Home â€ē Medicine

Sod Chloride 5% Inj, 500ml

Manufacturer BAXTER HEALTHCARE CORP Active Ingredient Intravenous (IV) Fluids(in truh VEE nuhs FLOO ids) Pronunciation SO-dee-um KLOR-ide
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.
🏷ī¸
Drug Class
Electrolyte and fluid replacement
đŸ§Ŧ
Pharmacologic Class
Crystalloid solution; Hypertonic saline
🤰
Pregnancy Category
Category C
✅
FDA Approved
Jan 1970
⚖ī¸
DEA Schedule
Not Controlled

Overview

ℹī¸

What is this medicine?

Sodium Chloride 5% Injection is a strong salt solution given directly into your vein (intravenously). It's used in very specific situations, usually when the salt level in your blood is dangerously low, or when there's too much swelling in your brain. It works by helping to pull extra water out of your cells and into your bloodstream, which can help balance your body's fluids and salt levels.
📋

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. Inspect the solution for any cloudiness, leakage, or particles, and do not use it if you notice any of these issues. Additionally, do not use the solution if it has changed color.

To dispose of needles and other sharp objects, use a designated needle/sharp disposal box. Never reuse needles or other items. When the disposal box is full, follow local regulations for proper disposal. If you have any questions or concerns, consult your doctor or pharmacist.

Storage and Disposal

Typically, this medication is administered in a hospital or doctor's office. If you need to store it at home, follow the storage instructions provided by your doctor.

Missed Dose

If you miss a dose, contact your doctor to determine the best course of action.
💡

Lifestyle & Tips

  • This medication is administered in a hospital setting under close medical supervision. No specific lifestyle changes are typically required by the patient during administration, but underlying conditions causing the electrolyte imbalance may require long-term management.
💊

Available Forms & Alternatives

Available Strengths:

Dosing & Administration

👨‍⚕ī¸

Adult Dosing

Standard Dose: Highly individualized based on clinical condition (e.g., severity of hyponatremia, presence of cerebral edema). Typically administered via central venous line due to hypertonicity. For severe symptomatic hyponatremia: 3% NaCl (often used instead of 5% due to less extreme tonicity) at 0.5-2 mL/kg/hr, or boluses of 100-150 mL over 10-20 minutes, aiming for a rapid increase of 4-6 mEq/L in serum sodium over the first few hours, then slower correction. For 5% NaCl, rates would be significantly lower and more cautiously titrated.

Condition-Specific Dosing:

severe_symptomatic_hyponatremia: Initial bolus of 1.5-2 mL/kg of 3% NaCl over 10-20 minutes, repeated up to 2-3 times if symptoms persist. For 5% NaCl, use with extreme caution and lower volumes/rates, often reserved for specific neurosurgical indications or refractory cases.
cerebral_edema: Variable, often 0.5-1 mL/kg/hr of 3% NaCl, or boluses for acute herniation. 5% NaCl would be used in very specific, highly monitored settings.
đŸ‘ļ

Pediatric Dosing

Neonatal: Not established for routine use; extreme caution and individualized dosing for severe, symptomatic hyponatremia under strict monitoring. Risk of osmotic demyelination is higher.
Infant: Not established for routine use; extreme caution and individualized dosing for severe, symptomatic hyponatremia under strict monitoring.
Child: Highly individualized for severe symptomatic hyponatremia or cerebral edema. Dosing similar to adults on a mL/kg basis but with even stricter monitoring of serum sodium and neurological status. E.g., 3% NaCl 0.5-1 mL/kg/hr, or boluses of 3-5 mL/kg over 10-20 minutes for acute symptoms.
Adolescent: Similar to adult dosing, but with careful consideration of weight and fluid status.
⚕ī¸

Dose Adjustments

Renal Impairment:

Mild: Adjustment needed (monitor fluid and electrolyte balance closely)
Moderate: Adjustment needed (monitor fluid and electrolyte balance closely, increased risk of fluid overload)
Severe: Adjustment needed (contraindicated in anuric patients unless for specific indications like dialysis-related hyponatremia, extreme caution due to fluid overload and electrolyte derangements)
Dialysis: Use with extreme caution; may be used to correct severe hyponatremia in dialysis patients, but requires precise calculation and close monitoring.

