Sodium Chloride 0.9% Inj, 20ml
It is used to treat low sodium levels. It is used to treat fluid loss.It is used to mix with a drug that is given as a shot.It may be given to you for other reasons. Talk with the doctor.
Drug Class
Electrolyte and Fluid Replenisher
Pharmacologic Class
Isotonic Solution; Crystalloid
Pregnancy Category
Category A
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium Chloride 0.9% Injection is a sterile solution of salt and water, similar to the salt concentration in your body. It is commonly used to replace lost body fluids and electrolytes, or to dilute other medications before they are given intravenously.
How to Use This Medicine
Taking Your Medication
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to follow the instructions carefully. This medication is administered as an infusion into a vein over a specified period.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
Missing a Dose
If you miss a dose, contact your doctor to receive guidance on what to do next.
To use this medication correctly, follow your doctor's instructions and read all the information provided. It is essential to follow the instructions carefully. This medication is administered as an infusion into a vein over a specified period.
Storing and Disposing of Your Medication
If you need to store this medication at home, consult with your doctor, nurse, or pharmacist to determine the proper storage procedure.
Missing a Dose
If you miss a dose, contact your doctor to receive guidance on what to do next.
Lifestyle & Tips
- Report any unusual swelling in your hands, feet, or ankles.
- Report any difficulty breathing or shortness of breath.
- Maintain adequate hydration as advised by your healthcare provider.
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 based on clinical need. For 20ml vial: typically used as a diluent for parenteral medications or for flushing intravenous catheters. Volume for dilution depends on the drug being diluted.
Condition-Specific Dosing:
diluent:
Sufficient volume to achieve desired concentration of drug.
IV_flush:
3-10 mL per flush, as per institutional protocol.
Pediatric Dosing
Neonatal:
Used as a diluent or flush; fluid replacement based on weight (e.g., 10-20 mL/kg bolus for hypovolemia, or maintenance fluids based on body surface area/weight).
Infant:
Used as a diluent or flush; fluid replacement based on weight (e.g., 10-20 mL/kg bolus for hypovolemia, or maintenance fluids based on body surface area/weight).
Child:
Used as a diluent or flush; fluid replacement based on weight (e.g., 10-20 mL/kg bolus for hypovolemia, or maintenance fluids based on body surface area/weight).
Adolescent:
Used as a diluent or flush; fluid replacement based on weight (e.g., 10-20 mL/kg bolus for hypovolemia, or maintenance fluids based on body surface area/weight).
Dose Adjustments
Renal Impairment:
Mild:
No specific adjustment for the solution itself, but monitor fluid balance closely.
Moderate:
No specific adjustment for the solution itself, but monitor fluid balance closely to avoid fluid overload.
Severe:
Use with extreme caution; monitor fluid balance, serum electrolytes (especially sodium), and signs of fluid overload frequently. May require fluid restriction.
Dialysis:
Use with caution; fluid and electrolyte balance must be carefully managed in conjunction with dialysis regimen. Avoid excessive fluid administration.
Hepatic Impairment:
Mild:
No specific adjustment.
Moderate:
No specific adjustment.
Severe:
No specific adjustment, but monitor for fluid retention and ascites.
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 fluid balance. It expands the extracellular fluid compartment without causing significant fluid shifts into the intracellular space.
Pharmacokinetics
Absorption:
Bioavailability:
100% (intravenous administration)
Tmax:
Immediate
FoodEffect:
Not applicable
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 water moves freely)
Elimination:
HalfLife:
Not applicable (ions are continuously exchanged and excreted)
Clearance:
Primarily renal excretion, dependent on fluid status and renal function.
ExcretionRoute:
Renal
Unchanged:
100% (as ions)
Pharmacodynamics
OnsetOfAction:
Immediate
PeakEffect:
Immediate
DurationOfAction:
Dependent on fluid balance, renal function, and ongoing losses.
