BACTERIOSTATIC SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Bacteriostatic sodium chloride 0.9% is an isotonic solution used as a diluent or vehicle for medications. Sodium chloride provides osmotic balance and acts as a source of electrolytes. The bacteriostatic property is due to the presence of benzyl alcohol, which inhibits bacterial growth by disrupting bacterial cell wall synthesis and protein function.
| Metabolism | Sodium chloride is not metabolized; it is distributed throughout the body and excreted primarily by the kidneys. Benzyl alcohol is metabolized in the liver via alcohol dehydrogenase to benzoic acid, which is conjugated with glycine to form hippuric acid and excreted in urine. |
| Excretion | Renal >99% as unchanged drug; negligible biliary or fecal elimination. |
| Half-life | Approximately 30 minutes; reflects rapid renal clearance and distribution equilibrium. |
| Protein binding | None (0%); sodium and chloride ions are not protein-bound. |
| Volume of Distribution | 0.05-0.1 L/kg; primarily confined to extracellular fluid space. |
| Bioavailability | 100% intravenously; not applicable for other routes as formulation is for IV use only. |
| Onset of Action | Immediate upon intravenous administration; no delay for bacteriostatic effect. |
| Duration of Action | Duration of bacteriostatic effect is approximately 1-2 hours; corresponds to maintenance of effective concentration. |
Intravenous infusion; typical adult dose is 1000 mL every 24 hours, administered at a rate of 50-100 mL/hour, to maintain intravascular volume and correct sodium deficiency.
| Dosage form | SOLUTION |
| Renal impairment | No dose adjustment required for normal renal function. In acute kidney injury or chronic kidney disease, monitor sodium and chloride levels; adjust infusion rate based on fluid status, electrolytes, and renal function. |
| Liver impairment | No dose adjustment required for hepatic impairment. Use with caution in patients with cirrhosis or ascites due to fluid overload risk. |
| Pediatric use | Intravenous infusion; dose based on weight and clinical condition. Typical maintenance: 100 mL/kg/day for first 10 kg, 50 mL/kg/day for next 10 kg, 20 mL/kg/day for each additional kg. Adjust rate based on hydration status. |
| Geriatric use | Elderly patients may have decreased renal function, heart failure, or fluid balance disorders. Infuse at lower initial rates (e.g., 25-50 mL/hour) and titrate based on clinical response and electrolyte monitoring. Avoid excess sodium load to prevent fluid overload. |
| 1st trimester | Consult provider |
| 2nd trimester | Consult provider |
| 3rd trimester | Consult provider |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Breastfeeding | Bacteriostatic sodium chloride 0.9% is considered compatible with breastfeeding. Benzyl alcohol is excreted into breast milk, but the amount transferred via maternal use is negligible. The M/P ratio is not well established due to lack of pharmacokinetic studies. The American Academy of Pediatrics lists benzyl alcohol as compatible with breastfeeding. Use of this solution in small volumes for flushing or drug dilution is unlikely to cause adverse effects in nursing infants. |
| Teratogenic Risk |
■ FDA Black Box Warning
Do not use in newborns due to the risk of benzyl alcohol toxicity (gasping syndrome). This product contains benzyl alcohol, which has been associated with fatal reactions in pediatric patients less than 1 month of age.
| Common Effects | fluid replacement |
| Serious Effects |
["Newborns (less than 1 month of age) due to benzyl alcohol toxicity.","Known hypersensitivity to sodium chloride or benzyl alcohol.","Patients with hypernatremia or fluid overload where sodium administration is contraindicated."]
| Precautions | ["Risk of fluid overload, especially in patients with heart failure, renal impairment, or edema.","Monitor serum electrolytes, particularly in patients receiving large volumes or with sodium/chloride imbalances.","Benzyl alcohol toxicity in neonates and low-birth-weight infants; avoid use in newborns.","Hypersensitivity reactions may occur (e.g., rash, urticaria).","Use with caution in patients with hepatic impairment due to benzyl alcohol metabolism.","Incompatibility with certain medications; check compatibility before admixture."] |
Loading safety data…
| Bacteriostatic sodium chloride 0.9% is a sterile isotonic solution containing 0.9% sodium chloride and benzyl alcohol as a preservative. Benzyl alcohol can cross the placenta and has been associated with 'gasping syndrome' in neonates when administered in high doses. However, standard volumes used for drug reconstitution or flushes are unlikely to cause significant fetal exposure. The FDA has not assigned a pregnancy risk category specifically for this product. In the first trimester, there is theoretical risk from benzyl alcohol exposure, though no specific teratogenic effects are established. In the second and third trimesters, the risk remains low with typical clinical use. |
| Fetal Monitoring | No specific maternal or fetal monitoring is required for the administration of bacteriostatic sodium chloride 0.9%. However, when used as a vehicle for other medications, monitoring should be based on the properties of the administered drug. In neonates, prolonged use of solutions containing benzyl alcohol can cause toxicity, so caution is warranted in pregnant or postpartum patients if high volumes are administered. |
| Fertility Effects | There are no known effects of bacteriostatic sodium chloride 0.9% on fertility. Sodium chloride and benzyl alcohol have not been shown to impair reproductive function in animal studies or human clinical experience. |
| Food/Dietary | No food interactions. However, patients on sodium-restricted diets should be monitored as this solution provides 154 mEq/L each of sodium and chloride. |
| Clinical Pearls | Bacteriostatic Sodium Chloride 0.9% contains benzyl alcohol as a preservative. Do not use in neonates due to risk of fatal 'gasping syndrome'. Use within 28 days after opening. Discard if turbid or contains precipitate. For intravenous use only; avoid intra-arterial or intramuscular administration. Monitor serum sodium and chloride in patients with heart failure, renal impairment, or hypernatremia. |
| Patient Advice | This solution contains a preservative and should not be used in newborns. · Do not use if the solution is cloudy or contains particles. · Discard any unused portion after 28 days of opening. · Inform your healthcare provider if you have a history of heart or kidney disease. · Report any signs of infection at the injection site such as redness, swelling, or warmth. |