0.225 % W/V SODIUM CHLORIDE INJECTION USP Infusion/Solution for

What is 0.225 % W/V SODIUM CHLORIDE INJECTION USP

0.225% w/v Sodium Chloride Injection USP is a sterile, non-pyrogenic intravenous solution primarily used for fluid replenishment and electrolyte balance. Each 100 ml contains 0.225 grams of sodium chloride dissolved in water for injection, equivalent to a hypotonic saline solution. Supplied in a 500 ml polypropylene bottle, this solution is particularly indicated in pediatric patients or adults who require a hypotonic fluid replacement therapy.

• Therapeutic Category: Electrolyte replenisher and parenteral fluid.
• Form: Solution for Infusion.
• Strength: 0.225% sodium chloride (2.25 mg/ml).
• Route of Administration: Intravenous (IV).
• Used for: Treatment or prevention of sodium depletion, hydration therapy, or as a diluent for compatible drugs.

Because of its hypotonic nature, it provides free water, which aids in hydrating cells in conditions such as hypernatremia or dehydration due to fluid loss. It is commonly utilized in neonatal and pediatric care or situations requiring cautious sodium administration.

How to use 0.225 % W/V SODIUM CHLORIDE INJECTION USP

0.225% Sodium Chloride Injection USP must be used under the guidance of a healthcare professional, typically administered in a hospital or clinical setting. It is infused intravenously, with the rate and volume tailored to the patient’s individual fluid and electrolyte requirements.

• Method of Administration: Administer by intravenous infusion using aseptic technique.
• Rate of Infusion: Depends on age, weight, clinical condition, and electrolyte balance of the patient.
• Do not use if: The solution is discolored or contains particulate matter.
• Use a sterile administration set: Ensure all equipment used is sterile and properly connected.
• Monitoring: Regular monitoring of fluid balance, serum electrolytes, and renal function is essential during treatment.

The solution may also be used as a vehicle for reconstituting or diluting other intravenous medications. In such cases, ensure compatibility with the drug being mixed. Do not add incompatible substances as precipitation or instability can occur.

Mode of Action 0.225 % W/V SODIUM CHLORIDE INJECTION USP

The primary mode of action of 0.225% w/v Sodium Chloride Injection USP revolves around the role of sodium and chloride ions in maintaining osmotic balance and proper cellular function.

• Sodium: Plays a key role in regulating extracellular fluid volume, nerve conduction, and muscle function.
• Chloride: Helps maintain acid-base balance and osmotic pressure alongside sodium.
• Hypotonic Effect: With a lower osmolarity than blood plasma (~77 mEq/L of sodium and chloride), it promotes fluid movement into intracellular spaces, making it ideal for cellular hydration.
• Electrolyte Replenishment: Replaces sodium and chloride lost through sweating, vomiting, diarrhea, or excessive urination.

When administered intravenously, the sodium and chloride ions diffuse throughout the extracellular fluid, helping correct deficiencies and maintaining homeostasis. The hypotonic nature of this solution is particularly useful for treating hypernatremia, as it allows water to move into cells and reduce plasma sodium levels.

0.225 % W/V SODIUM CHLORIDE INJECTION USP Interactions 0.225 % W/V SODIUM CHLORIDE INJECTION USP

While 0.225% Sodium Chloride Injection USP is generally safe, certain interactions must be considered when used in combination with other drugs or conditions affecting fluid and electrolyte balance.

• Drug-Drug Interactions:
• Corticosteroids: May increase sodium retention and potassium loss.
• Diuretics: Can influence electrolyte levels, potentially leading to imbalances.
• NSAIDs: May reduce renal function, affecting sodium and water retention.
• ACE inhibitors / ARBs: Can lead to hyperkalemia when used with sodium-containing fluids.
• Drug-Additive Interactions:
• Only mix with compatible drugs. Always verify pH and stability before combining with any IV medication.
• Medical Condition Interactions:
• Cardiac or renal impairment: May predispose to fluid overload.
• Hypertension or edema: Sodium-containing solutions may worsen these conditions.

Always consult a healthcare provider before combining with other drugs or in patients with existing health conditions. Compatibility charts should be referenced when used as a drug diluent.

Dosage of 0.225 % W/V SODIUM CHLORIDE INJECTION USP

The dosage of 0.225% Sodium Chloride Injection USP must be individualized according to the age, weight, clinical status, and specific electrolyte and fluid needs of the patient.

• Adults: Typically used as a maintenance fluid in combination with dextrose or other electrolytes. Dose varies from 500 ml to 2000 ml daily based on requirements.
• Pediatric Patients: Frequently used in neonates and children for gentle hydration. Dosage calculated based on weight and clinical assessment (commonly 100–150 ml/kg/day in neonates).
• Rate of Infusion: Depends on total volume required per day. Rates typically range from 20–150 ml/hr depending on indication.
• Maximum Dose: No fixed maximum, but fluid overload and sodium toxicity must be avoided. Monitoring is essential.

Dosage should always be prescribed and adjusted by a healthcare professional based on continuous monitoring of the patient's clinical and biochemical status. Fluid input and output, electrolyte levels, and signs of fluid overload should guide ongoing administration.

Possible side effects of 0.225 % W/V SODIUM CHLORIDE INJECTION USP

While 0.225% Sodium Chloride Injection USP is generally well-tolerated when used appropriately, it can cause adverse effects, especially in patients with impaired renal function or fluid regulation disorders.

• Common side effects:
• Injection site reactions (redness, pain, phlebitis).
• Mild fluid retention or swelling in susceptible individuals.
• Serious adverse effects (rare):
• Fluid overload: May lead to pulmonary edema, especially in patients with renal or cardiac impairment.
• Electrolyte imbalance: Risk of hyponatremia if excessive free water accumulates.
• Hypervolemia: Can result from rapid or excessive administration.
• Acidosis: Prolonged use may alter acid-base status.
• Allergic reactions: Rare, but may include rash or anaphylactoid symptoms if additives or plastic leachates are involved.

Prompt medical attention is required if any signs of adverse reaction occur, especially shortness of breath, confusion, or severe swelling.

0.225 % W/V SODIUM CHLORIDE INJECTION USP Contraindications 0.225 % W/V SODIUM CHLORIDE INJECTION USP

Despite its widespread use, 0.225% Sodium Chloride Injection USP is contraindicated in certain medical situations where hypotonic saline could be harmful.

• Established contraindications:
• Hypernatremia: Administration can exacerbate elevated sodium levels.
• Cellular overhydration: Conditions such as hyponatremia or SIADH may be worsened.
• Congestive heart failure: Risk of fluid overload and pulmonary edema.
• Severe renal impairment: Reduced excretion may lead to fluid accumulation.
• Relative contraindications:
• Use with caution in patients with edema, cirrhosis, or on corticosteroid therapy.

A thorough assessment of fluid balance, renal function, and serum electrolyte concentrations must precede administration to prevent complications.

Storage of 0.225 % W/V SODIUM CHLORIDE INJECTION USP

Proper storage of 0.225% Sodium Chloride Injection USP ensures safety, sterility, and therapeutic efficacy.

• Temperature: Store between 15°C and 25°C (59°F–77°F). Avoid freezing.
• Light protection: No special protection needed, but store away from direct sunlight.
• Packaging: Supplied in sealed polypropylene bottles for single use only.
• Do not use if:
• The solution is cloudy, colored, or contains visible particulates.
• The seal or container shows signs of damage or tampering.
• Shelf life: Use before the expiration date printed on the label.

Once opened or connected to an administration set, the solution should be used immediately and any unused portion discarded. Do not re-sterilize or reuse containers.