SODIUM CHLORIDE 0.45% IN PLASTIC CONTAINER
Clinical safety rating
safeNo significant drug interactions Can cause hypernatremia and fluid overload.
Sodium chloride 0.45% (half-normal saline) is an isotonic crystalloid solution that provides sodium and chloride ions to maintain or restore extracellular fluid volume. It expands intravascular volume, corrects electrolyte imbalances, and can dilute plasma osmolality. The chloride component helps maintain acid-base balance.
| Metabolism | Sodium and chloride are not metabolized; they are excreted primarily by the kidneys. No hepatic metabolism. |
| Excretion | Renal: >90% as sodium and chloride ions; negligible biliary/fecal elimination. |
| Half-life | Not applicable; sodium and chloride ions are endogenous substances with rapid renal regulation; no defined half-life. |
| Protein binding | Negligible (<5%); sodium and chloride are free ions. |
| Volume of Distribution | Sodium: 0.6-0.7 L/kg (total body water); chloride distribution similar. Clinically, distributes throughout extracellular fluid. |
| Bioavailability | IV: 100%; not administered orally as hypotonic solution; oral: negligible due to osmotic effects and gastrointestinal regulation. |
| Onset of Action | IV: Rapid (minutes) for volume expansion and electrolyte correction. |
| Duration of Action | IV: 1-2 hours for volume expansion; depends on renal function and hydration status. |
| Molecular Weight | 58.44 |
Intravenous; adult: 500-1000 mL at a rate of 50-100 mL/hour (maintenance); adjust based on fluid and electrolyte status.
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment; monitor serum electrolytes and fluid balance; use with caution in severe renal impairment due to risk of hypernatremia. |
| Liver impairment | No specific dose adjustment; monitor serum sodium in ascites or edema. |
| Pediatric use | Intravenous; weight-based: 20-100 mL/kg/day (maintenance); rate adjusted based on age, weight, and clinical condition. |
| Geriatric use | Consider reduced initial rate due to potential for fluid overload; monitor cardiovascular and renal function closely. |
| 1st trimester | Safe in pregnancy; used as vehicle for IV medications or to correct dehydration/hyponatremia. No known teratogenicity at therapeutic doses. |
| 2nd trimester | Safe; same as t1. Monitor serum sodium and volume status in prolonged use. |
| 3rd trimester | Safe; same as t1 and t2. Caution in preeclampsia or heart failure due to fluid overload risk. |
Clinical note
No significant drug interactions Can cause hypernatremia and fluid overload.
| FDA category | Animal |
| Placental transfer | Sodium and chloride freely cross the placenta via passive diffusion and active transport; concentrations in fetal blood are regulated by maternal levels and placental function. |
| Breastfeeding | Sodium chloride infusions are compatible with breastfeeding as sodium and chloride are normal milk constituents. Avoid excessive doses that may alter maternal plasma sodium; minimal transfer to milk. |
| Lactation Rating | L1 |
| Teratogenic Risk | No known teratogenic risk; sodium chloride is a normal constituent of body fluids and is not associated with fetal harm at standard doses. There is no evidence of teratogenicity in any trimester. |
| Fetal Monitoring | Monitor maternal serum electrolytes (sodium, chloride) and fluid balance, especially in prolonged infusion or compromised renal function. Fetal monitoring is not routinely required unless maternal complications arise. |
| Fertility Effects | No known adverse effects on fertility. Sodium chloride at physiological concentrations does not impair reproductive function. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
HypernatremiaFluid overload states (e.g., heart failure, pulmonary edema)Severe renal impairment with oliguria/anuria
| Precautions | Monitor serum electrolytes, renal function, and fluid status during prolonged therapy, Risk of fluid overload in patients with heart failure, renal impairment, or edema, Infusion rate should be adjusted based on clinical condition and lab values, Use with caution in patients with hypertension or hypernatremia, May cause hyperchloremic metabolic acidosis if large volumes are administered rapidly |
| Food/Dietary | None specific. However, monitor dietary salt intake if receiving concurrent IV sodium. Avoid excessive oral sodium consumption during treatment. |
| Clinical Pearls | 0.45% sodium chloride is a hypotonic solution used for maintenance fluid therapy or to treat hypernatremia. Avoid in patients with increased intracranial pressure due to risk of cerebral edema. Monitor serum sodium frequently to prevent rapid correction. Use with caution in patients with heart failure or renal impairment. |
| Patient Advice | This fluid is given intravenously to restore body water and salt levels. · Tell your healthcare provider if you have heart, kidney, or liver disease. · Report any swelling, shortness of breath, or headache promptly. · Do not stop the infusion without medical advice. |
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