Normal Saline

Indications

Sodium chloride is ordinary salt prepared to a medical standard. It is used in several forms:

• As a drip (intravenous infusion), usually 0.9% "normal saline", to replace water and salt lost through dehydration, vomiting, diarrhoea, bleeding, burns or surgery, and to dilute other injected medicines.
• Stronger solutions are used in hospital to correct a low blood sodium level.
• As nose drops or nasal spray, to moisten a dry or blocked nose and loosen mucus during colds, including in babies.
• As tablets or oral solution for salt loss in certain conditions, and as a sterile solution for washing wounds or eyes.

How It Works

Sodium and chloride are the main salts in the fluid around the body's cells. They hold water inside the blood vessels and help control fluid balance, blood pressure, and the working of nerves and muscles. In the nose, a salt solution thins and washes away thick mucus.

Dosage and Administration

• Drip (infusion): given by a doctor or nurse. The amount and speed depend on age, body weight and the condition being treated, as prescribed.
• Nose drops or spray: usually 2 to 3 drops or 1 to 2 sprays in each nostril, as often as needed, or as advised. For babies, clear the nose gently after the drops.
• Tablets or oral solution: only as prescribed.

Interactions

Nasal saline has no known important interactions. Large amounts of sodium by drip or by mouth can raise blood pressure and cause fluid retention, which can weaken the effect of blood pressure medicines and diuretics. Corticosteroids such as Dexamethasone and Prednisolone make the body hold on to more sodium. A high salt intake can lower blood levels of Lithium.

Contraindications

For drips and tablets: a high blood sodium level, fluid overload, or severe heart, kidney or liver disease with swelling, unless the doctor decides otherwise. For nasal use: allergy to any ingredient of the product.

Side Effects

• Nose drops or spray: mild stinging or sneezing.
• Drip: pain, redness or swelling where the needle goes in. Too much fluid can cause swollen legs or puffiness.

Get urgent medical help for breathlessness, swelling of the face or legs, confusion, fits, severe headache, or spreading redness and pain at the drip site.

Pregnancy and Lactation

Saline nose drops and normal saline drips are considered safe during pregnancy and breastfeeding when used as directed. Salt tablets should be taken only on a doctor's advice.

Precautions and Warnings

• Extra care is needed in heart failure, kidney disease, high blood pressure, liver disease, older people and small babies. Blood tests for sodium may be needed during treatment.
• Never change the speed of a drip yourself.
• Do not share a nasal bottle, and discard it within the time printed on the pack after opening.

Overdose

Too much sodium can cause strong thirst, vomiting, diarrhoea, swelling, confusion and fits. Correcting a low sodium level too quickly can also harm the brain, which is why it is done in hospital. Seek medical help straight away. A child swallowing a small amount of nose drops is usually harmless.

Therapeutic Class

Electrolyte replacement and intravenous fluid; saline nasal preparation.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children. Do not freeze. Do not use a drip bag or bottle that is cloudy, leaking or damaged.