Sodium Chloride 0.9% Inj, 50ml
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 replacement
Pharmacologic Class
Isotonic crystalloid solution
Pregnancy Category
Category C
FDA Approved
Jan 1970
DEA Schedule
Not Controlled
Overview
What is this medicine?
Sodium Chloride 0.9% Injection, commonly known as normal saline, is a sterile salt water solution given through a vein (intravenously). It's used to replace fluids and salts in your body, especially when you're dehydrated, have lost blood, or need to dilute other medications. It helps maintain the balance of water and salts in your body.
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 dosage 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 immediately 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 dosage 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 immediately to receive guidance on what to do next.
Lifestyle & Tips
- Report any unusual symptoms to your healthcare provider immediately.
- Maintain adequate oral fluid intake if able and advised by your doctor.
- Inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements.
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 clinical need (e.g., 100-1000 mL/hour for hydration, or as diluent for medications)
Condition-Specific Dosing:
General Fluid Replacement:
500 mL to 3 L per 24 hours, adjusted based on patient's fluid status, electrolyte balance, and renal function.
Diluent for Medications:
As per medication's reconstitution/dilution instructions, typically 50 mL to 250 mL.
Pediatric Dosing
Neonatal:
Individualized based on weight (e.g., 20 mL/kg bolus for hypovolemia, or maintenance fluid rates), clinical condition, and fluid/electrolyte needs. Close monitoring essential.
Infant:
Individualized based on weight (e.g., 20 mL/kg bolus for hypovolemia, or maintenance fluid rates), clinical condition, and fluid/electrolyte needs. Close monitoring essential.
Child:
Individualized based on weight (e.g., 20 mL/kg bolus for hypovolemia, or maintenance fluid rates), clinical condition, and fluid/electrolyte needs. Close monitoring essential.
Adolescent:
Individualized based on weight, clinical condition, and fluid/electrolyte needs; often similar to adult dosing for volume replacement.
Dose Adjustments
Renal Impairment:
Mild:
Use with caution, monitor fluid and electrolyte status.
Moderate:
Use with caution, monitor fluid and electrolyte status closely to avoid fluid overload and hypernatremia.
Severe:
Use with extreme caution, monitor fluid and electrolyte status closely, significant risk of fluid overload, hypernatremia, and hyperchloremic acidosis.
Dialysis:
Use with caution, monitor fluid and electrolyte status; may be used for volume expansion or as diluent, but careful monitoring is essential to avoid fluid overload, especially in anuric patients.
Hepatic Impairment:
Mild:
No specific adjustment, monitor fluid and electrolyte status.
Moderate:
No specific adjustment, monitor fluid and electrolyte status.
Severe:
No specific adjustment, monitor fluid and electrolyte status, especially in patients with ascites or edema, due to increased risk of fluid retention.
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 primarily expands the extracellular fluid compartment, including the interstitial and intravascular spaces. Sodium is the principal cation of the extracellular fluid and plays a large part in the control of water distribution, fluid and electrolyte balance, and osmotic pressure of body fluids. Chloride is the major extracellular anion and is involved in maintaining acid-base balance.
Pharmacokinetics
Absorption:
Bioavailability:
100% (administered intravenously)
Tmax:
Not applicable (immediate distribution upon IV administration)
FoodEffect:
Not applicable (IV administration)
Distribution:
Vd:
Approximately 0.2 L/kg (distributes throughout the extracellular fluid compartment)
ProteinBinding:
Not applicable (ions do not bind to plasma proteins)
CnssPenetration:
Yes (freely crosses the blood-brain barrier)
Elimination:
HalfLife:
Not applicable (ions are continuously regulated by physiological processes)
Clearance:
Renal excretion, regulated by the kidneys to maintain fluid and electrolyte homeostasis.
ExcretionRoute:
Renal
Unchanged:
100% (ions are excreted as ions, not chemically changed)
Pharmacodynamics
OnsetOfAction:
Immediate (upon intravenous administration)
PeakEffect:
Immediate (upon intravenous administration)
DurationOfAction:
Dependent on fluid and electrolyte balance, renal function, and ongoing fluid losses; typically short-lived as fluid is distributed and excreted.
