Sodium Chloride

What it is and how it works

Sodium chloride provides sodium and chloride, the main extracellular electrolytes that determine extracellular fluid volume and osmolality. Isotonic (0.9%) solutions replace extracellular fluid; hypertonic solutions raise plasma sodium and osmolality or, applied locally, draw water osmotically from oedematous tissue (e.g. corneal oedema, airway mucus).

Indications

Intravenous: fluid and sodium replacement, hyponatraemia (hypertonic, under specialist care), vehicle for drug dilution. Irrigation: wound and bladder irrigation. Nasal: nasal dryness and congestion, nasal hygiene. Inhalation: diluent for nebulised drugs and hypertonic saline for airway clearance (e.g. cystic fibrosis). Ophthalmic hypertonic (2–5%) drops and ointment: corneal oedema.

Dosage and administration (summary)

Intravenous volume, concentration and rate are individualised to fluid and electrolyte status; topical, nasal, ophthalmic and inhalation products are used as directed for the specific product (e.g. hypertonic eye drops 1–2 drops several times daily).

Contraindications

Intravenous use: hypernatraemia, fluid overload and hyperchloraemia; hypertonic solutions in conditions where sodium load is hazardous. Irrigation solutions must not be injected.

Warnings and precautions

Monitor fluid balance and plasma electrolytes during intravenous therapy; use caution in heart failure, renal impairment, hypertension and oedema, and correct chronic hyponatraemia slowly to avoid osmotic demyelination. Hypertonic ophthalmic preparations may sting, and nebulised hypertonic saline may cause bronchospasm, so a bronchodilator may be needed beforehand.

Pregnancy

May be used in pregnancy with monitoring of fluid and electrolyte balance.

Storage and supply

Store below 25 °C; do not freeze; use single-use containers immediately after opening and discard multi-dose eye or nasal products within the period stated after opening.

Source: reference summary prepared from the EU SmPC/EPAR, BNF and WHO Model Formulary. The approved product information in Iran governs.