Hepatic Impairment:

Mild: Adjustment (monitor fluid and electrolyte balance closely)
Moderate: Adjustment (monitor fluid and electrolyte balance closely, increased risk of fluid overload and ascites)
Severe: Adjustment (monitor fluid and electrolyte balance closely, increased risk of fluid overload and ascites)

Pharmacology

đŸ”Ŧ

Mechanism of Action

Sodium Chloride 5% Injection is a hypertonic solution that provides sodium and chloride ions. Its primary mechanism of action is to increase the extracellular fluid volume and raise serum osmolality. This creates an osmotic gradient that draws water from the intracellular compartment (including brain cells) into the extracellular space, thereby reducing cellular swelling (e.g., cerebral edema) and increasing serum sodium concentration in cases of hyponatremia.
📊

Pharmacokinetics

Absorption:

Bioavailability: 100%
Tmax: Immediate (upon completion of infusion)
FoodEffect: Not applicable (intravenous administration)

Distribution:

Vd: Approximately 0.2 L/kg (distributes primarily into the extracellular fluid space)
ProteinBinding: Not applicable (ions)
CnssPenetration: Limited (ions do not readily cross intact blood-brain barrier, but osmotic effect influences brain water content)

Elimination:

HalfLife: Variable (depends on fluid balance, renal function, and ongoing losses)
Clearance: Primarily renal excretion; rate depends on glomerular filtration rate and tubular reabsorption.
ExcretionRoute: Renal (urine)
Unchanged: 100% (as ions)
⏱ī¸

Pharmacodynamics

OnsetOfAction: Immediate (upon infusion)
PeakEffect: Within minutes to hours, depending on infusion rate and volume
DurationOfAction: Variable, depends on patient's fluid and electrolyte status, renal function, and ongoing losses/intake.

Safety & Warnings

⚠ī¸

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 notice 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, 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. 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 list is not exhaustive, and you may experience other 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:

  • Difficulty breathing or shortness of breath
  • Swelling in your hands, ankles, or feet
  • Sudden weight gain
  • Headache, dizziness, or confusion
  • Muscle weakness or cramps
  • Feeling unusually thirsty
  • Changes in your heart rate
  • Any new or worsening neurological symptoms (e.g., difficulty speaking, swallowing, weakness, numbness)
📋

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 you are taking.
* Any existing health problems, as this medication may interact with certain conditions.

To ensure your safety, do not start, stop, or change the dose of any medication without first consulting your doctor. It is crucial to verify that it is safe to take this medication in combination with your other medications and health conditions.
⚠ī¸

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. Be sure to follow their instructions and discuss any concerns or questions you may have.

When administering this medication to newborns, exercise caution due to a potentially higher risk of side effects in this age group.

If you are pregnant, planning to become pregnant, or are breastfeeding, notify 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:

  • Hypernatremia (excessively high blood sodium levels): severe thirst, lethargy, irritability, muscle twitching, seizures, coma, brain shrinkage.
  • Fluid overload/hypervolemia: pulmonary edema (fluid in lungs), peripheral edema, elevated blood pressure, heart failure.
  • Hyperchloremic acidosis: metabolic acidosis due to excessive chloride.
  • Osmotic demyelination syndrome (ODS): a delayed and severe neurological complication characterized by dysarthria, dysphagia, quadriparesis, and altered consciousness, occurring if hyponatremia is corrected too rapidly.

What to Do:

Immediate medical attention is required. Management involves discontinuing the infusion, administering hypotonic fluids (e.g., D5W) to lower serum sodium, and potentially administering diuretics to manage fluid overload. In cases of ODS, supportive care is paramount. Call 1-800-222-1222 (Poison Control) for further guidance.