Safety & Warnings
Side Effects
Urgent Side Effects: Seek Medical Help Right Away
While rare, some people may experience severe and potentially life-threatening side effects when 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 electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain, cramps, or spasms
+ Weakness
+ Shakiness
+ Change in balance
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe upset stomach 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 offer medical advice.
While rare, some people may experience severe and potentially life-threatening side effects when 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 electrolyte problems, including:
+ Mood changes
+ Confusion
+ Muscle pain, cramps, or spasms
+ Weakness
+ Shakiness
+ Change in balance
+ Abnormal heartbeat
+ Seizures
+ Loss of appetite
+ Severe upset stomach 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 offer medical advice.
Seek Immediate Medical Attention If You Experience:
- Swelling in your ankles, feet, or hands (edema)
- Difficulty breathing or shortness of breath
- Rapid weight gain
- Unusual thirst
- Confusion or lethargy
- Muscle weakness or cramps
- Headache
- Dizziness
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. Individuals with kidney problems and premature infants are at a higher risk of developing aluminum toxicity. Consult with your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. It is crucial to weigh the benefits and risks of taking this medication during this time, and your doctor will help you make an informed decision regarding your health and the health of your baby.
This medication may contain aluminum, which can increase the risk of aluminum toxicity with long-term use. Individuals with kidney problems and premature infants are at a higher risk of developing aluminum toxicity. Consult with your doctor to discuss this potential risk.
If you are pregnant, planning to become pregnant, or breastfeeding, inform your doctor. It is crucial to weigh the benefits and risks of taking this medication during this time, and your doctor will help you make an informed decision regarding your health and the health of your baby.
Overdose Information
Overdose Symptoms:
- Fluid overload (e.g., peripheral and pulmonary edema, dyspnea, hypertension, tachycardia)
- Hypernatremia (e.g., extreme thirst, lethargy, confusion, irritability, seizures, coma)
- Hyperchloremia (e.g., metabolic acidosis, tachypnea)
- Electrolyte imbalances
What to Do:
Discontinue the infusion immediately. Administer diuretics to promote fluid excretion. Correct severe electrolyte imbalances as needed. Provide supportive care for symptoms (e.g., respiratory support for pulmonary edema). In case of suspected overdose, seek immediate medical attention or call a poison control center (e.g., 1-800-222-1222 in the US).
Drug Interactions
Moderate Interactions
- Corticosteroids (e.g., prednisone, hydrocortisone): May increase sodium retention, leading to fluid overload and edema.
- Lithium: Large volumes of sodium chloride may increase renal excretion of lithium, potentially decreasing lithium levels and efficacy.
- Drugs that cause sodium retention (e.g., NSAIDs, some antihypertensives): May exacerbate fluid retention and edema when co-administered with large volumes of sodium chloride.
Monitoring
Baseline Monitoring
Serum electrolytes (Sodium, Potassium, Chloride)
Rationale: To assess baseline electrolyte status and guide appropriate fluid therapy.
Timing: Prior to initiation of therapy.
Renal function (BUN, Creatinine)
Rationale: To assess kidney's ability to handle fluid and electrolytes, especially important for patients at risk of fluid overload.
Timing: Prior to initiation of therapy.
Fluid status (Vital signs, Intake/Output, Weight, Edema assessment)
Rationale: To assess baseline hydration status and identify risk factors for fluid imbalance.
Timing: Prior to initiation of therapy.
Routine Monitoring
Serum electrolytes (Sodium, Potassium, Chloride)
Frequency: Daily or as clinically indicated, depending on patient's condition and volume of fluid administered.
Target: Sodium: 135-145 mEq/L, Chloride: 98-107 mEq/L
Action Threshold: Significant deviations from normal range or patient's baseline, or signs/symptoms of electrolyte imbalance.
Fluid balance (Intake/Output)
Frequency: Every 4-8 hours or as clinically indicated, especially in patients receiving large volumes or with compromised renal/cardiac function.
Target: Appropriate balance based on clinical need (e.g., slightly positive for rehydration, neutral for maintenance).
Action Threshold: Significant positive or negative fluid balance, or signs of fluid overload/dehydration.
Vital signs (Blood Pressure, Heart Rate, Respiratory Rate)
Frequency: Every 4-8 hours or as clinically indicated.
Target: Within normal limits for patient.
Action Threshold: Changes indicative of fluid imbalance (e.g., hypotension, tachycardia, dyspnea, hypertension).
