SODIUM CHLORIDE 3% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Hypertonic sodium chloride solution (3%) increases extracellular osmolarity, drawing water from intracellular space into extracellular compartment via osmotic gradient, thereby reducing cerebral edema and intracranial pressure. Sodium ions also restore electrolyte balance in hyponatremia.
| Metabolism | Sodium chloride is not metabolized; it is distributed in extracellular fluid and excreted primarily by the kidneys. No hepatic metabolism. |
| Excretion | Renal (essentially 100%): sodium and chloride ions are excreted unchanged in urine. No biliary or fecal elimination of intact drug; sodium and chloride are obligately filtered and variably reabsorbed based on volume status and renal function. |
| Half-life | Not applicable: sodium and chloride are endogenous electrolytes; administered dose mixes with body pools and is eliminated via renal excretion with a half-life dependent on renal function and hydration status. In euvolemic individuals with normal renal function, the terminal elimination half-life of excess sodium is approximately 6–12 hours. |
| Protein binding | 0%: sodium and chloride ions are not protein bound. |
| Volume of Distribution | Total body water (0.6 L/kg): sodium distributes primarily in extracellular fluid (0.2 L/kg); chloride distributes similarly. Clinical meaning: reflects rapid equilibration with the extracellular space. |
| Bioavailability | Intravenous: 100% (bioequivalent to endogenous electrolytes). No oral or other relevant routes for hypertonic saline; oral administration would have variable absorption and is not used. |
| Onset of Action | Intravenous: immediate (seconds to minutes); correction of hyponatremia begins upon infusion. No other routes. |
| Duration of Action | Intravenous: variable (hours); duration depends on infusion rate, volume of distribution, and renal excretion. A single dose transiently expands extracellular fluid volume and increases serum sodium; effects last until excess sodium and water are excreted. |
Intravenous infusion of 3% sodium chloride at a rate of 1-2 mL/kg/hour, with a typical rate of 50-100 mL/hour for adults, titrated to serum sodium goals. Maximum infusion rate: 100 mL/hour, with careful monitoring of serum sodium (increase not >8-10 mEq/L per 24 hours).
| Dosage form | INJECTABLE |
| Renal impairment | No specific dose adjustment for renal impairment based on GFR. Use with caution in patients with renal failure due to risk of fluid overload and hypernatremia. Monitor renal function and fluid balance closely. |
| Liver impairment | No specific dose adjustment for hepatic impairment based on Child-Pugh score. Use with caution in patients with cirrhosis due to risk of ascites and fluid overload. Monitor serum sodium and fluid status. |
| Pediatric use | Intravenous 3% sodium chloride: 0.5-1 mL/kg over 30-60 minutes, with a maximum rate of 1 mL/kg/hour, titrated to serum sodium. Typical dose for severe hyponatremia: 1-2 mL/kg/hour. Monitor serum sodium every 1-2 hours. |
| Geriatric use | Lower initial infusion rates (e.g., 25-50 mL/hour) due to decreased renal function and higher risk of fluid overload. More frequent monitoring of serum sodium and hemodynamic status. Avoid rapid correction (>8 mEq/L per 24 hours). |
| 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 hypertonic saline may transiently increase maternal serum sodium, but negligible transfer into milk is expected. M/P ratio not established. Generally considered compatible with breastfeeding, but monitor infant for signs of electrolyte imbalance if maternal therapy is prolonged or high-dose. |
| Teratogenic Risk |
■ FDA Black Box Warning
None
| Common Effects | fluid replacement |
| Serious Effects |
Hypernatremia; fluid overload; severe renal impairment with oliguria or anuria; pre-existing hyperchloremia; concurrent use of medications that cause sodium retention (e.g., corticosteroids) should be considered relative contraindication; not for use as a maintenance fluid.
| Precautions | Risk of osmotic demyelination syndrome (central pontine myelinolysis) if serum sodium is corrected too rapidly; use with caution in patients with heart failure, renal impairment, or pre-existing hypernatremia; monitor serum sodium, chloride, and fluid status; avoid extravasation as it may cause tissue necrosis. |
Loading safety data…
| Sodium chloride 3% is a hypertonic solution used intravenously for correction of severe hyponatremia. In pregnancy, no teratogenic effects have been reported; however, rapid correction of hyponatremia can cause osmotic demyelination syndrome, which may affect both mother and fetus. First trimester: no known teratogenic risk. Second and third trimesters: cautious use indicated as maternal fluid and electrolyte imbalances can impact fetal homeostasis. |
| Fetal Monitoring | Monitor maternal serum sodium, serum osmolality, and neurologic status closely during infusion to avoid overcorrection and osmotic demyelination. Assess fetal heart rate and uterine activity if administered for preeclampsia or other conditions. Monitor for signs of fluid overload (edema, pulmonary congestion) in mother. |
| Fertility Effects | No known direct effects on fertility. Underlying conditions requiring hypertonic saline (e.g., severe hyponatremia) may be associated with underlying endocrine or metabolic disorders that could affect fertility. |