Sod Chloride 0.9% Inj, 25ml
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
Pregnancy Category
Not formally categorized, generally considered safe (often referred to as Category C in older classifications, but no known adverse effects)
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium Chloride 0.9% Injection, often called 'Normal Saline,' is a sterile salt water solution given into a vein (IV). It's used to replace fluids and salts in your body if you're dehydrated, to help maintain your body's fluid balance, or to dilute other medicines before they are given through your IV.
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
- Maintain adequate oral fluid intake if able, as advised by your healthcare provider.
- Report any new or worsening symptoms, such as swelling, difficulty breathing, or unusual thirst, to your healthcare team immediately.
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, depends on clinical need and patient's fluid/electrolyte status. Typically administered as a bolus (e.g., 250-1000 mL) or continuous infusion (e.g., 50-200 mL/hr) for hydration or as a diluent for medications.
Condition-Specific Dosing:
dehydration:
Variable, based on severity and patient response.
hypovolemia:
Rapid infusion of 500-1000 mL, repeated as needed.
drugDiluent:
Volume as required for specific medication dilution (e.g., 25 mL for IV push or small infusion).
Pediatric Dosing
Neonatal:
Highly variable, typically 10-20 mL/kg bolus for hypovolemia, or maintenance fluid rates (e.g., 60-100 mL/kg/day) adjusted for specific needs. Close monitoring essential.
Infant:
Highly variable, typically 10-20 mL/kg bolus for hypovolemia, or maintenance fluid rates (e.g., 80-120 mL/kg/day) adjusted for specific needs. Close monitoring essential.
Child:
Highly variable, typically 10-20 mL/kg bolus for hypovolemia, or maintenance fluid rates (e.g., 60-100 mL/kg/day) adjusted for specific needs. Close monitoring essential.
Adolescent:
Highly variable, similar to adult dosing but adjusted for weight and clinical need.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution, monitor fluid balance and electrolytes.
Moderate:
Use with caution, monitor fluid balance and electrolytes (especially sodium and chloride), adjust rate as needed to prevent fluid overload or hypernatremia.
Severe:
Use with extreme caution, monitor fluid balance and electrolytes closely, adjust rate as needed to prevent fluid overload or hypernatremia. May require fluid restriction.
Dialysis:
Use with caution, monitor fluid balance and electrolytes, adjust rate as needed to prevent interdialytic weight gain or fluid overload.
Hepatic Impairment:
Mild:
Generally no specific dose adjustment required.
Moderate:
Generally no specific dose adjustment required, but monitor for fluid overload, especially in patients with ascites or edema.
Severe:
Generally no specific dose adjustment required, but monitor closely for fluid overload and electrolyte imbalances, particularly in patients with significant ascites or portal hypertension.
Pharmacology
Mechanism of Action
Sodium Chloride 0.9% Injection is an isotonic crystalloid solution that provides water and electrolytes (sodium and chloride) to maintain osmotic pressure and fluid balance. It primarily expands the extracellular fluid compartment (interstitial and intravascular spaces) without significantly shifting fluid into the intracellular space.
Pharmacokinetics
Absorption:
Bioavailability:
100% (Intravenous)
Tmax:
Immediate
FoodEffect:
Not applicable (Intravenous administration)
Distribution:
Vd:
Approximately 0.2 L/kg (equivalent to extracellular fluid volume)
ProteinBinding:
Not applicable (ions)
CnssPenetration:
Yes (freely crosses blood-brain barrier)
Elimination:
HalfLife:
Variable, depends on fluid balance, renal function, and physiological needs.
Clearance:
Renal clearance, highly variable based on physiological needs and kidney function.
ExcretionRoute:
Renal (urine)
Unchanged:
100% (as ions, regulated by kidneys)
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Immediate
DurationOfAction:
Variable, depends on fluid status, renal excretion, and ongoing fluid losses.
Safety & Warnings
Side Effects
Serious 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 or seek medical attention immediately:
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 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. 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, 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 immediately:
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 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. 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, 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 (edema)
- Shortness of breath or difficulty breathing
- Rapid weight gain
- Increased thirst or dry mouth
- Confusion, dizziness, or lethargy
- Headache
- 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 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 identify 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 other 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 identify 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 other 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 are crucial while taking this medication. Follow your doctor's instructions regarding the frequency and timing of these tests, and discuss the results with your doctor.
When administering this medication to newborns, exercise caution due to the potential for increased risk of side effects in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to discuss the benefits and risks of this medication with your doctor to make an informed decision about its use, considering both your health and the health of your baby.
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 are crucial while taking this medication. Follow your doctor's instructions regarding the frequency and timing of these tests, and discuss the results with your doctor.
When administering this medication to newborns, exercise caution due to the potential for increased risk of side effects in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to discuss the benefits and risks of this medication with your doctor to make an informed decision about its use, considering both your health and the health of your baby.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., pulmonary edema, peripheral edema, hypertension, heart failure)
- Hypernatremia (e.g., severe thirst, lethargy, confusion, seizures, coma, brain shrinkage)
- Hyperchloremic metabolic acidosis (e.g., rapid breathing, altered mental status)
What to Do:
Discontinue infusion immediately. Administer diuretics if fluid overload is present. Correct electrolyte imbalances. Provide supportive care. In case of suspected overdose, seek immediate medical attention or call Poison Control (1-800-222-1222).
