What Is Sodium Chloride?

Sodium Chloride is an electrolyte replenisher and isotonic crystalloid solution used across nearly every area of medicine. It is one of the most widely administered medications in the world. Common uses include:

• Replacing extracellular fluid in cases of dehydration, blood loss, or sepsis
• Treating metabolic alkalosis with associated fluid loss
• Diluting and delivering IV medications
• Priming hemodialysis equipment
• Nasal irrigation for congestion and sinus relief
• Treating corneal edema (ophthalmic formulations like Muro 128)
• Wound cleansing and irrigation

Off-label, nebulized hypertonic saline is commonly used for cystic fibrosis and bronchiolitis.

How does Sodium Chloride work?

Sodium Chloride provides sodium and chloride ions — essential electrolytes that maintain fluid balance, osmotic pressure, and acid-base equilibrium in the body. When administered intravenously as a 0.9% solution (isotonic), it expands extracellular fluid volume without shifting water into or out of cells, making it ideal for rehydration and fluid resuscitation.

Hypertonic solutions (3% and 5%) draw water out of cells via osmosis, which is useful for treating severe hyponatremia (dangerously low sodium levels) or reducing cerebral edema. Nasal formulations moisturize dry nasal passages and help thin mucus for easier drainage.

What doses are available for Sodium Chloride?

• IV Solution Bags: 0.45% (Half-Normal Saline), 0.9% (Normal Saline), 3% and 5% (Hypertonic Saline) — available in 25 mL to 1000 mL bags
• IV Flush Syringes: 0.9% in 3 mL, 5 mL, and 10 mL
• Nasal Spray: 0.65% Sodium Chloride
• Nebulizer Solution: 0.9%, 3%, and 7% concentrations
• Ophthalmic Solution and Ointment: 2% and 5% (Muro 128)
• Oral Tablets: 1 g
• Wound Irrigation Solution: 0.9%
• Bacteriostatic Injection: For reconstitution of compatible medications

How hard is it to find Sodium Chloride in stock?

Sodium Chloride earns a findability score of 75 out of 100, meaning it is generally available with minor gaps. The severe IV saline shortage caused by Hurricane Helene's damage to Baxter International's North Cove, North Carolina plant in September 2024 was officially resolved by the FDA in August 2025. However, given the history of recurring shortages (2014, 2017–2018, and 2024–2025), occasional supply disruptions for IV formulations remain possible. Outpatient formulations such as nasal sprays, nebulizer solutions, and ophthalmic drops are widely stocked at most pharmacies. If you're having trouble finding Sodium Chloride, Medfinder can help you locate it in stock near you.

Who Can Prescribe Sodium Chloride?

Sodium Chloride is prescribed and administered by a wide range of healthcare professionals, including:

• Emergency Medicine physicians (trauma, dehydration)
• Internal Medicine and Primary Care doctors
• Critical Care / ICU specialists
• Surgeons across all subspecialties
• Pediatricians (weight-based dosing required)
• Nephrologists (kidney disease, dialysis)
• Pulmonologists (nebulized saline for respiratory conditions)
• Anesthesiologists (perioperative fluid management)
• Oncologists (IV hydration during chemotherapy)

OTC nasal sprays and rinses do not require a prescription.

Is Sodium Chloride a controlled substance?

No, Sodium Chloride is not a controlled substance and has no DEA scheduling. It is not associated with abuse potential. Many Sodium Chloride formulations (nasal sprays, wound irrigation, ophthalmic drops) are available over the counter without a prescription. IV formulations require a prescription and are administered by healthcare professionals.

Common Side Effects of Sodium Chloride

• Injection site reactions (pain, redness, swelling) with IV administration
• Fluid overload and peripheral edema, especially with large volumes
• Hypernatremia (elevated sodium levels)
• Hyperchloremic metabolic acidosis with prolonged or high-volume IV use
• Nasal stinging or irritation with nasal spray formulations
• Temporary blurred vision with ophthalmic formulations

Serious side effects (less common) include pulmonary edema, congestive heart failure exacerbation, severe hypernatremia leading to confusion or seizures, and cerebral edema if hypertonic solutions are administered too rapidly. Use with caution in patients with heart failure, kidney disease, liver cirrhosis, or hypertension.

Alternative Medications to Sodium Chloride

Depending on the clinical use, alternatives to Sodium Chloride include:

• Lactated Ringer's Solution — A balanced crystalloid containing potassium, calcium, and lactate; often preferred over normal saline for large-volume resuscitation to reduce the risk of hyperchloremic acidosis
• Plasma-Lyte A — A balanced crystalloid with an electrolyte composition closer to blood plasma
• Dextrose 5% in Water (D5W) — Provides free water and calories; used when sodium supplementation is not needed
• 0.45% Sodium Chloride (Half-Normal Saline) — A hypotonic alternative used for maintenance fluids and free water replacement

Drug Interactions with Sodium Chloride

• Corticosteroids and Corticotropin — Can increase sodium and water retention, raising the risk of fluid overload when combined with IV saline
• Lithium — Sodium levels directly affect lithium clearance; increased sodium intake from IV saline can reduce lithium blood levels, potentially decreasing its effectiveness
• Amphotericin B — Incompatible with Sodium Chloride; do not mix in the same IV line
• Diuretics — May counteract the fluid replacement effects of IV saline
• ACE Inhibitors and ARBs — Monitor electrolytes closely when combining with IV saline
• Tolvaptan and Vasopressin Antagonists — May require dose adjustments when used alongside saline infusions

Final Thoughts on Sodium Chloride

Sodium Chloride is one of the most fundamental medications in healthcare — inexpensive, widely used, and essential for everything from emergency resuscitation to sinus relief. While the 2024–2025 IV saline shortage caused significant disruption across U.S. hospitals, the FDA declared the shortage resolved in August 2025. Outpatient formulations like nasal sprays, nebulizer solutions, and ophthalmic drops remain easy to find and affordable. If you're having difficulty locating any Sodium Chloride product, Medfinder can help you search pharmacies near you to find it in stock.