Magnesium chloride/Meglumine sodium succinate/potassium chloride/sodium chloride Overdose

How times a day do you take this medicine?
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Consists of magnesium chloride, Meglumine sodium succinate, potassium chloride, sodium chloride

What happens if I overdose Magnesium chloride?

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include confusion; dizziness; flushing; loss of consciousness; muscle weakness; severe drowsiness; slow heartbeat.

Proper storage of Magnesium chloride:

Store Magnesium chloride at room temperature, between 68 and 77 degrees F (20 and 25 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Keep Magnesium chloride out of the reach of children and away from pets.

Overdose of Magnesium chloride in details

When a dose is taken in higher dose than the recommended doses, it is called Overdose. Overdose always needs a clinical supervision. Any medicine or drug when consumed in Overdose produces untoward side effects on one or various organs in the body. A medicine is excreted in the kidney or metabolized in the liver most of the times. This process goes without any hurdles when taken in normal dose, but when taken in an overdose, the body is not able to metabolize it or send it out properly which causes the effects of anoverdose.
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If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. Symptoms of overdose may include slow heartbeat, severe drowsiness, dizziness, confusion, muscle weakness, loss of consciousness.

Notes

Keep all regular medical and laboratory appointments. If your doctor has directed you to take this medication, laboratory and/or medical tests (e.g., magnesium blood levels, kidney function tests) should be performed periodically to monitor your progress or check for side effects. Consult your doctor for more details.

Magnesium supplements are available in different forms with different amounts of magnesium. Many are available without a prescription. Ask your doctor or pharmacist for help in selecting the best product for you.

Eat a well-balanced diet. Foods high in magnesium include avocados, bananas, beans, whole grain cereals, green vegetables, and nuts.

Missed Dose

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose and resume your usual dosing schedule. Do not double the dose to catch up.

Storage

Store at room temperature away from light and moisture. Refer to the product package for details. Do not store in the bathroom. If you have any questions about storage, ask your pharmacist. Keep all drug products away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.

What should I avoid while taking Magnesium chloride?

Avoid taking other medicines at the same time you take Magnesium chloride.

Magnesium chloride warnings

Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.
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ALLERGY WARNING

This product is contraindicated in an individual with a history of hypersensitivity to any of its ingredients.

EXCIPIENT FREE

This product does not contain wheat, gluten, corn, yeast, soy, egg, dairy products, or artificial colors, sweeteners, or flavors. This product also does not contain lactose, palmitic acid, or magnesium, calcium, or vegetable stearates.

PREGNANCY WARNING

If pregnant, consult your health-care practitioner before using this product.

OTHER WARNINGS

Gas, bloating, or diarrhea may occur in some individuals taking magnesium supplements. This can occur at varying amounts depending on the individual and resolves when the amount is reduced.

What should I discuss with my healthcare provider before taking Magnesium chloride?

Some medical conditions may interact with Magnesium chloride. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

Some MEDICINES MAY INTERACT with Magnesium chloride. Tell your health care provider if you are taking any other medicines, especially any of the following:

This may not be a complete list of all interactions that may occur. Ask your health care provider if Magnesium chloride may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Magnesium chloride precautions

Certain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.
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The usual precautions for parenteral administration

should be observed. Administer with caution if flushing

and sweating occurs. A preparation of a calcium salt

should be readily available for intravenous injection

to counteract potential serious signs of magnesium

intoxication. As long as deep tendon reflexes are active

it is probable that the patient will not develop respiratory

paralysis. Respiration and blood pressure should be

carefully observed during and after administration of

Magnesium Chloride Injection.

