Potassium chloride 0. 3 % (potassium 40 mmol/ 1 litre) / Sodium chloride
0. 9 % infusion 1 litre bags| 1 bagPs
Potassium chloride 1.5 mg per 1 ml, Sodium chloride 9 mg per
1mlPotassium chloride 0. 15 % (potassium 10 mmol/ 500 ml) / Sodium
chloride 0. 9 % infusion 500 ml bags| 1 bagPs
Potassium chloride 0. 15 % (potassium 20 mmol/ 1 litre) / Sodium
chloride 0. 9 % infusion 1 litre bags| 1 bagPs
Potassium chloride 2 mg per 1 ml, Sodium chloride 9 mg per
1mlSteriflex No. 28 potassium chloride 0. 2 % (potassium
13. 3 mmol/ 500 ml) / sodium chloride 0. 9 % infusion 500 ml bags|
1 bagP£ 1. 67
Steriflex No. 28 potassium chloride 0. 2 % (potassium 27 mmol/ 1 litre) /
sodium chloride 0. 9 % infusion 1 litre bags| 1 bagP£ 2. 20ELECTROLYTES AND MINERALS›SODIUM
CHLORIDE
Sodium chloride
lINDICATIONS AND DOSE
Chronic renal salt wasting
▶BY MOUTH
▶Child: 1 – 2 mmol/kg daily in divided doses, adjusted
according to requirements
Sodium supplementation in neonates
▶INITIALLY BY MOUTH
▶Neonate up to 36 weeks corrected gestational age: 2 mmol,
dose to be administered in 100 ml of formula feed
(consult dietician), alternatively (by mouth using
modified-release tablets) 3 – 4 mmol, dose to be
administered in 100 ml of breast milk (consult dietician).Sodium replacement
▶BY MOUTH USING MODIFIED-RELEASE TABLETS
▶Child: 1 – 2 mmol/kg daily in divided doses, adjusted
according to requirements, higher doses may be
needed in severe depletion
Management of diabetic ketoacidosis (to restore
circulating volume if systolic blood pressure is below
90 mmHg and adjusted for age, sex, and medication as
appropriate)
▶BY INTRAVENOUS INFUSION
▶Child:(consult local protocol)
Diluent for instillation of drugs to the bladder
▶BY INTRAVESICAL INSTILLATION
▶Child:(consult product literature)lCAUTIONS
▶With intravenous useAvoid excessive administration.
cardiac failure.cardio-respiratory diseases.children
receiving glucocorticoids.dilutional hyponatraemia.
hepatic cirrhosis.hypertension.peripheral oedema.
pulmonary oedema.reducedfluid loss.renal insufficiency
.restrict intake in impaired renal function.toxaemia of
pregnancy
CAUTIONS, FURTHER INFORMATION
▶Reduced fluid loss
▶With intravenous useThe volume offluid infused should
take into account the possibility of reducedfluid loss
owing to increased antidiuretic hormone and factors such
as renal failure, hypothermia, and high humidity.
▶Dilutional hyponatraemia
▶With intravenous useDilutional hyponatraemia is a rare but
potentially fatal risk of parenteral hydration. It may be
caused by inappropriate use of hypotonicfluids such as
sodium chloride 0. 18 % and glucose 4 % intravenous
infusion, especially in the postoperative period when
antidiuretic hormone secretion is increased. Dilutional
hyponatraemia is characterized by a rapid fall in plasma-
sodium concentration leading to cerebral oedema and
seizures; any child with severe hyponatraemia or rapidly
changing plasma-sodium concentration should be referred
urgently to a paediatric high dependency facility.
lSIDE-EFFECTS
▶With intravenous useChills.fever.hypervolaemia.
hypotension.local reaction.localised pain.paraesthesia.
skin reactions.tremor.vascular disorders.venous
thrombosis
▶With oral useAbdominal cramps.acidosis hyperchloraemic
.diarrhoea.generalised oedema.hypertension.
