3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP Infusion/Solution for

What is 3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP

3% w/v Sodium Chloride Intravenous Infusion BP is a sterile, hypertonic solution intended for intravenous administration. It contains 3 grams of sodium chloride per 100 mL, equating to 513 mEq/L of both sodium and chloride ions. This high-concentration solution is used in specialized clinical settings to correct significant electrolyte disturbances.

• Purpose: Corrects severe symptomatic hyponatremia (low blood sodium levels) and reduces elevated intracranial pressure.
• Category: Electrolyte replacement / Osmotic agent.
• Form: Ready-to-use 500 mL plastic bag for IV infusion.
• Use environment: Administered only under close medical supervision in hospitals or intensive care units.

Because of its hypertonic nature, this solution must be used cautiously to avoid complications from rapid sodium correction or fluid overload. It's not suitable for routine fluid replacement.

How to use 3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP

3% Sodium Chloride should only be administered by healthcare professionals trained in electrolyte management and fluid therapy. Its use requires continuous clinical and laboratory monitoring.

• Route: Intravenous infusion, preferably via a central venous line due to hyperosmolarity.
• Preparation: The solution is pre-mixed and ready to use; do not mix with other IV medications unless compatibility is confirmed.
• Administration:
  • Begin with a slow infusion rate, typically 1–2 mL/kg/hour depending on sodium deficit.
  • In emergencies (e.g., acute cerebral edema), rapid bolus doses of 100–150 mL over 30–60 minutes may be warranted.
• Monitoring:
  • Check serum sodium every 2–4 hours during infusion.
  • Monitor fluid input/output, neurological status, and blood pressure.
• Precautions: Do not use if the solution is discolored or contains particulates. Always check bag integrity before use.

The key to safe administration is gradual correction of sodium to avoid central pontine myelinolysis (CPM) or osmotic demyelination syndrome.

Mode of Action 3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP

This hypertonic saline solution exerts its effects through osmotic and electrolyte-restoring mechanisms. It helps move water from intracellular to extracellular compartments and replenishes sodium levels.

• Osmotic Shift: High sodium concentration increases extracellular fluid osmolality, drawing water out of swollen cells (especially brain cells), relieving cerebral edema.
• Sodium Repletion: Supplies sodium ions to correct hypoosmolar states such as severe hyponatremia.
• Electrolyte Balancing: Stabilizes action potentials and nerve conduction by restoring sodium levels.
• Short-Term Plasma Volume Expansion: Temporary increase in intravascular volume due to osmotic fluid shift.

The solution does not provide calories or other electrolytes (like potassium or bicarbonate) and is meant for acute, controlled correction of sodium deficits rather than maintenance therapy.

3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP Interactions 3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP

This medication may interact with other agents affecting fluid balance, kidney function, or electrolyte regulation. Caution and professional evaluation are essential when co-administering with:

• Diuretics (e.g., furosemide): May lead to further electrolyte imbalance, especially hypokalemia or hypomagnesemia.
• Corticosteroids: Promote sodium and fluid retention, possibly increasing the risk of hypertension or edema.
• ACE Inhibitors / ARBs: Can impair renal sodium handling and increase the risk of hypernatremia or renal complications.
• Desmopressin (DDAVP): May alter the renal response to sodium infusion and exacerbate hyponatremia if not discontinued timely.
• Anticonvulsants (e.g., carbamazepine): May affect serum sodium via SIADH, necessitating cautious monitoring.

Always consult with pharmacy and nephrology or critical care teams when integrating 3% NaCl infusion into a patient’s therapeutic regimen.

Dosage of 3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP

The dosage must be individualized and calculated based on the patient’s serum sodium level, weight, and clinical status. Overcorrection should always be avoided.

• Typical Dosing Strategy:
  • Slow infusion: 1–2 mL/kg/hour.
  • Acute bolus: 100–150 mL over 30–60 minutes (e.g., for seizure or severe cerebral edema).
• Calculation: Sodium deficit (mEq) = (Target Na⁺ – Actual Na⁺) × TBW × 0.6 (TBW = total body water, based on weight and sex)
• Correction Target:
  • Do not increase serum sodium by more than 8–10 mEq/L in 24 hours.
  • In high-risk patients, limit to 6 mEq/L per 24 hours.

All dosing should be guided by specialist teams with the ability to monitor labs and adjust treatment in real-time.

Possible side effects of 3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP

While beneficial in specific situations, 3% sodium chloride carries a risk of side effects, particularly when administered rapidly or without monitoring.

• Common Adverse Effects:
  • Dry mouth, thirst
  • Injection site discomfort or irritation
  • Fluid retention or edema
• Serious Side Effects:
  • Hypernatremia
  • Pulmonary edema (especially in cardiac or renal patients)
  • Hypertension
  • Seizures (if sodium levels rise too rapidly)
  • Osmotic demyelination syndrome (ODS)

Patients should be observed continuously during therapy, and any signs of adverse effects should prompt reevaluation of dosing strategy and rate of correction.

3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP Contraindications 3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP

This medicine should not be administered in certain clinical conditions due to the risk of severe complications.

• Absolute Contraindications:
  • Hypernatremia
  • Severe fluid retention or edema
  • Congestive heart failure
• Relative Contraindications:
  • Renal failure (especially anuric states)
  • Uncontrolled hypertension
  • Liver cirrhosis with ascites

Use with caution in patients at risk for fluid overload or electrolyte shifts. A multidisciplinary approach is advised before initiating therapy.

Storage of 3% w/v SODIUM CHLORIDE INTRAVENOUS INFUSION BP

Proper storage ensures safety and efficacy of the product.

• Storage Temperature: Store at 20–25°C (68–77°F); excursions between 15–30°C may be acceptable short-term.
• Packaging: Supplied in sealed plastic IV bags; keep in original packaging until ready for use.
• Do Not Freeze: Freezing may cause container rupture or salt precipitation.
• Inspection: Always check for particulates, discoloration, or bag leakage before administration.
• Shelf Life: Use before the expiration date printed on the packaging. Do not use if the solution appears cloudy or contains sediment.

Keep out of reach of children and store in a secure, temperature-controlled environment within hospital or pharmacy settings.