3% SODIUM CHLORIDE INJECTION [WELLPHARMA] Infusion/Solution for

What is 3% SODIUM CHLORIDE INJECTION [WELLPHARMA]

3% Sodium Chloride Injection [Wellpharma] is a sterile, hypertonic solution of sodium chloride intended for intravenous (IV) administration. It contains 3 grams of sodium chloride per 100 mL of water, making it significantly more concentrated than normal saline (0.9%). This solution is supplied in a 500 mL plastic infusion bag and is used under controlled medical settings to treat critical electrolyte imbalances, particularly severe or symptomatic hyponatremia (low sodium levels).

This hypertonic saline solution is not for routine fluid replacement; rather, it is used when rapid correction of sodium levels is required, often in intensive care units or emergency settings. It must be administered with strict monitoring to avoid complications such as osmotic demyelination syndrome (ODS).

Indications include:

• Severe hyponatremia (especially when symptomatic)
• Increased intracranial pressure (ICP), particularly in cases of traumatic brain injury or cerebral edema
• Adjunct therapy in the management of shock or hypotension (when indicated)

Each mL contains:

• Sodium Chloride – 30 mg
• Water for Injection – q.s.

This formulation is free of antimicrobial agents and must be used with appropriate aseptic technique. 3% Sodium Chloride is a high-alert medication and should be administered only by trained healthcare professionals in monitored clinical environments.

How to use 3% SODIUM CHLORIDE INJECTION [WELLPHARMA]

3% Sodium Chloride Injection [Wellpharma] is administered by intravenous infusion, typically via a central line due to its hyperosmolarity. Its use requires clinical expertise and intensive monitoring, particularly in patients with fluid or electrolyte imbalances.

Administration guidelines:

• Route: Intravenous infusion (preferably via central venous access)
• Rate: Infusion rate must be customized based on serum sodium levels, volume status, and clinical condition
• Preparation: No dilution is required; the solution is ready to use
• Compatibility: Should not be mixed with other medications unless compatibility has been verified

Monitoring during use:

• Serum sodium levels every 2–4 hours during initial treatment
• Neurological assessments to detect signs of cerebral edema or osmotic demyelination
• Urine output and osmolality to monitor renal function
• Central venous access site for signs of phlebitis or infiltration

It is critical to avoid rapid correction of hyponatremia. The rate of sodium increase should generally not exceed 8–12 mEq/L in 24 hours. Rapid shifts can lead to severe neurological complications.

Healthcare providers must follow institutional protocols for administering hypertonic solutions, including double-checking dosage, rate of administration, and patient parameters.

Mode of Action 3% SODIUM CHLORIDE INJECTION [WELLPHARMA]

3% Sodium Chloride Injection exerts its therapeutic effects by increasing extracellular sodium concentration, thereby enhancing plasma osmolality. This solution is hypertonic relative to blood plasma and draws water out of cells into the extracellular space, including the intravascular compartment.

Mechanism of action includes:

• Correction of hyponatremia: Supplies concentrated sodium ions to restore deficient plasma sodium levels and stabilize cellular osmotic balance
• Osmotic gradient shift: Creates a shift of water from the intracellular to extracellular space, reducing cellular swelling—particularly in neurons
• Reduction of intracranial pressure: Effective in managing cerebral edema and reducing ICP by drawing fluid out of brain tissue

Physiological impact:

• Improves neurologic function in hyponatremia-induced cerebral edema
• Restores vascular volume in hypovolemic patients when used judiciously
• Enhances perfusion in critical care settings where fluid resuscitation must be carefully titrated

The onset of action is rapid, with observable improvements in serum sodium and neurologic status often seen within hours. However, the response must be closely tracked to avoid overcorrection and associated complications.

3% SODIUM CHLORIDE INJECTION [WELLPHARMA] Interactions 3% SODIUM CHLORIDE INJECTION [WELLPHARMA]

Though primarily an electrolyte solution, 3% Sodium Chloride Injection may interact with other medications or therapeutic fluids, especially those affecting renal function, fluid status, or electrolyte balance.

