SODIUM CHLORIDE 0.9% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Sodium chloride 0.9% is an isotonic solution that expands extracellular fluid volume, replacing sodium and chloride deficits. Sodium is the primary cation maintaining osmotic pressure and acid-base balance; chloride is the major extracellular anion. The solution provides electrolyte replacement and hydration without altering serum osmolality.
| Metabolism | Sodium and chloride are not metabolized; they are excreted primarily by the kidneys with small amounts lost in sweat and feces. |
| Excretion | Renal: >95% of administered sodium and chloride ions are excreted unchanged in urine; fecal and biliary elimination are negligible (<1%). |
| Half-life | Not applicable; sodium and chloride ions are endogenous substances with no defined terminal elimination half-life. Excretion half-life is dependent on renal function, typically 6-12 hours in individuals with normal kidney function. |
| Protein binding | Negligible (<1%); sodium and chloride ions are not significantly bound to plasma proteins. |
| Volume of Distribution | Approximately 0.5-0.7 L/kg (sodium distributes primarily in extracellular fluid; chloride distributes similarly reflecting extracellular space). |
| Bioavailability | Intravenous: 100% (bioavailability not applicable via other routes; oral administration not used for therapeutic effect, and bioavailability is incomplete due to gastrointestinal regulation). |
| Onset of Action | Intravenous: immediate (within seconds to minutes) for volume expansion and correction of electrolyte imbalances. |
| Duration of Action | Intravenous: duration is dependent on renal clearance and fluid status; typically 1-2 hours for volume effect, but electrolyte correction persists until redistribution and excretion occur. Continuous infusion required for sustained effect. |
Intravenous, 100-200 mL/hour for maintenance; up to 1000 mL bolus for volume resuscitation in adults.
| Dosage form | INJECTABLE |
| Renal impairment | Use with caution in renal impairment; monitor fluid and electrolyte balance. No specific dose adjustment required; adjust volume as needed based on urine output and fluid status. |
| Liver impairment | No specific dose adjustment required. Monitor for fluid overload in cirrhosis with ascites. |
| Pediatric use | Intravenous, maintenance: 100 mL/kg/day for first 10 kg, then 50 mL/kg/day for next 10 kg, then 20 mL/kg/day for remaining kg. Bolus for hypovolemia: 20 mL/kg. |
| Geriatric use | Use with caution due to increased risk of fluid overload and electrolyte disturbances. Lower initial infusion rates recommended, with careful monitoring of cardiovascular and renal function. |
| 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 | Sodium chloride 0.9% is considered compatible with breastfeeding. Sodium and chloride are normal components of breast milk, and intravenous administration does not significantly alter milk composition. No M/P ratio is available as it is a physiologic salt solution. |
| Teratogenic Risk | Sodium chloride 0.9% is a physiologic saline solution. No teratogenic effects are expected at standard therapeutic doses. Administration during any trimester is considered safe when clinically indicated, as sodium and chloride are normal body constituents. There are no known fetal risks associated with appropriate use. |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
["Hypernatremia","Fluid overload states (e.g., pulmonary edema, decompensated heart failure)","Severe renal impairment with oliguria or anuria"]
| Precautions | ["May cause fluid overload, especially in patients with heart failure, renal impairment, or hepatic cirrhosis","Risk of hypernatremia with excessive administration","Monitor serum electrolytes, fluid balance, and renal function during prolonged therapy","Use with caution in patients with hypertension, congestive heart failure, or edema"] |
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| Fetal Monitoring | Monitor maternal serum electrolytes, fluid balance, and renal function. Assess for signs of fluid overload or electrolyte imbalance. Fetal monitoring is not routinely required but may be indicated based on maternal condition. |
| Fertility Effects | No known adverse effects on fertility. Sodium chloride 0.9% is a physiologic solution and does not impair reproductive function at therapeutic doses. |