Magnesium chloride

magnesium chloride injection, solution

Product Information
Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:30727-304
Route of Administration INTRAVENOUS DEA Schedule
Active Ingredient/Active Moiety
Ingredient Name Basis of Strength Strength
Magnesium Chloride (Magnesium cation) Magnesium Chloride 200 mg in 1 mL
Inactive Ingredients
Ingredient Name Strength
Sodium Chloride 9 mg in 1 mL
Benzyl Alcohol 1 mL in 100 mL
Water
Sodium Hydroxide
Hydrochloric Acid
Packaging
# Item Code Package Description
1 NDC:30727-304-90 50 mL in 1 VIAL, MULTI-DOSE
Marketing Information
Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
unapproved drug other 06/11/2011
Labeler - Merit Pharmaceutical (093370369)
Registrant - Merit Pharmaceutical (093370369)
Establishment
Name Address ID/FEI Operations
Merit Pharmaceutical 093370369 manufacture
Revised: 07/2011 Merit Pharmaceutical

What happens if I miss a dose of Magnesium chloride?

When you miss a dose, you should take it as soon as you remember, but you should take care that it should be well spaced from the next dose. You should not take an extra dose at the time of the second dose as it will become a double dose. The double dose can give unwanted side effects, so be careful. In chronic conditions or when you have a serious health issue, if you miss a dose, you should inform your health care provider and ask his suggestion.

Since Magnesium chloride is used when needed, you may not be on a dosing schedule. Skip any missed dose if it's almost time for your next dose. Do not use two doses at one time.

Meglumine sodium succinate warnings

Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.
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For all indications

The following warnings and precautions apply to any mode of administration however, the risks mentioned are higher in intravascular administration.

Hypersensitivity

Patients with hypersensitivity or a previous reaction to iodinated contrast media are at increased risk of having a severe reaction. However, such reactions are irregular and unpredictable in nature.

Before any contrast medium is injected, the patient should be questioned for a history of allergy (eg seafood allergy, hay fever, hives), sensitivity to iodine or to radiographic media and bronchial asthma as the reported incidence of adverse reactions to contrast media is higher in patients with these conditions. Patients with bronchial asthma are at special risk of having bronchospasms or a hypersensitivity reaction.

In patients with an allergic disposition, known hypersensitivity to iodinated contrast media or a history of asthma, premedication with antihistamines and/or glucocorticoids may be considered.

Occasionally, allergy-like hypersensitivity reactions have been observed after use of X-ray contrast media such as Urografin. These reactions are usually manifest as non-serious respiratory or cutaneous symptoms, as mild respiratory distress, reddening of the skin (erythema), urticaria, itching or facial oedema. Serious events such as angioedema, subglottic oedema, bronchospasm and allergic shock are possible.

Fatal reactions have been associated with the administration of water-soluble contrast media. It is therefore of the utmost importance that a course of action be carefully planned in advance for the treatment of serious reactions, and that adequate and appropriate facilities and personnel be readily available in case of a severe reaction. Patients should be observed for a possible severe reaction during and for at least 30 to 60 minutes after administration. In rare cases delayed reactions may occur (after hours to days).

Generally these reactions occur within one hour after administration of contrast media. However, in rare cases delayed reactions may occur (after hours to days).

If hypersensitivity reactions occur, administration of the contrast medium must be discontinued immediately and –if necessary – specific therapy instituted via a venous access. It is therefore advisable to use a flexible indwelling cannula for intravenous contrast medium administration. To permit immediate countermeasures to be taken in emergencies, appropriate drugs, an endotracheal tube and a respirator should be ready at hand.

Thyroid dysfunction

The small amount of free inorganic iodide from iodinated contrast media might interfere with thyroid function. Therefore, the need for examination merits particularly careful consideration in patients with latent hyperthyroidism or goitre.

Cardiovascular disease

There is an increased risk of severe reactions in individuals with severe cardiac disease and particularly in those with heart failure and coronary artery disease.

The elderly

Underlying vascular pathology and neurological disorders often seen in the elderly constitute an increased risk of adverse reactions to iodinated contrast media.

Very poor state of health

The need for examination merits particularly careful consideration in patients with a very poor general state of health.

Intravascular use

Renal failure

Temporary renal failure may occur in rare cases. Preventative measures against acute renal failure following contrast medium administration include:

Identification of high-risk patients, eg patients with: a history of renal disease, pre-existing renal insufficiency, previous renal failure after contrast medium administration, diabetes mellitus with nephropathy, volume depletion, multiple myeloma, age greater than 60 years, advanced vascular disease, paraproteinaemia, severe and chronic hypertension, gout, receiving large or repeated doses.

