Sod Chloride 0.9% Inj, 500ml
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
Intravenous solutions, Electrolyte replenisher, Plasma volume expander
Pharmacologic Class
Isotonic crystalloid solution, Electrolyte
Pregnancy Category
Category B
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 directly into your vein (IV). It's used to help your body stay hydrated, replace lost fluids and salts, and can also be used to dilute and deliver other medications 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
- Follow your healthcare provider's instructions regarding fluid intake and dietary restrictions.
- Report any unusual swelling, shortness of breath, or changes in urination to your nurse or doctor 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, individualized based on patient's fluid and electrolyte needs, clinical condition, and purpose of administration.
Condition-Specific Dosing:
Dehydration:
Typically 1000-3000 mL/24 hours, adjusted based on clinical response.
Hypovolemia:
Rapid infusion of 500-1000 mL over 15-60 minutes, then adjusted.
Vehicle for drug administration:
As required by the specific drug's dilution and infusion rate.
Pediatric Dosing
Neonatal:
Individualized based on weight, age, and clinical condition (e.g., 10-20 mL/kg bolus for hypovolemia, then maintenance fluids).
Infant:
Individualized based on weight, age, and clinical condition (e.g., 10-20 mL/kg bolus for hypovolemia, then maintenance fluids).
Child:
Individualized based on weight, age, and clinical condition (e.g., 10-20 mL/kg bolus for hypovolemia, then maintenance fluids).
Adolescent:
Individualized based on weight, age, and clinical condition (similar to adult dosing for maintenance, weight-based for bolus).
Dose Adjustments
Renal Impairment:
Mild:
Use with caution; monitor fluid balance and serum electrolytes closely.
Moderate:
Use with caution; monitor fluid balance and serum electrolytes closely; may require reduced rates or volumes.
Severe:
Use with extreme caution; monitor fluid balance and serum electrolytes closely; often requires significant reduction in rates/volumes to prevent fluid overload.
Dialysis:
Administer with extreme caution; fluid removal during dialysis must be considered; monitor fluid balance and electrolytes closely.
Hepatic Impairment:
Mild:
No specific adjustment typically required, but monitor for fluid retention.
Moderate:
No specific adjustment typically required, but monitor for fluid retention and ascites.
Severe:
No specific adjustment typically required, but monitor for fluid retention, ascites, and electrolyte imbalances; use with caution.
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 helps to restore fluid and electrolyte balance, serving as a source of water and electrolytes for hydration and as a vehicle for the administration of compatible medications.
Pharmacokinetics
Absorption:
Bioavailability:
100%
Tmax:
Not applicable (continuous infusion)
FoodEffect:
Not applicable
Distribution:
Vd:
Approximately 0.2 L/kg (distributes primarily to extracellular fluid)
ProteinBinding:
Not applicable (ions)
CnssPenetration:
Limited (unless blood-brain barrier is compromised)
Elimination:
HalfLife:
Physiologically regulated; not a fixed half-life for the solution itself. Individual ions are regulated by renal and hormonal mechanisms.
Clearance:
Primarily renal excretion, regulated by the kidneys.
ExcretionRoute:
Renal
Unchanged:
100% (ions are excreted, not chemically changed)
Pharmacodynamics
OnsetOfAction:
Immediate (upon initiation of infusion)
PeakEffect:
Dependent on infusion rate and volume administered; effects on fluid volume are immediate.
DurationOfAction:
As long as infusion continues and body maintains homeostatic balance; effects dissipate rapidly upon discontinuation.
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 immediate 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, 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 ones. If you notice 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 a complete list of possible side effects. If you have questions or concerns about side effects, talk 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 or seek immediate 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, 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 ones. If you notice 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 a complete list of possible side effects. If you have questions or concerns about side effects, talk 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 your hands, feet, or ankles
- Difficulty breathing or shortness of breath
- Rapid weight gain
- Unusual thirst
- Dizziness or lightheadedness
- Confusion or changes in mental status
- 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 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, do not start, stop, or modify the dosage of any medication without first consulting your doctor. It is your responsibility to verify that it is safe to take this medication in conjunction with all your other medications and health conditions. Always consult your doctor and pharmacist to confirm the safe use of this medication.
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 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, do not start, stop, or modify the dosage of any medication without first consulting your doctor. It is your responsibility to verify that it is safe to take this medication in conjunction with all your other medications and health conditions. Always consult your doctor and pharmacist to confirm the safe use of this medication.
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 have potassium in them.
If your medication contains dextrose and you have diabetes (high blood sugar), discuss this with your doctor to determine the best course of action.
Regular blood tests will be necessary, as directed by your doctor. Be sure to discuss any concerns or questions you have with your doctor.
When administering this medication to newborns, exercise caution, as the risk of side effects may be increased in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
If your medication contains potassium, consult your doctor before using any salt substitutes or products that have potassium in them.
If your medication contains dextrose and you have diabetes (high blood sugar), discuss this with your doctor to determine the best course of action.
Regular blood tests will be necessary, as directed by your doctor. Be sure to discuss any concerns or questions you have with your doctor.
When administering this medication to newborns, exercise caution, as the risk of side effects may be increased in this age group.
