SODIUM CHLORIDE 5% IN PLASTIC CONTAINER
Clinical safety rating: safe
No significant drug interactions Can cause hypernatremia and fluid overload.
Sodium chloride 5% acts as an osmotic diuretic. The hypertonic solution creates an osmotic gradient that draws water from the intracellular space into the extracellular compartment, increasing intravascular volume and promoting free water clearance. It also replaces sodium and chloride deficits.
| Metabolism | Sodium and chloride are not metabolized; they are excreted primarily by the kidneys. |
| Excretion | Sodium and chloride ions are freely filtered by the glomerulus; >90% is reabsorbed in the renal tubules under homeostatic regulation. Fractional excretion of sodium (FENa) is typically <1% in euvolemic states. Unabsorbed ions are eliminated in urine, with negligible biliary or fecal excretion. |
| Half-life | The terminal half-life of administered sodium and chloride is approximately 8–12 hours for excess free water elimination, reflecting renal clearance; for sodium ions, the half-life is highly variable and dependent on hydration status, renal function, and hormonal regulation (ADH, aldosterone). In anuric patients, half-life may extend to 24–48 hours. |
| Protein binding | Sodium and chloride ions are not protein bound; they exist as free ions in plasma. |
| Volume of Distribution | Approximately 0.6–0.7 L/kg, corresponding to total body water. For sodium, the Vd approximates the extracellular fluid volume (~0.2 L/kg) because sodium is primarily extracellular; chloride distributes similarly. |
| Bioavailability | Intravenous: 100% bioavailability. Oral: Variable; sodium and chloride are nearly completely absorbed (≥95%) via active transport and solvent drag in the small intestine. |
| Onset of Action | Intravenous infusion: Immediate correction of plasma volume depletion occurs within minutes; plasma sodium concentration begins to rise within 30–60 minutes of infusion start. Hypotonic hyponatremia correction: onset within 1–2 hours. |
| Duration of Action | Intravenous: Volume expansion effects persist for 2–6 hours depending on infusion rate, renal function, and distribution. Sodium and water redistribution continues for 12–24 hours. |
Intravenous infusion: 500-1000 mL as a single dose; rate varies based on patient status and indication.
| Dosage form | INJECTABLE |
| Renal impairment | Contraindicated in severe renal impairment with oliguria or anuria; use with caution and monitor fluid balance in mild to moderate impairment. |
| Liver impairment | No adjustment required; monitor sodium levels in patients with ascites or cirrhosis. |
| Pediatric use | Intravenous infusion: 5-10 mL/kg/dose, administered over 2-6 hours; maximum rate 0.5-1 mEq/kg/hour. |
| Geriatric use | Use with caution due to increased risk of fluid overload and electrolyte disturbances; consider reduced infusion rates and close monitoring. |
| 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 excreted into breast milk but is considered compatible with breastfeeding. The M/P ratio is not reported as it is a normal electrolyte. |
| Teratogenic Risk | Sodium chloride is a normal constituent of body fluids and is not teratogenic. No fetal risks have been associated with its administration at therapeutic doses in any trimester. |
■ FDA Black Box Warning
None.
| Common Effects | fluid replacement |
| Serious Effects |
["Hypernatremia, hyperchloremia, hypokalemia, or hyperosmolality.","Patients with fluid overload (e.g., pulmonary edema, congestive heart failure).","Severe renal impairment with oliguria or anuria.","Concurrent use of corticosteroids or corticotropin (may increase sodium retention)."]
| Precautions | ["Risk of hypernatremia and hyperosmolality, especially in patients with renal impairment or those receiving large volumes.","Central pontine myelinolysis (osmotic demyelination) if hyponatremia is corrected too rapidly.","Infusion reactions: phlebitis, extravasation, and hypervolemia.","Use with caution in patients with heart failure, renal failure, or edema."] |
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| Fetal Monitoring | Monitor serum electrolytes, fluid balance, and renal function during prolonged or high-volume infusion. Assess for signs of fluid overload or hypernatremia. |
| Fertility Effects | No adverse effects on fertility are expected as sodium chloride is a physiological electrolyte. |