Weight
Frequency: Daily, especially in patients at risk of fluid overload.
Target: Stable or appropriate change based on clinical goals.
Action Threshold: Rapid weight gain (suggesting fluid retention) or loss (suggesting dehydration).
Symptom Monitoring
- Signs of fluid overload (e.g., peripheral edema, pulmonary crackles, dyspnea, jugular venous distension, rapid weight gain)
- Signs of hypernatremia (e.g., thirst, lethargy, confusion, irritability, seizures, coma)
- Signs of hyperchloremia (e.g., metabolic acidosis, tachypnea)
- Signs of electrolyte imbalance (e.g., muscle weakness, cramps, arrhythmias)
Special Patient Groups
Pregnancy
Generally considered safe and frequently used during pregnancy for fluid replacement, hydration, or as a diluent for medications. However, large volumes should be used with caution and close monitoring in conditions like pre-eclampsia or other states of fluid retention.
Trimester-Specific Risks:
First Trimester:
Low risk, generally safe for appropriate indications.
Second Trimester:
Low risk, generally safe for appropriate indications.
Third Trimester:
Low risk, generally safe, but monitor closely for fluid overload, especially in patients with pre-existing cardiac or renal conditions, or pre-eclampsia.
Lactation
Compatible with breastfeeding. Sodium and chloride are natural components of breast milk and are not expected to cause adverse effects in the breastfed infant.
Infant Risk:
Low risk (L1)
Pediatric Use
Dosing must be carefully individualized based on weight, age, and clinical condition to avoid fluid overload or electrolyte imbalances. Infants and young children have less developed renal function and are more susceptible to fluid and electrolyte disturbances. Close monitoring of fluid balance and serum electrolytes is crucial.
Geriatric Use
Use with caution due to increased risk of fluid overload, especially in patients with underlying cardiac, renal, or hepatic impairment. Geriatric patients may have reduced renal function and decreased compensatory mechanisms for fluid and electrolyte shifts. Monitor fluid and electrolyte status closely.
Clinical Information
Clinical Pearls
- Sodium Chloride 0.9% is isotonic and primarily expands the extracellular fluid compartment; only about 25% remains intravascular.
- Risk of fluid overload (pulmonary edema, peripheral edema) is significant, especially in patients with heart failure, renal impairment, or liver disease.
- Large volumes can lead to hypernatremia and hyperchloremic metabolic acidosis.
- It is the most commonly used diluent for intravenous medications due to its isotonicity and compatibility with many drugs.
- Not suitable for patients requiring free water (e.g., severe hypernatremia, pure water deficit) as it contains sodium.
- Always assess patient's fluid and electrolyte status (I&O, weight, vital signs, labs) before and during administration.
Alternative Therapies
- Dextrose 5% in Water (D5W) (for free water deficit or to provide calories)
- Dextrose 5% in 0.45% Sodium Chloride (D5 1/2 NS) (for maintenance fluid with some free water)
- Colloids (e.g., albumin, for specific volume expansion needs, particularly in hypovolemic shock or severe hypoalbuminemia)
Cost & Coverage
Average Cost:
Highly variable, typically low cost per 50mL bag/vial
Generic Available:
Yes
Insurance Coverage:
Generally covered by most insurance plans as a medical supply/service when administered in a healthcare setting.
General Drug Facts
If your symptoms or health problems persist or worsen, it is essential to contact your doctor for further guidance. To ensure your safety and the safety of others, never share your medication with anyone, and do not take medication prescribed to someone else.
Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion. Properly dispose of any unused or expired medication. Unless instructed to do so by a healthcare professional or pharmacist, avoid flushing medications down the toilet or pouring 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, so it is a good idea to check with your pharmacist. If you have any questions or concerns about your medication, do not hesitate 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, the quantity, and the time it was taken, as this will aid in providing appropriate care.
Store all medications in a secure location, out of the reach of children and pets, to prevent accidental ingestion. Properly dispose of any unused or expired medication. Unless instructed to do so by a healthcare professional or pharmacist, avoid flushing medications down the toilet or pouring 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, so it is a good idea to check with your pharmacist. If you have any questions or concerns about your medication, do not hesitate 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, the quantity, and the time it was taken, as this will aid in providing appropriate care.