If you are pregnant, planning to become pregnant, or are breastfeeding, inform your doctor. It is crucial to discuss the potential benefits and risks of this medication to both you and your baby to make an informed decision.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., peripheral edema, pulmonary congestion, hypertension, rapid weight gain)
- Hypernatremia (e.g., extreme thirst, lethargy, confusion, seizures, coma)
- Electrolyte imbalances (e.g., hyperchloremia, metabolic acidosis)
What to Do:
If you suspect an overdose, the infusion will be stopped immediately. Treatment involves supportive care, administration of diuretics to remove excess fluid, and correction of electrolyte imbalances. Call 911 or Poison Control (1-800-222-1222) for advice.
Drug Interactions
Moderate Interactions
- Corticosteroids (may increase sodium retention and fluid overload risk)
- Lithium (large volumes of sodium chloride may increase lithium excretion, potentially reducing lithium levels)
- Diuretics (may alter fluid and electrolyte balance, requiring careful monitoring)
Monitoring
Baseline Monitoring
Serum Electrolytes (Na, K, Cl)
Rationale: To assess baseline electrolyte status and identify pre-existing imbalances.
Timing: Prior to initiation of therapy.
Renal Function (BUN, Creatinine)
Rationale: To assess kidney function, which is crucial for fluid and electrolyte balance.
Timing: Prior to initiation of therapy.
Fluid Status (Blood Pressure, Heart Rate, Urine Output, Edema)
Rationale: To establish baseline hydration status and identify signs of fluid deficit or overload.
Timing: Prior to initiation of therapy.
Body Weight
Rationale: To establish baseline weight for monitoring fluid shifts.
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 appropriate for clinical goal (e.g., positive balance for rehydration, negative for diuresis).
Action Threshold: Significant positive or negative balance, indicating fluid overload or dehydration.
Vital Signs (BP, HR, RR)
Frequency: Every 4-8 hours or as clinically indicated.
Target: Within patient's normal range.
Action Threshold: Significant changes (e.g., hypertension, tachycardia, tachypnea) indicating fluid overload or hypovolemia.
Serum Electrolytes (Na, K, Cl)
Frequency: Daily or more frequently as clinically indicated, especially with large volumes or in patients with renal/cardiac impairment.
Target: Normal physiological ranges (e.g., Na 135-145 mEq/L).
Action Threshold: Hypernatremia, hyponatremia, or other significant electrolyte imbalances.
Body Weight
Frequency: Daily.
Target: Stable or trending towards desired weight.
Action Threshold: Rapid weight gain (e.g., >2 kg/day) indicating fluid overload, or rapid weight loss indicating dehydration.
Signs of Edema/Pulmonary Congestion
Frequency: Regularly during physical assessment.
Target: Absence of new or worsening edema/congestion.
Action Threshold: Development of peripheral edema, crackles on lung auscultation, shortness of breath.
Symptom Monitoring
- Peripheral edema (swelling of ankles, feet, hands)
- Shortness of breath or difficulty breathing
- Rapid weight gain
- Headache
- Nausea/Vomiting
- Thirst
- Dry mucous membranes
- Decreased urine output
- Confusion or altered mental status
- Muscle weakness or cramps
Special Patient Groups
Pregnancy
Sodium Chloride 0.9% Injection is generally considered safe and is frequently used during pregnancy for hydration, electrolyte replacement, and as a vehicle for other medications. Close monitoring of fluid and electrolyte balance is recommended.
Trimester-Specific Risks:
First Trimester:
No known specific risks associated with appropriate use.
Second Trimester:
No known specific risks associated with appropriate use.
Third Trimester:
No known specific risks associated with appropriate use.
Lactation
Sodium Chloride 0.9% Injection is compatible with breastfeeding. Sodium and chloride are natural components of breast milk and are essential for infant health. Administration of this solution at therapeutic doses is not expected to harm the breastfed infant.
Infant Risk:
L1 (Safest)
Pediatric Use
Dosing must be carefully calculated based on the child's weight, age, and clinical condition to avoid fluid overload, electrolyte imbalances (especially hypernatremia), and cerebral edema. Close monitoring of fluid balance and electrolytes is crucial.
Geriatric Use
Use with caution in elderly patients due to potential for impaired renal and cardiac function, which increases the risk of fluid overload, hypernatremia, and other electrolyte disturbances. Monitor fluid balance, electrolytes, and cardiovascular status closely.
Clinical Information
Clinical Pearls
- 0.9% Sodium Chloride is an isotonic crystalloid solution, making it the primary choice for rapid volume expansion in hypovolemic states without significant fluid shifts into the intracellular compartment.
- It is the most commonly used intravenous fluid for general hydration, maintenance fluid therapy, and as a diluent or vehicle for the administration of a wide range of compatible medications.
- While generally safe, careful and continuous monitoring of fluid balance (intake/output), vital signs, and serum electrolytes is essential, especially in patients with pre-existing cardiac, renal, or hepatic impairment, or those at risk for fluid overload.
- Avoid rapid or excessive administration in patients with heart failure, severe renal impairment, or conditions predisposing to hypernatremia or fluid retention.
- Always check compatibility when mixing other medications with 0.9% Sodium Chloride.
Alternative Therapies
- Dextrose 5% in Water (D5W) (for free water deficit, not volume expansion)
- Colloid solutions (e.g., Albumin, Hetastarch) (for specific volume expansion needs, particularly in shock)
- Oral rehydration solutions (for mild to moderate dehydration in conscious patients)
Cost & Coverage
Average Cost:
Typically $1 - $5 per 500ml bag
Generic Available:
Yes
Insurance Coverage:
Generally covered by most insurance plans as a standard medical supply/treatment.
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 quantity, and the time of ingestion to ensure prompt and effective treatment.