Drug Interactions
Monitoring
Baseline Monitoring
Serum Electrolytes (Na+, Cl-, K+)
Rationale: To assess baseline fluid and 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, guiding infusion rate.
Timing: Prior to initiation of therapy.
Fluid Balance (Intake/Output)
Rationale: To establish baseline hydration status and guide fluid replacement.
Timing: Prior to initiation and continuously during therapy.
Vital Signs (Blood Pressure, Heart Rate, Respiratory Rate)
Rationale: To assess cardiovascular status and identify signs of hypovolemia or fluid overload.
Timing: Prior to initiation and regularly.
Routine Monitoring
Serum Electrolytes (Na+, Cl-, K+)
Frequency: Daily or more frequently as clinically indicated (e.g., every 4-6 hours in critical care).
Target: Physiological normal ranges (e.g., Na+ 135-145 mEq/L).
Action Threshold: Significant deviations from normal range, rapid changes, or symptoms of imbalance.
Fluid Balance (Intake/Output)
Frequency: Every 4-8 hours or continuously.
Target: Balanced or as per clinical goal (e.g., slightly positive in dehydration, negative in fluid overload).
Action Threshold: Significant positive or negative balance, indicating fluid retention or inadequate replacement.
Vital Signs (Blood Pressure, Heart Rate, Respiratory Rate)
Frequency: Regularly as per clinical protocol (e.g., every 1-4 hours).
Target: Normal for age and clinical condition.
Action Threshold: Signs of fluid overload (hypertension, tachycardia, tachypnea) or dehydration (hypotension, tachycardia).
Physical Exam (Peripheral Edema, Lung Sounds, Skin Turgor)
Frequency: Daily or as needed.
Target: Absence of new edema, clear lung sounds, normal skin turgor.
Action Threshold: Development of peripheral or pulmonary edema, crackles on lung auscultation, or worsening skin turgor.
Symptom Monitoring
- Signs of fluid overload (e.g., dyspnea, shortness of breath, peripheral edema, rapid weight gain, jugular venous distension)
- Signs of hypernatremia (e.g., excessive thirst, lethargy, confusion, irritability, seizures, coma)
- Signs of hyperchloremic metabolic acidosis (e.g., tachypnea, altered mental status)
- Signs of hyponatremia (if used inappropriately or in specific conditions, e.g., nausea, headache, confusion, seizures, weakness)
Special Patient Groups
Pregnancy
Generally considered safe and commonly used during pregnancy for fluid replacement, hydration, or as a diluent for medications. No known adverse effects on the fetus when used appropriately.
Trimester-Specific Risks:
First Trimester:
No known risks.
Second Trimester:
No known risks.
Third Trimester:
No known risks, but monitor for fluid overload, especially in conditions like pre-eclampsia or cardiac dysfunction.
Lactation
Compatible with breastfeeding. Sodium and chloride are natural components of breast milk and are essential for infant nutrition. Administration of 0.9% Sodium Chloride is not expected to harm the breastfed infant.
Infant Risk:
L1 (Safest - no known risk to infant).
Pediatric Use
Use with caution, especially in neonates and infants, due to immature renal function, higher body water content, and increased risk of fluid and electrolyte imbalances. Dosing must be carefully calculated based on body weight, age, and clinical need. Close monitoring of fluid balance and electrolytes is crucial.
Geriatric Use
Use with caution due to increased risk of fluid overload, heart failure, and renal impairment. Geriatric patients may have reduced compensatory mechanisms for fluid and electrolyte shifts. Monitor fluid balance, electrolytes, and cardiovascular status closely.
Clinical Information
Clinical Pearls
- 0.9% Sodium Chloride is commonly referred to as 'Normal Saline' (NS) and is the most frequently used intravenous fluid.
- While isotonic, rapid or excessive administration can lead to fluid overload, hypernatremia, and hyperchloremic metabolic acidosis, especially in patients with impaired renal or cardiac function.
- It is not a source of free water and should not be used to correct free water deficits (e.g., hypernatremic dehydration); hypotonic solutions are more appropriate for this purpose.
- Always assess the patient's fluid status, renal function, and electrolyte levels before and during administration.
- When used as a diluent for medications, ensure compatibility with the specific drug.
Alternative Therapies
- Dextrose 5% in Water (D5W) (for free water replacement or glucose provision)
- Dextrose 5% in 0.45% Sodium Chloride (D5 1/2 NS)
- Colloid solutions (e.g., Albumin, Hetastarch - for more rapid and sustained intravascular volume expansion)
- Oral rehydration solutions (for mild to moderate dehydration in conscious patients)
Cost & Coverage
Average Cost:
Typically very low, ranging from less than $1 to $10 per 25ml vial/bag
Generic Available:
Yes
Insurance Coverage:
Covered by most insurance plans as a medical supply or component of drug administration/fluid therapy.
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 to do so by a healthcare professional, do not flush medications down the toilet or pour them down the drain. If you are unsure about the proper disposal method, consult your pharmacist, who can also inform you about potential drug take-back programs in your area. Some medications may come with an additional 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 emergency medical attention. Be prepared to provide information about the medication taken, the amount, and the time it was taken to ensure prompt and effective treatment.