3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL] Injection/Solution for

What is 3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL]

3% w/v Sodium Chloride Injection, USP [MEDISAL] is a sterile, non-pyrogenic, hypertonic solution of sodium chloride (NaCl) intended for intravenous administration. It is primarily used for the management of severe hyponatremia (low serum sodium levels) and as an osmotic agent in clinical settings requiring controlled sodium replenishment.

• Composition: Each 100 mL contains 3 grams of sodium chloride.
• Form: Injectable solution presented in a 500 mL polypropylene bottle.
• Classification: Electrolyte replenisher, parenteral fluid.
• Primary Use: Corrects severe sodium deficits, treats intracranial hypertension, and reduces cerebral edema under critical care.

This solution is to be used only under medical supervision, typically in an inpatient setting, due to its potential to cause rapid shifts in serum osmolality, which must be closely monitored.

How to use 3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL]

3% Sodium Chloride Injection is administered intravenously by a healthcare professional. It is critical that the infusion rate and total volume be carefully calculated based on individual patient needs, laboratory parameters, and clinical condition.

• Administration Route: Intravenous (IV), typically through a central venous catheter due to its hypertonicity.
• Usage Setting: Administered in hospital environments with appropriate monitoring facilities.
• Monitoring Requirements:
  • Serum sodium concentration
  • Osmolality
  • Fluid status and urine output
• Special Instructions:
  • Do not administer without dilution in patients who are not critically hyponatremic.
  • Always inspect for particulates or discoloration prior to use.

Improper administration or overly rapid correction of sodium levels may lead to severe complications such as osmotic demyelination syndrome (ODS), so caution is imperative.

Mode of Action 3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL]

Sodium chloride acts by replenishing sodium ions (Na⁺) and chloride ions (Cl⁻) in the extracellular fluid. These electrolytes are essential for a variety of physiological processes, including nerve conduction, muscle contraction, and fluid balance.

• Osmotic Action: The 3% hypertonic solution increases plasma osmolality, drawing fluid from intracellular and interstitial spaces into the vascular compartment.
• Restores Sodium Balance: Corrects hyponatremia by increasing extracellular sodium concentration.
• Reduces Cerebral Edema: Used in neurology and neurosurgery to lower elevated intracranial pressure.

Due to its hypertonic nature, the solution exerts a strong osmotic pull, making it effective in acute emergencies involving electrolyte imbalance and fluid shifts.

3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL] Interactions 3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL]

Although sodium chloride is a simple salt, its administration at high concentrations may interact with various drugs and clinical conditions. Careful assessment is needed when used alongside certain medications or in patients with comorbidities.

• Diuretics (e.g., Furosemide, Hydrochlorothiazide):
  • May alter serum electrolyte levels and exacerbate sodium imbalances.
• Corticosteroids (e.g., Prednisone):
  • May promote sodium and water retention, increasing the risk of fluid overload.
• Lithium:
  • Changes in sodium levels can affect lithium reabsorption and toxicity risk.
• Antihypertensives (e.g., ACE inhibitors, ARBs):
  • Risk of hyperkalemia increases when electrolyte balance is disrupted.

Always consult a clinician or pharmacist before combining therapies, especially in patients with cardiac, renal, or hepatic impairment.

Dosage of 3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL]

Dosage must be individualized based on the severity of the sodium deficit, patient weight, and underlying condition. The general aim is to raise serum sodium cautiously to avoid neurological damage.

• General Dosage Guidance:
  • Start with 1–2 mL/kg/hour, adjusted based on monitoring.
  • Total correction should not exceed 8–12 mEq/L in 24 hours.
• Calculation: Requires the use of the Adrogue-Madias formula or other validated sodium deficit correction tools.
• Route: Central IV infusion preferred due to solution osmolarity (~1027 mOsm/L).
• Duration: Varies from several hours to days depending on the condition being treated.

Frequent monitoring of serum sodium is essential. Adjustments should be based on clinical response and lab values every 2–4 hours during acute correction phases.

Possible side effects of 3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL]

While effective, 3% Sodium Chloride Injection can cause significant side effects if not administered cautiously. These are often related to electrolyte disturbances or fluid imbalances.

• Common Side Effects:
  • Headache
  • Nausea or vomiting
  • Thirst and dry mouth
• Serious Side Effects:
  • Pulmonary edema (fluid accumulation in the lungs)
  • Cerebral demyelination syndrome (from rapid sodium correction)
  • Hypertension or hypotension
  • Hypernatremia (excess sodium)
• Infusion-related Reactions:
  • Pain, inflammation, or thrombophlebitis at the infusion site

Prompt discontinuation and intervention are needed if any severe adverse effects occur. Always monitor patients closely during treatment.

3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL] Contraindications 3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL]

This medication should not be used in certain clinical situations where sodium or fluid overload may be dangerous.

• Absolute Contraindications:
  • Hypernatremia (elevated serum sodium levels)
  • Congestive heart failure (due to risk of fluid overload)
  • Severe renal impairment without dialysis access
• Relative Contraindications:
  • Pregnancy (only if absolutely necessary and under close supervision)
  • Severe hypertension or pre-existing edema

The risk-benefit ratio must always be carefully considered, and alternative treatments should be evaluated where appropriate.

Storage of 3% w/v SODIUM CHLORIDE INJECTION, USP [MEDISAL]

Proper storage is essential to maintain the sterility and chemical stability of this hypertonic IV solution.

• Temperature: Store at 20°C to 25°C (68°F to 77°F); avoid freezing.
• Light Protection: No specific light sensitivity, but protect from direct sunlight.
• Container: Polypropylene bottle should remain sealed and intact.
• Shelf Life: Check manufacturer’s expiration date on the label.
• Do Not Use If:
  • Solution appears discolored or contains particulate matter
  • The seal is broken or bottle is leaking

Keep out of reach of children. Only qualified medical personnel should handle and administer this preparation.