Sodium Chloride – Injection

Sodium chloride is used to dilute medicines and to rehydrate patients among a multitude of other applications.

Overview

Sodium chloride is an essential component of human life. The human body is made up of approximately 60% water, which contains numerous minerals, salts, and other elements. Sodium chloride is one of the main salts in all bodily fluids, and an optimum level of sodium chloride is essential for the maintenance of good health.

When administered intravenously, sodium chloride is used to treat fluid loss and to restore the balance of the compound within the body. It is typically used to treat patients who are unable to take nutrients or fluids by mouth due to extreme weakness or illness.

It is often used to help replenish electrolytes. Many automatic processes in the body require an electric current, and electrolytes provide these charges. These electrolytes interact with one another as well as with cells in muscles, tissues, and nerves. A balance of different types of electrolytes is important for the body to function healthily. Older adults are generally at greater risk of electrolyte imbalance.

Sodium chloride can also be used to dilute other medicines before they are administered at a slow rate of injection via an IV drip to ensure a steady, incremental stream of the medicine is absorbed by the body.

It is often marketed under different names for different treatments and can be prescribed by doctors for a variety of approved and off-label purposes. For example, sodium chloride is sold as Syrex as a product designed to prevent IV catheters from becoming blocked and to remove excess medication left at a catheter site. Sodium chloride solution at a 20% concentration can be used to induce abortion when injected into the uterus.

Conditions Treated

  • Dehydration
  • Electrolyte imbalance
  • Gastroenteritis
  • Diarrhea

Type of Medicine

  • Essential mineral solution

Side effects

Along with its required effects, intravenous sodium chloride can also cause certain unwanted side effects. The most common effects reported by patients undergoing treatment with this medication include the following: fever, fast heartbeat, hoarseness, itching, irritation, redness of the skin, joint pain or swelling, shortness of breath, swelling of the extremities, tightness in the chest, difficulty swallowing or breathing.

As the patient continues to take this medication as prescribed, some (if not all) of the previously mentioned side effects should lessen. If side effects persist or appear to get worse over time, the patient is advised to inform their doctor as soon as possible. A doctor or healthcare provider may be able to advise a patient on how to alleviate uncomfortable side effects with natural or over the counter medicines.

Dosage

As with all medications, it is vital that patients are only administered intravenous sodium chloride as prescribed by a qualified doctor. This means that healthcare professionals should avoid administering more of this medicine than advised, either in dose size or frequency. In addition to this, clinicians should discontinue use of this medication on a patient if a doctor says so, even if they have a supply of the medicine remaining. In some instances, as patients regain strength after one or more courses of IV sodium chloride solution, it may be beneficial to switch to manual means of administration (taking in liquids by mouth). Patients who already have sufficient levels of sodium chloride in their fluids are advised against taking anymore via IV unless a doctor considers it necessary (to dilute another medication, for example).

Sodium chloride solution is typically given by injection in a vein as directed by a qualified healthcare professional. While it is more common for it to be administered in a hospital or clinic, in some circumstances it may be given at home. If the patient is using sodium chloride solution at home, they are advised to check all usage and preparation instructions and seek demonstration from a qualified clinician prior to self-administration, particularly if they are mixing the solution with another medicine.

Before use, sodium chloride solution should be visually checked for discoloration or particles. If either of these is present, the solution should not be used and should be exchanged or discarded.

While the manufacturers of sodium chloride provide general dosage instructions, it should be reiterated that these are simply recommendations and are likely to be altered by the patient’s doctor. Numerous factors will influence dosage amounts, including the height, weight and medical condition of the patient along with their response to treatment with the solution.

For dehydration, loss of fluids and sodium depletion, sodium chloride intravenous infusion at 0.9% concentration is typically administered. It is also used at this concentration as a vehicle or diluent of other medications.

The recommended dose for treatment of the previously mentioned conditions in adults is between 500ml and 3 liters per 24 hours. For babies and children, 20 to 100ml per kg of body weight should be administered per 24 hours.

As a vehicle or diluent for another medication, doses range from 50ml to 250ml per dose of medicine to be administered. These ranges will differ depending on the drug the patient is being treated with, and a qualified doctor should make the decision with regard to the level of dilution.

Sodium chloride solution should be administered via a sterile, non-pyrogenic IV set, using aseptic technique. Equipment must be primed with the sodium chloride solution to prevent air from entering the system. The unit should not be removed from the overwrap until it is ready for administration. The inner bag ensures the solution is sterile and should be administered immediately after the insertion of the infusion set.

Flexible plastic containers should not be connected in a series, as this poses a risk of air embolism on account of the possibility of residual air within the primary container. When intravenous solutions in flexible containers are pressurized to increase flow rates, air embolism can occur if the residual air in the container has not been completely evacuated before administration. Use of a vented IV administration set with the vent set to the open position can also result in air embolism – therefore, vented IV sets should not be used with flexible containers unless the vent has been shut and checked prior to administration.

Interactions

All medicines have the potential to interact with other medicines or chemicals within the human body. In some instances, this can cause a medicine to become ineffective. In other circumstances, these interactions can cause serious side effects to occur. Because of this possibility, patients are advised to keep a detailed list of all drugs they are currently undergoing treatment with. This extends to complementary medicines, herbal supplements, vitamins and over-the-counter remedies.

Below is a partial list of medicines known to interact negatively with sodium chloride IV solution:

  • Eskalith
  • Lithium
  • Lithonate
  • Tithotabs
  • Lithium Carbonate
  • Lithobid
  • Tolvaptan

Patients who are currently taking any of these medications should inform their doctor prior to beginning treatment with sodium chloride, either as a standalone product or as a vehicle for another medicine.

Warnings

Sodium chloride solution may not be suitable for patients suffering from the following health conditions:

  • Heart disease
  • Asthma
  • Edema (swelling)
  • High blood pressure
  • Epilepsy

Those who have been diagnosed with one or more of these health problems should consult with their doctor prior to using an IV sodium chloride solution. In some instances, a doctor may prescribe another medication to counteract the effects (such as a diuretic), and in other instances, a doctor may advise against using the solution altogether, or insist it is used with great caution and under observation.

Excess alcohol and/or coffee should be avoided by patients undergoing treatment with sodium chloride, as these substances can contribute towards high blood pressure or have a diuretic effect which counteracts the use of the medication.

Patients who have ever experienced an allergic reaction to this medication (or any other medicine) should mention this to their healthcare provider prior to undergoing treatment with sodium chloride solution.

Storage

50ml, 100ml, 250ml, 500ml and 1 liter bags of sodium chloride solution should be stored at room temperature, not exceeding 30C. Sodium chloride bags should be kept away from direct sunlight and out of the reach of children or pets, in a dedicated medicine cabinet if possible.

Summary

Sodium chloride is essential for humans to function. In intravenous form, it is useful in the treatment of dehydration, sodium depletion, and electrolyte imbalance. However, there are risks associated with IV administration of this compound, and in most instances, it will be given to a patient in a supervised, clinical setting such as a hospital or doctor’s practice.

When administered correctly, it helps to provide relief from moderate unpleasant symptoms of cramp to severe episodes of dehydration due to gastroenteric illness. To get the most out of this medicine, patient and doctor must work together to ascertain the optimum dose based on the patient’s height, weight, state of hydration and clinical condition. Plasma electrolyte concentrations and fluid balances should be monitored during treatment with this medication.

 

Resources
Last Reviewed:
January 31, 2018
Last Updated:
February 10, 2018