Key drug interactions include:

• Diuretics (e.g., furosemide): May enhance sodium loss or interfere with electrolyte homeostasis; monitor closely
• Corticosteroids: Can cause sodium retention and potassium loss, potentially compounding sodium overload
• Desmopressin (DDAVP): Increases water retention, which can counteract sodium correction and increase risk of hyponatremia
• Vasopressin receptor antagonists: May potentiate rapid serum sodium increases when used concurrently

Fluid and electrolyte interaction concerns:

• Concomitant administration with hypotonic solutions can dilute therapeutic effect
• Hypertonic solutions should not be mixed with incompatible drugs or solutions in the same IV line without a compatibility check

Monitoring considerations:

• Regular serum electrolytes and renal function
• Neurological status to assess for complications from rapid sodium shifts

Always consult institutional drug compatibility charts and pharmacists when co-administering other intravenous therapies alongside 3% Sodium Chloride.

Dosage of 3% SODIUM CHLORIDE INJECTION [WELLPHARMA]

3% Sodium Chloride Injection dosage varies based on the clinical indication, serum sodium levels, patient weight, and presence of neurological symptoms. It must always be prescribed and titrated by a physician.

Typical dosage guidance:

• For symptomatic hyponatremia: Initial bolus of 100 mL over 10 minutes may be given, repeated up to two times if symptoms persist
• Continuous infusion: Often started at 0.5–2 mL/kg/hour with close monitoring of serum sodium
• Maximum rate: Sodium should not rise faster than 8–12 mEq/L in 24 hours

Increased intracranial pressure (ICP):

• Dosage is tailored to maintain serum sodium at 145–155 mEq/L and reduce cerebral edema
• Typical rate: 30–50 mL/hour via central line under continuous ICP and sodium monitoring

Pediatric dosing: Adjusted based on body weight and clinical status, under specialist supervision.

Warnings:

• Risk of osmotic demyelination if corrected too rapidly
• Use in central line is preferred due to risk of vein irritation with peripheral administration

All dosing must be guided by serial laboratory assessments and clinical response. Titration should cease once target sodium correction is achieved.

Possible side effects of 3% SODIUM CHLORIDE INJECTION [WELLPHARMA]

3% Sodium Chloride Injection can cause serious adverse effects if not administered carefully. As a high-alert medication, its use requires continuous clinical monitoring to minimize risks.

Common side effects:

• Thirst, dry mouth
• Fluid overload (e.g., pulmonary edema, peripheral edema)
• Irritation or pain at the injection site

Serious adverse reactions:

• Osmotic demyelination syndrome (ODS): Risk increases if sodium is corrected too rapidly
• Hypernatremia: Excess sodium can cause confusion, seizures, or coma
• Congestive heart failure: May worsen fluid overload in susceptible individuals

Other possible reactions:

• Metabolic acidosis or alkalosis, depending on volume status and acid-base balance
• Phlebitis or thrombosis at infusion site (especially with peripheral use)

Prompt cessation and supportive measures are necessary if serious side effects occur. Regular monitoring of sodium levels and neurologic status helps mitigate these risks.

3% SODIUM CHLORIDE INJECTION [WELLPHARMA] Contraindications 3% SODIUM CHLORIDE INJECTION [WELLPHARMA]

3% Sodium Chloride Injection is contraindicated in specific clinical scenarios due to its hypertonic nature and potential for serious complications.

Absolute contraindications:

• Hypernatremia: Use would further elevate sodium levels, risking CNS toxicity
• Severe renal impairment: May cause fluid overload and inability to excrete excess sodium
• Uncontrolled congestive heart failure: May exacerbate fluid retention

Relative contraindications:

• Patients with generalized edema or ascites
• Peripheral IV administration (unless no central access is available and infusion is brief)

Clinical precautions:

• Rapid infusion without monitoring can lead to severe neurological complications
• Use in pregnancy or lactation should be based on clinical need and monitored closely

Always evaluate fluid status, sodium levels, renal function, and comorbidities before initiating therapy. Contraindications must be weighed against the urgency of sodium correction.

Storage of 3% SODIUM CHLORIDE INJECTION [WELLPHARMA]

Proper storage of 3% Sodium Chloride Injection [Wellpharma] ensures its stability and sterility for clinical use.

• Storage temperature: Store between 15°C and 25°C (59°F to 77°F)
• Avoid freezing: Do not freeze the solution; crystallization can compromise safety
• Light protection: Store in original packaging to protect from direct sunlight
• Bag integrity: Inspect the bag for leaks, discoloration, or particulate matter before use

Handling guidelines:

• Do not use if the solution is cloudy or if the seal is broken
• Use only once; discard unused portion after opening
• Follow aseptic techniques during administration to avoid contamination

Healthcare facilities should adhere to first-expired, first-out (FEFO) inventory practices and routinely check expiry dates to ensure patient safety.