Ensuring adequate hydration in risk patients before contrast medium administration, preferably by maintaining intravascular infusion before and after the procedure and until the contrast medium has been cleared by the kidneys.

Avoiding additional strain on the kidneys in the form of nephrotoxic drugs, oral cholecystographic agents, arterial clamping, renal arterial angioplasty, major surgery, etc, until the contrast medium has been cleared.

Postponing a new contrast medium examination until renal function returns to pre-examination levels.

In patients with severely restricted renal function, 24 hours are recommended to elapse between two iodinated contrast medium examination sessions.

Patients on dialysis may receive contrast media for radiological procedures as iodinated contrast media are cleared by the dialysis process.

Cardiovascular disease.

In patients with valvular disease and pulmonary hypertension contrast medium administration may lead to pronounced haemodynamic changes. Reactions involving ischaemic ECG changes and major arrhythmia are more common in older patients and in those with preexisting cardiac disease.

The intravascular injection of contrast media may precipitate pulmonary oedema in patients with heart failure.

CNS disorders

Particular care should be paid to the intravascular administration of contrast media in patients with acute cerebral infarction, acute intracranial haemorrhage, and other conditions involving blood-brain barrier damage, cerebral oedema or acute demyelination. Intracranial tumours or metastases and a history of epilepsy may increase the incidence of convulsive seizures after administration of iodinated contrast media. Neurological symptoms due to cerebrovascular diseases, intracranial tumours or metastases, degenerative or inflammatory pathologies may be exacerbated by contrast medium administration. Vasospasm and subsequent cerebral ischaemic phenomena may be caused by intraarterial injections of contrast media. Patients with symptomatic cerebrovascular disease, recent stroke or frequent transient ischaemic attacks have an increased risk of neurological complications.

Severe liver dysfunction

In the case of severe renal insufficiency the coexistence of severe hepatic dysfunction can seriously delay contrast medium excretion, possibly necessitating haemodialysis.

Myeloma and paraproteinaemia

Myeloma or paraproteinaemia may predispose to renal impairment following contrast medium administration. Adequate hydration is mandatory.

Phaeochromocytoma

Patients with phaeochromocytoma may develop a severe (occasionally uncontrollable) hypertensive crisis following intravascular contrast medium use. Premedication with alpha-receptor blockers is recommended.

Patients with autoimmune disorders

Cases of severe vasculitis or Stevens-Johnson like syndrome have been reported in patients with preexisting autoimmune disorders.

Myasthenia gravis

The administration of iodinated contrast media may aggravate the symptoms of myasthenia gravis and/or precipitate a myasthenic crisis.

Alcoholism

Acute or chronic alcoholism may increase blood-brain barrier permeability. This facilitates the passage of the contrast medium into cerebral tissue, possibly leading to CNS reactions. Caution must also be exercised in alcoholics and drug addicts because of the possibility of a reduced seizure threshold.

Coagulation

Ionic iodinated contrast media inhibit blood coagulation in vitro, more than non-ionic contrast media. Nevertheless medical personnel performing vascular catheterisation procedures should consider that numerous factors in addition to the contrast medium, including length of procedure, number of injections, catheter and syringe material, underlying disease state, and concomitant medication may contribute to the development of thromboembolic events. Therefore, when performing a vascular catheterisation procedure one should be aware of this and pay meticulous attention to the angiographic technique and flush the catheter frequently with physiological saline (if possible with the addition of heparin) and minimise the length of the procedure so as to minimise the risk of procedure-related thrombosis and embolism.

The use of plastic syringes in place of glass syringes has been reported to decrease but not eliminate the likelihood of in vitro clotting.

Caution is advised in patients with homocystinuria because of the risk of inducing thrombosis and embolism.

Effects on ability to drive and use machines

As with all iodinated contrast media, there is a possibility of delayed reactions following administration in rare cases.