Safety & Warnings
Side Effects
Urgent 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 immediately or seek emergency 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
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain, cramps, or spasms
+ Weakness
+ Shakiness
+ Balance changes
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe nausea or vomiting
Shortness of breath
Sudden weight gain or swelling in the arms or legs
Severe dizziness or fainting
Fever or chills
Shakiness
Chest pain or pressure, or a rapid heartbeat
Flushing
Burning, stinging, or redness at the injection site
* Pain and irritation at the injection site
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice. Not all possible side effects are listed here. If you have questions or concerns about side effects, talk to your doctor.
Reporting Side Effects
You can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can also provide guidance on managing side effects and answering any questions you may have.
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 immediately or seek emergency 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
+ Difficulty breathing, swallowing, or talking
+ Unusual hoarseness
+ Swelling of the mouth, face, lips, tongue, or throat
Signs of electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain, cramps, or spasms
+ Weakness
+ Shakiness
+ Balance changes
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe nausea or vomiting
Shortness of breath
Sudden weight gain or swelling in the arms or legs
Severe dizziness or fainting
Fever or chills
Shakiness
Chest pain or pressure, or a rapid heartbeat
Flushing
Burning, stinging, or redness at the injection site
* Pain and irritation at the injection site
Other Possible Side Effects
Like all medications, this drug can cause side effects. However, many people do not experience any side effects or only have mild ones. If you have any side effects that bother you or do not go away, contact your doctor for advice. Not all possible side effects are listed here. If you have questions or concerns about side effects, talk to your doctor.
Reporting Side Effects
You can report side effects to the FDA at 1-800-332-1088 or online at https://www.fda.gov/medwatch. Your doctor can also provide guidance on managing side effects and answering any questions you may have.
Seek Immediate Medical Attention If You Experience:
- Swelling (edema) in the face, hands, ankles, or feet
- Shortness of breath or difficulty breathing
- Rapid weight gain
- Unusual thirst
- Dizziness or lightheadedness
- Confusion or lethargy
- 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.
If you have elevated sodium levels or swelling, as these conditions may be relevant to your treatment.
This list is not exhaustive, and it is crucial to discuss all your medications (including prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. They will help determine whether it is safe to take this medication in conjunction with your other treatments and health conditions.
Remember, do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor to ensure your safety.
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.
If you have elevated sodium levels or swelling, as these conditions may be relevant to your treatment.
This list is not exhaustive, and it is crucial to discuss all your medications (including prescription, over-the-counter, natural products, and vitamins) and health issues with your doctor and pharmacist. They will help determine whether it is safe to take this medication in conjunction with your other treatments and health conditions.
Remember, do not initiate, discontinue, or modify the dosage of any medication without first consulting your doctor to ensure your safety.
Precautions & Cautions
It is essential to inform all your healthcare providers, including doctors, nurses, pharmacists, and dentists, that you are taking this medication. If you are following a low-salt or salt-free diet, consult with your doctor to discuss any potential interactions. Regular blood tests will be necessary, as directed by your doctor, to monitor your condition.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. Be sure to discuss this potential risk with your doctor.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to consult with your doctor. You and your doctor will need to weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. This risk is particularly higher if you have kidney problems or if you are a premature infant. Be sure to discuss this potential risk with your doctor.
If you are pregnant, planning to become pregnant, or are breastfeeding, it is crucial to consult with your doctor. You and your doctor will need to weigh the benefits and risks of taking this medication to ensure the best possible outcome for you and your baby.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., peripheral edema, pulmonary congestion, hypertension)
- Hypernatremia (e.g., thirst, lethargy, confusion, seizures, coma)
- Hyperchloremia (e.g., metabolic acidosis)
What to Do:
Stop the infusion immediately. Administer diuretics to promote fluid and electrolyte excretion. Correct severe electrolyte imbalances as needed. In case of severe symptoms, seek immediate medical attention or call 911. For general overdose information, contact a poison control center (1-800-222-1222).