Drug Interactions

🔴

Major Interactions

  • Corticosteroids (may increase sodium retention and fluid overload risk)
  • Lithium (increased sodium intake can increase lithium excretion, potentially reducing lithium levels)
  • Diuretics (especially loop diuretics, can alter sodium and water balance, requiring careful monitoring when co-administered with hypertonic saline)
🟡

Moderate Interactions

  • Drugs that cause sodium retention (e.g., NSAIDs, some antihypertensives)
  • Drugs that affect ADH secretion (e.g., carbamazepine, SSRIs, desmopressin - can exacerbate hyponatremia or lead to fluid overload if not carefully managed)

Monitoring

đŸ”Ŧ

Baseline Monitoring

Serum Sodium (Na+)

Rationale: To establish baseline and guide initial dosing for hyponatremia correction.

Timing: Prior to initiation

Serum Osmolality

Rationale: To assess overall solute concentration and guide therapy.

Timing: Prior to initiation

Electrolytes (K+, Cl-, HCO3-)

Rationale: To assess overall electrolyte balance and identify co-existing derangements.

Timing: Prior to initiation

Renal Function (BUN, Creatinine)

Rationale: To assess kidney's ability to excrete fluid and electrolytes.

Timing: Prior to initiation

Fluid Status (I&O, weight, vital signs, physical exam)

Rationale: To assess hydration status and risk of fluid overload.

Timing: Prior to initiation

Neurological Status (GCS, mental status)

Rationale: Crucial for patients with hyponatremia or cerebral edema to monitor response and detect complications.

Timing: Prior to initiation

📊

Routine Monitoring

Serum Sodium (Na+)

Frequency: Every 1-2 hours initially, then every 2-4 hours, then less frequently as stable.

Target: Correction rate typically <10-12 mEq/L in 24 hours and <18 mEq/L in 48 hours to prevent osmotic demyelination syndrome (ODS). Target specific to patient's condition.

Action Threshold: If serum Na+ rises too rapidly (>10-12 mEq/L/24hr or >0.5 mEq/L/hr), stop infusion, consider administering D5W or desmopressin. If Na+ not rising as expected, reassess fluid balance and other factors.

Serum Osmolality

Frequency: Every 4-6 hours or with serum sodium.

Target: Approaching normal range (285-295 mOsm/kg).

Action Threshold: Significant deviation from target.

Electrolytes (K+, Cl-)

Frequency: Every 4-6 hours or with serum sodium.

Target: Normal ranges.

Action Threshold: Significant deviation from normal.

Fluid Status (I&O, daily weight, vital signs, CVP if available)

Frequency: Continuous monitoring of I&O, daily weight, vital signs every 1-4 hours.

Target: Maintain euvolemia or desired fluid balance.

Action Threshold: Signs of fluid overload (e.g., crackles, edema, dyspnea, elevated CVP) or dehydration.

Neurological Status

Frequency: Continuous or every 1-2 hours initially, then every 4 hours.

Target: Improvement in symptoms, stable GCS.

Action Threshold: Worsening neurological symptoms (e.g., seizures, decreased consciousness) or signs of ODS (delayed onset, progressive neurological deficits).

👁ī¸

Symptom Monitoring

  • Signs of fluid overload (shortness of breath, swelling in ankles/feet, rapid weight gain, crackles in lungs, elevated blood pressure)
  • Signs of hypernatremia (thirst, lethargy, weakness, irritability, seizures, coma)
  • Signs of osmotic demyelination syndrome (delayed onset, progressive neurological deficits such as dysarthria, dysphagia, quadriparesis, locked-in syndrome)
  • Signs of electrolyte imbalance (muscle weakness, cramps, irregular heart beat)
  • Headache, nausea, vomiting (can be signs of fluid shifts or cerebral edema)

Special Patient Groups

🤰

Pregnancy

Sodium chloride 5% injection should be used during pregnancy only if clearly needed and the potential benefits outweigh the potential risks. Careful monitoring of maternal fluid and electrolyte status is essential. Rapid correction of hyponatremia should be avoided due to potential risks to both mother and fetus.

