sodium chloride solution (intravenous) normal saline (NS), 1/2 NS

Our body cells are bathed in a watery fluid that contains primary sodium and chloride ions. These molecules play a vital role in maintaining proper fluid balance and keeping our tissues hydrated. Additionally, sodium is involved in many cell processes such as muscle contraction, transmission of nerve impulses, and kidney function. Chloride ions are responsible for maintaining the acid-base balance. To sustain life it's very important to maintain these ions within a narrow therapeutic range.

Sodium chloride is available in a variety of formulations including:

• nasal gel,
• nasal spray,
• nasal wash,
• nebulizer solution,
• ophthalmic (eye) drops,
• ophthalmic ointment,
• topical solution for irrigation,
• diluent for injection,
• topical spray, and
• solution for intravenous (into the vein) injection.

Sodium chloride was initially approved by the FDA in 1951.

N/A

GENERIC AVAILABLE: Yes

Yes

Side effects associated with use of intravenous sodium chloride include:

• hypernatremia (high levels of sodium),
• fluid retention,
• high blood pressure,
• heart failure,
• intraventricular hemorrhage in neonates,
• injection site reactions,
• kidney damage,
• electrolyte abnormalities, and
• others.

Dosing of sodium chloride intravenous solution varies. Total volume of administration depends on many factors including condition being treated, laboratory results, and other patient specific characteristics.

Systemic administration of sodium chloride solution should be done with extreme caution as rapid or overt administration may cause complications such as:

• fluid overload,
• pulmonary edema (water in the lungs),
• cell damage,
• severe electrolyte abnormalities,
• brain damage, and
• intraventricular hemorrhage.

Although use of sodium chloride solution has not been associated with any serious or life threatening drug interactions, unintended increases in sodium and water retention may occur when used with corticosteroids.

Use of sodium chloride intravenous solution may increase the renal elimination of lithium (Eskalith, Lithobid). Lithium concentrations and control of symptoms should be monitored frequently in patients receiving IV sodium chloride.

Use of tolvaptan (Samsca) with hypertonic preparations of sodium chloride (3% or 5% solution for injection) is not recommended as rapid correction of hyponatremia (low levels of sodium in the blood) increases the risk of osmotic demyelination (nerve damage).

It is not known if sodium chloride can cause harm to unborn baby. However, 0.9% sodium chloride (normal saline or NS) has been administered to pregnant women without any reports of harm. The manufacturer recommends that sodium chloride should only be administered to pregnant women if clearly needed. Sodium chloride is classified as FDA pregnancy risk category C (Animal reproduction studies have shown an adverse effect on the fetus and there are no adequate and well-controlled studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.).

It is not known if sodium chloride is excreted into human milk. As 0.9% sodium chloride solution has the same osmotic pressure as that in the serum, risk of adverse effects with its use during breastfeeding is considered minimal. However, sodium chloride bacteriostatic injection should be used cautiously in nursing mothers as the benzyl alcohol preservative found in the solution has been found to cause adverse events in the nursing infant.

What preparations of sodium chloride solution-intravenous are available?

• Sodium chloride diluent for injection: 0.9%
• Sodium chloride solution for injection: 0.9% prefilled syringe, normal saline flush 0.9% solution, sodium chloride 0.45% solution (1/2 NS), sodium chloride hypertonic 3% solution, sodium chloride hypertonic 5% solution.

How should I keep sodium chloride solution-intravenous stored?

Sodium chloride preparations should be stored at room temperature between 59 F to 86 F (15 C to 30 C).