hypotension.irritability.muscle complaints.nausea.
vomiting
lMONITORING REQUIREMENTSDuring parenteral hydration,
fluids and electrolytes should be monitored closely and
any disturbance corrected by slow infusion of an
appropriate solution.
lPRESCRIBING AND DISPENSING INFORMATION
▶With intravenous useSodium chloride 0. 9 % intravenous
infusion contains Na+and Cl-each 150 mmol/litre. The
term‘normal saline’should not be used to describe
sodium chloride intravenous infusion 0. 9 %; the term
‘physiological saline’is acceptable but it is preferable to
give the composition (i.e. sodium chloride intravenous
infusion 0. 9 %).
▶With oral useEachSlow Sodium®tablet contains
approximately 10 mmol each of Na+and Cl-;gtablets
can be crushed before administrationl.
The RCPCH and NPPG recommend that, when a liquid
special of sodium chloride is required, the following
strength is used: 5 mmol/mL.
lPATIENT AND CARER ADVICE
Medicines for Children leaflet: Sodium chloride for hyponatraemia
http://www.medicinesforchildren.org.uk/sodium-chloride-for-
hyponatraemialMEDICINAL FORMS
There can be variation in the licensing of different medicines
containing the same drug. Forms available from special-order
manufacturers include: capsule, solution for injection,
infusion, solution for infusion
Modified-release tablet
CAUTIONARY AND ADVISORY LABELS 25
▶Slow Sodium(HK Pharma Ltd)
Sodium chloride 600 mgSlow Sodium 600 mg tablets|
100 tabletG£ 9. 20 DT = £ 9. 20
Solution for injection
▶Sodium chloride (Non-proprietary)
Sodium chloride 9 mg per 1 mlSodium chloride 0. 9 % solution for
injection 5 ml Sure-Amp ampoules| 20 ampouleP£ 7. 15
Sodium chloride 0. 9 % solution for injection 50 ml vials| 25 vialP
£ 85. 00 – £ 85. 25
Sodium chloride 0. 9 % solution for injection 10 ml ampoules|
10 ampouleP£ 2. 96 – £ 3. 26 DT = £ 2. 96 | 50 ampouleP£ 14. 75
Sodium chloride 0. 9 % solution for injection 20 ml Mini-Plasco
ampoules| 20 ampouleP£ 18. 93
Sodium chloride 0. 9 % solution for injection 5 ml Mini-Plasco ampoules
| 20 ampouleP£ 8. 96
Sodium chloride 0. 9 % solution for injection 2 ml Sure-Amp ampoules|
20 ampouleP£ 7. 15
Sodium chloride 0. 9 % solution for injection 20 ml ampoules|
20 ampouleP£ 15. 75
Sodium chloride 0. 9 % solution for injection 2 ml ampoules|
10 ampouleP£ 2. 07 – £ 2. 57 DT = £ 2. 07
Sodium chloride 0. 9 % solution for injection 5 ml ampoules|
10 ampouleP£ 2. 11 – £ 2. 32 DT = £ 2. 11 | 50 ampouleP£ 10. 50
Sodium chloride 0. 9 % solution for injection 10 ml Sure-Amp ampoules
| 20 ampouleP£ 8. 15
Sodium chloride 0. 9 % solution for injection 10 ml Mini-Plasco
ampoules| 20 ampouleP£ 10. 21
Sodium chloride 300 mg per 1 mlSodium chloride 30 % solution for
injection 10 ml ampoules| 10 ampouleP£ 70. 43 DT = £ 70. 43
▶Drytec saline(GE Healthcare Biosciences)
Sodium chloride 9 mg per 1 mlDrytec saline eluent 5 ml vials|
20 vialPs(Hospital only)
Drytec saline eluent 10 ml vials| 20 vialPs(Hospital only)
Drytec saline eluent 20 ml vials| 20 vialPs(Hospital only)BNFC 2018 – 2019 Fluid and electrolyte imbalances 589
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