Trimester-Specific Risks:

First Trimester: No specific data indicating teratogenicity, but fluid and electrolyte imbalances can be detrimental.
Second Trimester: Risk of fluid overload and electrolyte disturbances.
Third Trimester: Risk of fluid overload and electrolyte disturbances, potential for adverse effects on fetal fluid balance.
🤱

Lactation

Sodium chloride is a normal component of breast milk. Administration of sodium chloride 5% injection is generally considered compatible with breastfeeding when clinically indicated, provided maternal fluid and electrolyte balance is carefully monitored. The amount transferred to breast milk is unlikely to cause harm to a healthy infant.

Infant Risk: Low risk, but monitor infant for signs of fluid or electrolyte imbalance if maternal doses are very high or prolonged.
đŸ‘ļ

Pediatric Use

Pediatric patients, especially neonates and infants, are at higher risk for fluid and electrolyte imbalances and osmotic demyelination syndrome due to their smaller fluid compartments and immature renal function. Dosing must be highly individualized, and extremely close monitoring of serum sodium, fluid status, and neurological signs is critical. Correction rates should be even more conservative than in adults.

👴

Geriatric Use

Elderly patients are at increased risk for fluid overload, hypernatremia, and electrolyte disturbances due to age-related changes in renal function, cardiac reserve, and thirst perception. They may also have multiple comorbidities and polypharmacy. Close monitoring of fluid status, electrolytes, and renal function is essential. Slower infusion rates and more conservative correction targets may be appropriate.

Clinical Information

💎

Clinical Pearls

  • Sodium Chloride 5% Injection is a highly hypertonic solution and should generally be administered via a central venous catheter to minimize the risk of phlebitis and tissue damage.
  • This solution is NOT for routine fluid replacement or maintenance. Its use is reserved for severe, symptomatic hyponatremia or conditions requiring rapid reduction of cerebral edema.
  • The primary danger of rapid correction of chronic hyponatremia is Osmotic Demyelination Syndrome (ODS), a severe and often irreversible neurological disorder. Strict adherence to correction rate guidelines (typically <10-12 mEq/L in 24 hours and <18 mEq/L in 48 hours) is paramount.
  • Frequent monitoring of serum sodium (every 1-2 hours initially) and neurological status is critical during administration.
  • Consider co-administration of desmopressin (DDAVP) in patients at high risk for ODS (e.g., alcoholics, malnourished, liver disease) to prevent overcorrection of hyponatremia.
  • Monitor for signs of fluid overload, especially in patients with cardiac or renal impairment.
🔄

Alternative Therapies

  • Sodium Chloride 0.9% Injection (Normal Saline): Isotonic, used for volume expansion, maintenance fluid, and diluent.
  • Sodium Chloride 3% Injection: Less hypertonic than 5%, often preferred for symptomatic hyponatremia correction due to lower risk profile.
  • Dextrose 5% in Water (D5W): Hypotonic solution, used for free water replacement and to treat hypernatremia.
  • Lactated Ringer's Solution: Isotonic, balanced electrolyte solution for volume replacement.
  • Mannitol: Osmotic diuretic, used for cerebral edema, but mechanism differs from hypertonic saline.
💰

Cost & Coverage

Average Cost: Low cost (typically a few dollars per 500ml bag) per 500ml bag
Generic Available: Yes
Insurance Coverage: Tier 1 (generic, widely covered)
📚

General Drug Facts

If your symptoms or health problems persist or worsen, it is essential to contact your doctor promptly. To ensure safe use, do not share your medication with others, and never 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. 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 correct 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 medical attention. Be prepared to provide information about the medication taken, the amount, and the time of the incident.