As a precaution, driving or operating machinery should be avoided for the first 24 hours after administration of contrast media.

What happens if I overdose Potassium chloride?

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local, or emergency room immediately. Symptoms may include chest pain; fast, slow, or irregular heartbeat; limp muscles; listlessness; muscle weakness or paralysis; slow or difficult breathing.

Proper storage of Potassium chloride:

Store Potassium chloride at 77 degrees F (25 degrees C). Brief storage at temperatures between 59 and 86 degrees F (15 and 30 degrees C) is permitted. Store away from heat, moisture, and light. Do not store in the bathroom. Keep Potassium chloride out of the reach of children and away from pets.

Overdose of Potassium chloride in details

When a dose is taken in higher dose than the recommended doses, it is called Overdose. Overdose always needs a clinical supervision. Any medicine or drug when consumed in Overdose produces untoward side effects on one or various organs in the body. A medicine is excreted in the kidney or metabolized in the liver most of the times. This process goes without any hurdles when taken in normal dose, but when taken in an overdose, the body is not able to metabolize it or send it out properly which causes the effects of anoverdose.

The administration of oral potassium salts to persons with normal excretory mechanisms for potassium rarely causes serious hyperkalemia. However, if excretory mechanisms are impaired or if potassium is administered too rapidly intravenously, potentially fatal hyperkalemia can result. It is important to recognize that hyperkalemia is usually asymptomatic and may be manifested only by an increased serum potassium concentration (6.5-8.0 mEq/L) and characteristic electrocardiographic changes (peaking of T-waves, loss of P-waves, depression of S-T segment, and prolongation of the QT-interval). Late manifestations include muscle paralysis and cardiovascular collapse from cardiac arrest (9-12 mEq/L).

Treatment measures for hyperkalemia include the following:

  1. Patients should be closely monitored for arrythmias and electrolyte changes.
  2. Elimination of foods and medications containing potassium and of any agents with potassium-sparing properties such as potassium-sparing diuretics, ARBS, ACE inhibitors, NSAIDs, certain nutritional supplements and many others.
  3. Intravenous calcium gluconate if the patient is at no risk or low risk of developing digitalis toxicity.

  4. Intravenous administration of 300 to 500 mL/hr of 10% dextrose solution containing 10-20 units of crystalline insulin per 1,000 mL.

  5. Correction of acidosis, if present, with intravenous sodium bicarbonate.
  6. Use of exchange resins, hemodialysis, or peritoneal dialysis.

In treating hyperkalemia, it should be recalled that in patients who have been stabilized on digitalis, too rapid a lowering of the serum potassium concentration can produce digitalis toxicity.

The extended release feature means that absorption and toxic effects may be delayed for hours. Consider standard measures to remove any unabsorbed drug.

What should I avoid while taking Potassium chloride?

Avoid taking potassium supplements or using other products that contain potassium without first asking your doctor. Salt substitutes or low-salt dietary products often contain potassium. If you take certain products together you may accidentally get too much potassium. Read the label of any other medicine you are using to see if it contains potassium.

Potassium chloride warnings

Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.

Hyperkalemia

In patients with impaired mechanisms for excreting potassium, the administration of potassium salts can produce hyperkalemia and cardiac arrest. This occurs most commonly in patients given potassium by the intravenous route but may also occur in patients given potassium orally. Potentially fatal hyperkalmia can develop rapidly and be asymptomatic. The use of potassium salts in patients with chronic renal disease, or any other condition which impairs potassium excretion, requires particularly careful monitoring of the serum potassium concentration and appropriate dosage adjustments.

Interaction with Potassium-Sparing Diuretics

Hypokalemia should not be treated by the concomitant administration of potassium salts and a potassium-sparing diuretic (e.g., spironolactone, triamterene, or amiloride), since the simultaneous administration of these agents can produce severe hyperkalemia.

