Your Patients Need Sodium Chloride — Here's How to Help Them Get It

As a healthcare provider, you've likely fielded calls from frustrated patients who can't find Sodium Chloride at their pharmacy. Whether it's nebulizer saline, IV fluids for home infusion, or even prescription ophthalmic drops, supply disruptions can leave patients without a medication they depend on.

The good news: the national IV saline shortage was officially resolved by the FDA in August 2025. But patients may still encounter localized availability issues, and navigating the pharmacy landscape can be confusing — especially for patients managing chronic conditions.

This guide offers five practical steps you can take to help patients find Sodium Chloride, plus information on alternatives, cost considerations, and workflow tips to streamline the process in your practice.

Current Availability of Sodium Chloride

As of early 2026, Sodium Chloride supply is largely restored across all formulations:

• 0.9% IV saline bags: Normal supply at most distributors and hospital pharmacies
• IV flush syringes: Widely available with occasional spot shortages
• Nebulizer saline (0.9%): Available at most retail and specialty pharmacies
• Hypertonic nebulizer saline (3%, 7%): May require specialty pharmacy sourcing
• Nasal saline sprays: Broadly available OTC (Ayr, Ocean, NeilMed, generics)
• Ophthalmic formulations (Muro 128): Generally in stock at retail pharmacies

The primary remaining challenge is for patients who need home IV saline through specialty infusion pharmacies, or those in rural areas with fewer pharmacy options.

Why Patients Can't Find Sodium Chloride

Even with national supply restored, individual patients may struggle for several reasons:

• Pharmacy-level stock variability: Individual pharmacy locations may be temporarily out of stock even when the national supply is adequate.
• Distributor allocation differences: Chain pharmacies and independent pharmacies use different wholesalers with different inventory levels.
• Formulation-specific gaps: A pharmacy may have 0.9% nebulizer saline but not 3% hypertonic, or vice versa.
• Geographic disparities: Rural and underserved areas may have fewer pharmacy options and slower restocking cycles.
• Patient confusion: Patients may not know that some formulations are available OTC, or may not think to try a different pharmacy.

What Providers Can Do: 5 Practical Steps

Step 1: Direct Patients to Medfinder

The single most impactful thing you can do is point patients to Medfinder. This free tool lets patients search for Sodium Chloride availability at pharmacies near their zip code in real time.

Consider adding Medfinder to your patient handouts or after-visit summaries. A simple line like: "If your pharmacy doesn't have this in stock, try searching at medfinder.com" can save patients hours of phone calls.

Step 2: Prescribe with Flexibility

When writing prescriptions for Sodium Chloride, build in flexibility where clinically appropriate:

• Allow generic substitution (this is usually the default for NaCl)
• Specify acceptable alternative concentrations if applicable (e.g., "0.9% NaCl nebulizer solution, may substitute 0.9% unit-dose vials")
• Include DAW 0 (Dispense as Written = no) to maximize pharmacy options
• Consider e-prescribing to multiple pharmacies if your state allows it, so patients have backup options

Step 3: Recommend Independent and Specialty Pharmacies

Chain pharmacies are convenient but not always the best option during tight supply. Independent pharmacies often use different wholesalers and may have access to stock that chains don't.

For patients needing specialty formulations (home IV saline, hypertonic nebulizer solution), a specialty pharmacy is often the most reliable source. If your practice works with a home infusion company, they typically manage sourcing for the patient.

Step 4: Educate Patients on OTC Options

Many patients don't realize that certain Sodium Chloride formulations are available over the counter:

• Nasal saline sprays: Ayr, Ocean, NeilMed, and generic store brands — no prescription needed
• Nasal irrigation kits: Neti pots with saline packets — widely available at drugstores and online
• Saline wound wash: Available OTC for minor wound care

If a patient is using prescription nasal saline primarily for moisturizing or congestion, switching to an OTC product may be simpler and more cost-effective.

Step 5: Have a Backup Plan with Alternatives

When Sodium Chloride is genuinely unavailable, be prepared to prescribe alternatives:

• IV hydration: Lactated Ringer's Solution or Plasma-Lyte A (see clinical considerations in our provider shortage briefing)
• Nebulizer diluent: Some medications can be nebulized without saline dilution — check individual drug compatibility
• Ophthalmic: Generic hypertonic saline drops as alternative to Muro 128

For a comprehensive overview of alternatives, see Alternatives to Sodium Chloride.

Alternatives to Sodium Chloride at a Glance

Here's a quick reference for the most common clinical alternatives:

• Lactated Ringer's Solution: Balanced crystalloid with sodium, potassium, calcium, and lactate. Preferred for surgical and trauma resuscitation. Avoid with Ceftriaxone and severe liver disease.
• Plasma-Lyte A: Most physiologically balanced crystalloid. Appropriate for most scenarios. Higher cost.
• 0.45% NaCl (Half-Normal Saline): Hypotonic option for maintenance fluids and hypernatremia. Not for volume resuscitation.
• D5W: Provides free water and minimal calories. Not a sodium or volume replacement.

Workflow Tips for Your Practice

To minimize the impact of supply disruptions on your workflow:

• Bookmark Medfinder for Providers on your office computers for quick reference
• Create a patient handout with pharmacy search tips and links to Medfinder, OTC alternatives, and your office callback number
• Designate a staff member (MA, RN, or office coordinator) as the point person for medication access questions
• Monitor the FDA Drug Shortage Database for early warnings of new or recurring shortages
• Maintain a list of reliable specialty pharmacies in your area for home infusion and specialty formulations

Additional Resources to Share with Patients

Here are patient-facing articles from Medfinder that you can share:

• How to Find Sodium Chloride in Stock Near You
• Sodium Chloride Shortage Update for Patients
• How to Save Money on Sodium Chloride
• What Is Sodium Chloride?

Final Thoughts

Helping patients access essential medications like Sodium Chloride is a core part of patient care — even when supply chain challenges make it harder. By directing patients to the right tools, prescribing with flexibility, and having clinical alternatives ready, you can reduce frustration for both your patients and your team.

Medfinder for Providers is a free resource designed to help you and your patients navigate medication availability. Consider making it part of your standard workflow.

For the broader shortage context, see our provider shortage briefing.