SODIUM CHLORIDE 0.9% IN STERILE 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 provides sodium and chloride ions, essential for maintenance of osmotic pressure and fluid balance. It acts as a volume expander and vehicle for drug administration.
| Metabolism | Sodium chloride is not metabolized; it is excreted unchanged primarily by the kidneys. |
| Excretion | Primarily renal excretion; >90% of administered sodium and chloride ions are eliminated unchanged in urine via glomerular filtration and tubular reabsorption. Less than 10% is lost through sweat, feces, and insensible losses. |
| Half-life | The terminal elimination half-life of sodium and chloride ions is approximately 8-12 hours in individuals with normal renal function, reflecting the time required to excrete a load and reestablish homeostasis. In renal impairment, half-life is prolonged proportionally to the decrease in glomerular filtration rate. |
| Protein binding | Sodium and chloride ions are not bound to plasma proteins; protein binding is negligible (<1%). |
| Volume of Distribution | The apparent volume of distribution for sodium is approximately 0.2-0.5 L/kg, reflecting distribution primarily in extracellular fluid (ECF). Chloride distributes similarly. This Vd indicates that sodium chloride does not extensively penetrate cells and remains largely in the intravascular and interstitial spaces. |
| Bioavailability | Oral: approximately 100% (sodium chloride is completely absorbed from the gastrointestinal tract). Intravenous: 100% (direct administration into bloodstream). |
| Onset of Action | Intravenous infusion: immediate onset (within seconds to minutes) as the solution directly expands intravascular volume and corrects electrolyte deficits. Oral administration: onset of fluid and electrolyte effects occurs within 15-30 minutes following gastric emptying. |
| Duration of Action | Intravenous infusion: duration of hemodynamic effect (volume expansion) lasts 30-60 minutes after completion of infusion, depending on the rate of redistribution and renal excretion. Electrolyte correction duration is variable and depends on ongoing losses and renal function. Oral administration: effects on hydration and electrolyte balance persist for 1-2 hours after ingestion. |
Intravenous infusion; 0.9% sodium chloride is administered at a rate and volume determined by the patient's fluid and electrolyte needs, typically 500-1000 mL per hour for resuscitation or 100-200 mL per hour for maintenance.
| Dosage form | SOLUTION FOR SLUSH |
| Renal impairment | No dose adjustment required for renal impairment; use caution in severe renal impairment due to risk of volume overload and hypernatremia. |
| Liver impairment | No dose adjustment required for hepatic impairment; monitor for fluid overload. |
| Pediatric use | Intravenous infusion; maintenance dose 100-150 mL/kg/day for children up to 10 kg, 50-100 mL/kg/day for 10-20 kg, and 30-50 mL/kg/day for >20 kg; adjust as per clinical need. |
| Geriatric use | Use caution due to increased risk of volume overload; start at low infusion rates and titrate based on clinical response, renal function, and cardiovascular status. |
| 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 is a normal constituent of breast milk. Intravenous infusion of 0.9% saline does not significantly alter milk sodium concentration. M/P ratio is not applicable as sodium is endogenous. Use during breastfeeding is considered safe. |
| Teratogenic Risk | Sodium chloride 0.9% is a crystalloid solution that maintains extracellular fluid volume and osmolality. It is not teratogenic; no fetal malformations have been reported. During pregnancy, excessive sodium administration may lead to fluid overload and edema in the mother, which can compromise placental perfusion. There is no known direct fetal risk from therapeutic use. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hypernatremia","Fluid overload states (e.g., pulmonary edema)","Hypersensitivity to sodium chloride","Severe renal impairment with oliguria or anuria"]
| Precautions | ["Use with caution in patients with congestive heart failure, renal impairment, or conditions predisposing to fluid overload","Monitor serum electrolytes and fluid balance regularly","Avoid in patients with hypernatremia or fluid overload","Risk of dilutional hyponatremia with excessive use"] |
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| Fetal Monitoring | Monitor maternal vital signs, urine output, serum electrolytes, and fluid balance. Assess for signs of fluid overload (e.g., peripheral edema, pulmonary congestion). In pregnancy, monitor for maternal hypotension or hypertension, and fetal heart rate if indicated by maternal condition. |
| Fertility Effects | No known impact on fertility. Sodium chloride 0.9% does not affect reproductive function at therapeutic doses. |