Interaction with Angiotensin Converting Enzyme Inhibitors

Angiotensin converting enzyme (ACE) inhibitors (e.g., captopril, enalapril) will produce some potassium retention by inhibiting aldosterone production. Potassium supplements should be given to patients receiving ACE inhibitors only with close monitoring.

Gastrointestinal Lesions

Solid oral dosage forms of potassium chloride can produce ulcerative and/or stenotic lesions of the gastrointestinal tract. Based on spontaneous adverse reaction reports, enteric coated preparations of potassium chloride are associated with an increased frequency of small bowel lesions (40 - 50 per 100,000 patient years) compared to sustained-release wax matrix formulations (less than one per 100,000 patient years). Because of the lack of extensive marketing experience with microencapsulated products, a comparison between such products and wax matrix or enteric coated products is not available. Potassium chloride (potassium chloride extended-release) ® Extencaps® and Potassium chloride (potassium chloride extended-release) ® 10 Extencaps® are microencapsulated capsules formulated to provide a controlled rate of release of microencapsulated potassium chloride and thus to minimize the possibility of high local concentration of potassium near the gastrointestinal wall.

Prospective trials have been conducted in normal human volunteers in which the upper gastrointestinal tract was evaluated by endoscopic inspection before and after one week of solid oral potassium chloride therapy. The ability of this model to predict events occurring in usual clinical practice is unknown. Trials which approximated usual clinical practice did not reveal any clear differences between the wax matrix and microencapsulated dosage forms. In contrast, there was a higher incidence of gastric and duodenal lesions in subjects receiving a high dose of a wax matrix controlled-release formulation under conditions which did not resemble usual or recommended clinical practice (i.e., 96 mEq per day in divided doses of potassium chloride administered to fasted patients, in the presence of an anticholinergic drug to delay gastric emptying). The upper gastrointestinal lesions observed by endoscopy were asymptomatic and were not accompanied by evidence of bleeding (hemoccult testing). The relevance of these findings to the usual conditions (i.e., non-fasting, no anticholinergic agent, smaller doses) under which controlled-release potassium chloride products are used is uncertain; epidemiologic studies have not identified an elevated risk, compared to microencapsulated products, for upper gastrointestinal lesions in patients receiving wax matrix formulations. Potassium chloride (potassium chloride extended-release) ® Extencaps® and Potassium chloride (potassium chloride extended-release) ® 10 Extencaps® should be discontinued immediately and the possibility of ulceration, obstruction or perforation considered if severe vomiting, abdominal pain, distention, or gastrointestinal bleeding occur.

Metabolic Acidosis

Hypokalemia in patients with metabolic acidosis should be treated with an alkalinizing potassium salt such as potassium bicarbonate, potassium citrate, potassium acetate, or potassium gluconate.

What should I discuss with my healthcare provider before taking Potassium chloride?

Some medical conditions may interact with Potassium chloride. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

Some MEDICINES MAY INTERACT with Potassium chloride. Tell your health care provider if you are taking any other medicines, especially any of the following:

This may not be a complete list of all interactions that may occur. Ask your health care provider if Potassium chloride may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Potassium chloride precautions

Certain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.

General

The diagnosis of potassium depletion is ordinarily made by demonstrating hypokalemia in a patient with a clinical history suggesting some cause for potassium depletion. In interpreting the serum potassium level, the physician should bear in mind that acute alkalosis per se can produce hypokalemia in the absence of a deficit in total body potassium, while acute acidosis per se can increase the serum potassium concentration into the normal range even in the presence of a reduced total body potassium. The treatment of potassium depletion, particularly in the presence of cardiac disease, renal disease, or acidosis requires careful attention to acid-base balance and appropriate monitoring of serum electrolytes, the electrocardiogram, and the clinical status of the patient.

Laboratory Tests

When blood is drawn for analysis of plasma potassium, it is important to recognize that artifactual elevations can occur after improper venipuncture technique or as a result of in vitro hemolysis of the sample.

Carcinogenesis, Mutagenesis, Impairment of Fertility

Carcinogenicity, mutagenicity, and fertility studies in animals have not been performed. Potassium is a normal dietary constituent.

