0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P. Infusion/Solution for

What is 0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P.

0.45% w/v Sodium Chloride Intravenous Infusion B.P. is a sterile, non-pyrogenic solution used to replenish fluids and electrolytes in the body. Commonly known as “half-normal saline,” it contains 0.45 grams of sodium chloride per 100 ml of solution, and it is administered intravenously to restore and maintain the body's fluid balance.

• Formulation: The product is available in a 1000ml plastic infusion bag designed for single-use administration.
• Composition: Each 100ml contains 0.45g of Sodium Chloride, equivalent to 77 mEq/L of sodium and chloride ions.
• Purpose: It is primarily used for fluid replacement in cases of mild sodium depletion, dehydration, or to maintain hydration when oral intake is not possible.
• Clinical Settings: Widely used in hospitals, especially in perioperative care, pediatric care, and in patients requiring parenteral hydration.
• Osmolarity: This solution is hypotonic relative to plasma, which allows it to help rehydrate cells.

Unlike isotonic (0.9%) saline, 0.45% sodium chloride delivers a lower concentration of sodium and chloride, making it suitable in specific clinical scenarios where excessive sodium may pose risks. This infusion is not used as a calorie source or for long-term maintenance therapy without electrolyte monitoring.

How to use 0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P.

The administration of 0.45% Sodium Chloride Intravenous Infusion should always be guided by a healthcare professional. The route of administration is strictly intravenous (IV), typically via a sterile drip set. Usage depends on the patient’s individual fluid and electrolyte needs.

• Preparation: Inspect the infusion bag for clarity, leaks, and expiration date. Do not use if the solution is cloudy or contains particles.
• Administration: Connect to an IV line using aseptic technique. Adjust the infusion rate according to the prescribed dose and patient’s condition.
• Monitoring: Monitor fluid balance, electrolyte levels, renal function, and signs of fluid overload during administration.
• Duration: May be administered as a slow continuous infusion or intermittent boluses depending on clinical judgment.
• Pediatric and Geriatric Use: Dosage and infusion rate may need adjustments due to variations in renal function or comorbidities.

Do not administer with blood products or medications unless compatibility has been established. Always use a dedicated IV line when possible.

Mode of Action 0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P.

The therapeutic effect of 0.45% Sodium Chloride IV infusion stems from its ability to restore intracellular and extracellular fluid balance through osmotic mechanisms. Being a hypotonic solution, it distributes into both the extracellular and intracellular compartments.

• Sodium Role: Sodium ions help regulate blood pressure, blood volume, and pH balance by influencing osmotic gradients and water movement across membranes.
• Chloride Role: Chloride maintains electrical neutrality, participates in acid-base balance, and supports gastric secretion in the form of hydrochloric acid.
• Water Rehydration: The hypotonic nature encourages fluid entry into dehydrated cells, correcting cellular dehydration.
• Volume Expansion: Initially expands plasma volume but subsequently diffuses into interstitial and intracellular spaces, making it suitable for mild extracellular fluid loss.
• Metabolic Impact: Does not supply calories or alter metabolic pathways directly, but supports physiological function by maintaining volume status and electrolytes.

Because it lacks other electrolytes or buffers, prolonged or excessive use without monitoring may lead to imbalances such as hyponatremia or fluid overload.

0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P. Interactions 0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P.

While 0.45% Sodium Chloride infusion is generally safe and inert, it can interact with certain medications or clinical conditions, especially those affecting fluid and electrolyte balance.

• Diuretics: May enhance the risk of electrolyte disturbances when used concurrently with loop or thiazide diuretics.
• Corticosteroids: These may cause sodium retention and potassium loss, necessitating closer monitoring during concurrent use.
• Renin-Angiotensin System Inhibitors (ACE inhibitors, ARBs): May alter sodium and water balance, increasing the risk of hyperkalemia and renal dysfunction.
• NSAIDs: Can reduce renal function and impair the body’s ability to handle sodium loads, leading to fluid retention.
• Antihypertensives: Electrolyte shifts may counteract or potentiate antihypertensive therapy depending on the drug class used.
• Lithium: Sodium intake affects lithium reabsorption in the kidneys; changes in sodium levels may impact lithium toxicity.

Always inform your healthcare provider about all medications you are taking to avoid interactions and ensure optimal fluid management.

Dosage of 0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P.

The dosage of 0.45% Sodium Chloride Intravenous Infusion is individualized based on age, weight, clinical status, and electrolyte needs. It is crucial to administer under medical supervision to avoid under- or overhydration.

• Adults: Typically infused at rates between 50–250 ml/hr depending on the degree of fluid loss and underlying condition.
• Pediatrics: Dose is weight-based; maintenance fluid rates may range from 4–10 ml/kg/hr.
• Elderly: Lower infusion rates are often required due to reduced renal clearance and susceptibility to fluid overload.
• Surgical Patients: Often used postoperatively for hydration and electrolyte balance, typically titrated hourly.
• Renal or Cardiac Conditions: Dose must be minimized and strictly monitored due to risk of fluid retention.

Overuse may result in dilutional hyponatremia or fluid overload. The rate should be adjusted if signs of electrolyte imbalance or pulmonary edema appear.

Possible side effects of 0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P.

Though generally well tolerated, 0.45% Sodium Chloride IV Infusion may cause side effects, especially when administered in large volumes or too rapidly.

• Common Side Effects:
  • Injection site irritation, redness, or phlebitis
  • Mild swelling at the infusion site
  • Transient electrolyte imbalances
• Serious Side Effects:
  • Hyponatremia (low sodium levels)
  • Pulmonary edema due to fluid overload
  • Peripheral or pulmonary fluid retention
  • Metabolic acidosis (rarely)
• Allergic Reactions: Though rare, hypersensitivity reactions such as rash or itching may occur.

Promptly report symptoms such as confusion, difficulty breathing, swollen limbs, or chest discomfort to a healthcare provider.

0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P. Contraindications 0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P.

This infusion is not suitable for all patients. It is contraindicated in cases where water retention or sodium dilution may aggravate existing health conditions.

• Hyponatremia: Further dilution of plasma sodium can worsen the condition.
• Congestive Heart Failure: Risk of exacerbating volume overload.
• Severe Renal Impairment: Compromised fluid excretion may lead to dangerous fluid accumulation.
• Pulmonary Edema: Worsening of fluid buildup in the lungs.
• Cirrhosis or Ascites: Hypotonic solutions may increase third-spacing of fluids.

Careful assessment of clinical condition and lab values is essential before initiating this treatment.

Storage of 0.45% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION B.P.

Proper storage is essential to ensure the safety and efficacy of 0.45% Sodium Chloride IV Infusion.

• Temperature: Store at room temperature between 15°C to 25°C.
• Light Protection: Although not photosensitive, it should be stored away from direct sunlight.
• Packaging: Keep the solution in its original plastic bag. Do not puncture or squeeze the bag prior to use.
• Sterility: Use aseptic technique when connecting to the IV line. Discard unused portions after use.
• Expiration: Check the label for the expiration date. Do not use expired or compromised bags.

Keep out of reach of children and do not freeze. Do not reuse partially administered bags to prevent contamination.