Drug Interactions
Moderate Interactions
- Corticosteroids (may increase sodium retention)
- Drugs that cause sodium retention (e.g., NSAIDs)
- Diuretics (may alter electrolyte balance, requiring careful monitoring)
Monitoring
Baseline Monitoring
Serum Electrolytes (Sodium, Chloride)
Rationale: To assess baseline electrolyte status, especially if large volumes are anticipated or patient has pre-existing imbalances.
Timing: Prior to initiation of significant fluid therapy.
Renal Function (BUN, Creatinine)
Rationale: To assess kidney's ability to excrete excess fluid and electrolytes.
Timing: Prior to initiation of significant fluid therapy.
Fluid Status (Weight, Edema, Vital Signs)
Rationale: To establish baseline hydration status and identify signs of fluid overload or dehydration.
Timing: Prior to initiation of significant fluid therapy.
Routine Monitoring
Fluid Intake and Output (I&O)
Frequency: Every 4-8 hours or as clinically indicated
Target: Balanced I&O or as per clinical goal
Action Threshold: Significant positive or negative fluid balance, signs of fluid overload or dehydration.
Vital Signs (BP, HR, RR)
Frequency: Every 4-8 hours or as clinically indicated
Target: Within normal limits for patient
Action Threshold: Significant changes indicating fluid overload (e.g., hypertension, tachycardia) or dehydration (e.g., hypotension, orthostasis).
Body Weight
Frequency: Daily (if significant fluid shifts are expected)
Target: Stable or as per clinical goal
Action Threshold: Rapid weight gain (>1-2 kg/day) or loss.
Serum Electrolytes (Sodium, Chloride)
Frequency: Daily or as clinically indicated (especially with large volumes or renal impairment)
Target: Na: 135-145 mEq/L; Cl: 98-107 mEq/L
Action Threshold: Values outside normal range, particularly hypernatremia or hyperchloremia.
Symptom Monitoring
- Peripheral edema (swelling in ankles, feet, hands)
- Pulmonary congestion (shortness of breath, crackles on lung auscultation)
- Rapid weight gain
- Signs of dehydration (dry mucous membranes, decreased skin turgor, thirst)
- Signs of electrolyte imbalance (e.g., muscle weakness, lethargy, confusion, seizures)
Special Patient Groups
Pregnancy
Sodium chloride 0.9% injection is generally considered safe and is frequently used during pregnancy for fluid and electrolyte replacement. It is a naturally occurring component of the body.
Trimester-Specific Risks:
First Trimester:
No known risks associated with appropriate use.
Second Trimester:
No known risks associated with appropriate use.
Third Trimester:
No known 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 nutrition.
Infant Risk:
L1 - Safest (no known adverse effects on the breastfed infant).
Pediatric Use
Used widely in pediatric patients for fluid and electrolyte replacement, and as a diluent for medications. Dosing must be carefully calculated based on the child's weight, age, and clinical condition to avoid fluid overload or electrolyte imbalances.
Geriatric Use
Used with caution in elderly patients due to an increased risk of fluid overload and electrolyte imbalances, particularly in those with pre-existing cardiac, renal, or hepatic impairment. Close monitoring of fluid status, vital signs, and serum electrolytes is essential.
Clinical Information
Clinical Pearls
- 0.9% Sodium Chloride is isotonic with human plasma, making it ideal for intravascular volume expansion.
- Commonly referred to as 'Normal Saline' (NS).
- It is the most common diluent for intravenous medications and for flushing intravenous catheters.
- While generally safe, excessive administration can lead to fluid overload (especially in patients with heart failure or renal dysfunction) and hyperchloremic metabolic acidosis.
- Not suitable for free water replacement (e.g., in hypernatremia caused by water deficit) as it contains sodium.
Alternative Therapies
- Other crystalloid solutions (e.g., Ringer's Solution, Plasmalyte)
- Colloid solutions (e.g., albumin, synthetic starches) for specific volume expansion needs
- Oral rehydration solutions for mild to moderate dehydration
Cost & Coverage
Generic Available:
Yes
Insurance Coverage:
Tier 1 (Preferred Generic)
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 otherwise, 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 emergency medical attention. Be prepared to provide information about the medication taken, the quantity, and the time of the incident.