance (Intake/Output)
Frequency: Every 4-8 hours or as clinically indicated
Target: Appropriate balance based on clinical need
Action Threshold: Significant positive or negative balance, signs of fluid overload/deficit
Serum Electrolytes (Na+, K+, Cl-)
Frequency: Daily or more frequently if large volumes administered or clinical status changes
Target: Na: 135-145 mEq/L, K: 3.5-5.0 mEq/L, Cl: 98-107 mEq/L
Action Threshold: Values outside normal range, especially hypernatremia or hyperchloremia
Vital Signs (BP, HR, RR)
Frequency: Every 4 hours or as clinically indicated
Target: Within patient's normal range
Action Threshold: Significant changes indicating fluid overload (e.g., hypertension, tachycardia) or hypovolemia
Physical Assessment (Edema, Lung Sounds, Skin Turgor)
Frequency: Daily or as clinically indicated
Target: Absence of significant edema, clear lung sounds
Action Threshold: New or worsening edema, crackles/rales in lungs
Symptom Monitoring
- Signs of fluid overload (e.g., dyspnea, orthopnea, peripheral edema, weight gain, jugular venous distension)
- Signs of electrolyte imbalance (e.g., muscle weakness, confusion, lethargy, seizures, cardiac arrhythmias)
- Signs of hypernatremia (e.g., thirst, dry mucous membranes, restlessness, irritability, disorientation, seizures, coma)
- Signs of hyperchloremic acidosis (e.g., hyperventilation, lethargy, confusion)
Special Patient Groups
Pregnancy
Sodium chloride is a naturally occurring and essential component of the body. Administration of isotonic saline is generally considered safe and appropriate for fluid and electrolyte replacement in pregnant women when clinically indicated. 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, but caution with excessive volumes to avoid fluid overload, especially in pre-eclampsia.
Lactation
Sodium chloride is a normal component of breast milk. Administration of isotonic saline is generally considered safe for lactating women and poses no known risk to the breastfed infant.
Infant Risk:
Minimal to none (L1 - Safest).
Pediatric Use
Use with caution, especially in neonates and infants, due to immature renal function and higher risk of fluid and electrolyte imbalances. Dosing must be carefully calculated based on weight, age, and clinical condition. Close monitoring of fluid balance, serum electrolytes, and vital signs is crucial to prevent fluid overload, hypernatremia, and hyperchloremic acidosis.
Geriatric Use
Use with caution due to increased prevalence of renal impairment, cardiovascular disease, and altered fluid regulation. Geriatric patients are more susceptible to fluid overload and electrolyte imbalances. Lower infusion rates and close monitoring of fluid balance, electrolytes, and cardiac status are recommended.
Clinical Information
Clinical Pearls
- Sodium Chloride 0.9% is the most commonly used IV fluid for general hydration and drug dilution.
- While 'normal saline,' it is not truly physiological as its chloride content is higher than plasma, which can lead to hyperchloremic metabolic acidosis with large volumes.
- Always assess patient's fluid status, renal function, and electrolyte levels before and during administration.
- Avoid rapid or excessive administration in patients with heart failure, severe renal impairment, or conditions predisposing to fluid overload (e.g., cirrhosis, pre-eclampsia).
- Not suitable for free water deficit correction (e.g., severe hypernatremia) as it is isotonic; hypotonic solutions are preferred for this purpose.
Alternative Therapies
- Dextrose 5% in Water (D5W) - for free water replacement, not volume expansion
- Dextrose 5% in 0.45% Sodium Chloride (D5 1/2 NS) - for maintenance fluids
- Colloid solutions (e.g., albumin, synthetic colloids) - for plasma volume expansion, but with different indications and risks
Cost & Coverage
Average Cost:
$5 - $20 per 150 mL bag
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Preferred Generic)
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 evaluation and guidance. To ensure safe use, never share your prescription medications with others, and do not take medications that have been prescribed to someone else.
All medications should be stored in a secure location, out of the reach of children and pets, to prevent accidental ingestion. When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless specifically instructed to do so by a healthcare professional or pharmacist. Instead, consult with your pharmacist to determine the best method for disposal, as some communities may have designated drug take-back programs.
Additionally, some medications may come with a separate patient information leaflet; check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, it is crucial 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 information about the medication taken, including the dosage, time of ingestion, and any other relevant details to ensure prompt and effective treatment.
All medications should be stored in a secure location, out of the reach of children and pets, to prevent accidental ingestion. When disposing of unused or expired medications, do not flush them down the toilet or pour them down the drain unless specifically instructed to do so by a healthcare professional or pharmacist. Instead, consult with your pharmacist to determine the best method for disposal, as some communities may have designated drug take-back programs.
Additionally, some medications may come with a separate patient information leaflet; check with your pharmacist to see if this applies to your prescription. If you have any questions or concerns about your medication, it is crucial 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 information about the medication taken, including the dosage, time of ingestion, and any other relevant details to ensure prompt and effective treatment.