Drugs List

Therapeutic Indications

Uses

Sodium chloride deficiency - prophylaxis and treatment

Unlicensed Uses

Sodium supplement

Administration

In infants and children sodium chloride must be added and thoroughly mixed into the drink, breast milk or formula feed immediately before administration.

In adults a maximum rate of administration of 10 to 12 mmol per litre of body water per 24 hour period or 18 mmol per litre per 48 hour period should be observed.

Contraindications

Oedema
Cardiac disorder
Decompensated cardiac failure
Gastrointestinal obstruction
Hyperaldosteronism
Hypernatraemia

Precautions and Warnings

Elderly
Restricted sodium intake
Hepatic impairment
Hypertension
Pre-eclampsia
Renal impairment

Some formulations contain more than 1mmol (23mg) sodium per dose
Not all available brands are licensed for all age groups
Some formulations contain hydroxybenzoate
Ensure patient has adequate fluid intake
Monitor periodically for signs of fluid or electrolyte imbalance

Use with caution when administering in conditions where normal electrolyte balance may be disturbed e.g additional loss through diuretic therapy or additional sodium intake through other sources such as medication or intravenous fluids.

During the first few days after birth, there is a physiological reduction of extracellular fluid volume as the infant adjusts to extra-uterine life. Hyponatraemia may reflect water retention rather than sodium deficiency, and treatment should be undertaken by monitoring adjustment of water balance rather than administration of sodium chloride.

Pregnancy and Lactation

Pregnancy

Sodium chloride in pregnancy is usually considered safe.

However, caution should be exercised in pre-eclampsia.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Sodium chloride during breastfeeding is usually considered safe.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abdominal cramps
Decreased lachrymal secretion
Diarrhoea
Dizziness
Fever
Headache
Hyperchloraemic acidosis
Hypertension
Hypotension
Irritability
Muscle rigidity
Muscle twitch
Nausea
Oedema
Restlessness
Salivation changes
Sweating
Tachycardia
Thirst
Vomiting
Weakness

Presentation

Oral formulation of sodium chloride

Drugs List

Therapeutic Indications

Uses

Sodium chloride deficiency - prophylaxis and treatment

Unlicensed Uses

Sodium supplement

Dosage

Treatment in children should only be prescribed under the supervision of a paediatric specialist.

Dosage can be adjusted if necessary according to clinical need and after plasma sodium monitoring.

Adults

Children

Neonates

Administration

In infants and children sodium chloride must be added and thoroughly mixed into the drink, breast milk or formula feed immediately before administration.

In adults a maximum rate of administration of 10 to 12 mmol per litre of body water per 24 hour period or 18 mmol per litre per 48 hour period should be observed.

Contraindications

Oedema
Cardiac disorder
Decompensated cardiac failure
Gastrointestinal obstruction
Hyperaldosteronism
Hypernatraemia

Precautions and Warnings

Elderly
Restricted sodium intake
Hepatic impairment
Hypertension
Pre-eclampsia
Renal impairment

Some formulations contain more than 1mmol (23mg) sodium per dose
Not all available brands are licensed for all age groups
Some formulations contain hydroxybenzoate
Ensure patient has adequate fluid intake
Monitor periodically for signs of fluid or electrolyte imbalance

Use with caution when administering in conditions where normal electrolyte balance may be disturbed e.g additional loss through diuretic therapy or additional sodium intake through other sources such as medication or intravenous fluids.

During the first few days after birth, there is a physiological reduction of extracellular fluid volume as the infant adjusts to extra-uterine life. Hyponatraemia may reflect water retention rather than sodium deficiency, and treatment should be undertaken by monitoring adjustment of water balance rather than administration of sodium chloride.

Pregnancy and Lactation

Pregnancy

Sodium chloride in pregnancy is usually considered safe.

However, caution should be exercised in pre-eclampsia.

The use of all medication in pregnancy should be avoided whenever possible; particularly in the first trimester. Non-drug treatments should also be considered. When essential, a medication with the best safety record over time should be chosen, employing the lowest effective dose for the shortest possible time. Polypharmacy should be avoided. Teratogens taken in the pre-embryonic period, often quoted as lasting until 14 to 17 days post-conception, are believed to have an all-or-nothing effect. Where drugs have a short half-life, and when the date of conception is certain, this may allow women to be reassured where drug exposure has occurred within this time frame. Further advice may be available from the UK National Teratology Information Service (NTIS) and through ToxBase, available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Lactation

Sodium chloride during breastfeeding is usually considered safe.

Neonates, infants born prematurely, those with low birth weight, those with an unstable gastrointestinal function or who have serious illnesses may require special consideration. For any infant, if a drug is prescribed to the nursing mother, it should be at the lowest practical dose and for the shortest time. When drug administration is unavoidable and breastfeeding is to continue, minimisation of exposure of the infant to the drug may sometimes be achieved by timing the maternal doses to just after a feeding episode. Infants exposed to drugs via breast milk should be monitored for unusual signs or symptoms. Interactions between the drug received by the infant from the mother's milk and medication prescribed for the infant should also be considered, for example, when the drug given to the infant may prevent metabolism of the drug received via breast milk.
Specialist advice is available from the UK Drugs in Lactation Advisory Service at https://www.midlandsmedicines.nhs.uk/content.asp?section=6&subsection=17&pageIdx=1

Side Effects

Abdominal cramps
Decreased lachrymal secretion
Diarrhoea
Dizziness
Fever
Headache
Hyperchloraemic acidosis
Hypertension
Hypotension
Irritability
Muscle rigidity
Muscle twitch
Nausea
Oedema
Restlessness
Salivation changes
Sweating
Tachycardia
Thirst
Vomiting
Weakness

Overdosage

It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.

The following number will direct the caller to the relevant local centre (0844) 892 0111

Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).

Further Information

Last Full Review Date: March 2016

Reference Sources

Summary of Product Characteristics: Sodium Chloride 1 mmol/ml Oral Solution. Viridian Pharma Ltd. Revised July 2015

Summary of Product Characteristics: Syrisal 1 mmol/ml Oral Solution. Syri Limited t/a Thame Laboratories. Revised September 2016