Pregnancy Category C

Animal reproduction studies have not been conducted with Potassium chloride (potassium chloride). It is unlikely that potassium supplementation that does not lead to hyperkalemia would have an adverse effect on the fetus or would affect reproductive capacity.

Nursing Mothers

The normal potassium ion content of human milk is about 13 mEq per liter. It is not known if Potassium chloride (potassium chloride) has an effect on this content. Since oral potassium becomes part of the body potassium pool, so long as body potassium is not excessive, the contribution of potassium chloride supplementation should have little or no effect on the level in human milk.

Pediatric Use

Safety and effectiveness in pediatric patients have not been established.

Geriatric Use

Clinical studies of Potassium chloride (potassium chloride) tablets did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in responses between the elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal or cardiac function, and of concomitant disease or other drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.

What happens if I miss a dose of Potassium chloride?

When you miss a dose, you should take it as soon as you remember, but you should take care that it should be well spaced from the next dose. You should not take an extra dose at the time of the second dose as it will become a double dose. The double dose can give unwanted side effects, so be careful. In chronic conditions or when you have a serious health issue, if you miss a dose, you should inform your health care provider and ask his suggestion.

Take the missed dose as soon as you remember. If it is almost time for your next dose, skip the missed dose and take the medicine at the next regularly scheduled time. Do not take extra medicine to make up the missed dose.

What happens if I overdose Sodium chloride?

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Sodium chloride may be harmful if swallowed.

Proper storage of Sodium chloride:

Store Sodium chloride at room temperature, between 59 and 86 degrees F (15 and 30 degrees C). Store away from heat, moisture, and light. Do not store in the bathroom. Do not use the solution if it is discolored or contains particles. Store ampules in foil pouch until ready for use. Keep Sodium chloride out of the reach of children and away from pets.

Overdose of Sodium chloride in details

When a dose is taken in higher dose than the recommended doses, it is called Overdose. Overdose always needs a clinical supervision. Any medicine or drug when consumed in Overdose produces untoward side effects on one or various organs in the body. A medicine is excreted in the kidney or metabolized in the liver most of the times. This process goes without any hurdles when taken in normal dose, but when taken in an overdose, the body is not able to metabolize it or send it out properly which causes the effects of anoverdose.

Excessive administration of 0.45% Sodium Chloride Injection, USP may lead to hypo- and hypernatremia, while excessive administration of 0.9% Sodium Chloride Injection, USP may lead to hypernatremia. Both hypo- and hypernatremia can lead to CNS manifestations, including seizures, coma, cerebral edema and death.

Excessive administration of Sodium Chloride Injection, USP may lead to sodium overload (which can lead to central and/or peripheral edema).

When assessing an overdose, any additives in the solution must also be considered. The effects of an overdose may require immediate medical attention and treatment.

What should I avoid while taking Sodium chloride?

Avoid getting Sodium chloride in your eyes.

Avoid sharing nasal products with other people. Sharing a nasal spray container or applicator that is inserted into the nose can allow infections or disease to pass from one person to another.

Sodium chloride warnings

Warnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.

Hypersensitivity/infusion reactions, including hypotension, pyrexia, tremor, chills, urticaria, rash, and pruritus have been reported with 0.9% Sodium Chloride Injection, USP and may occur with 0.45% Sodium Chloride Injection, USP.

Stop the infusion immediately if signs or symptoms of a hypersensitivity reaction develop, such as tachycardia, chest pain, dyspnea and flushing. Appropriate therapeutic countermeasures must be instituted as clinically indicated.

Depending on the volume and rate of infusion, the intravenous administration of Sodium Chloride Injection, USP can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration/hypervolemia, congested states, pulmonary edema, or acid-base imbalance. The risk of dilutive states is inversely proportional to the electrolyte concentration of the injection. The risk of solute overload causing congested states with peripheral and pulmonary edema is directly proportional to the electrolyte concentrations of the injection.

Monitor changes in fluid balance, electrolyte concentrations, and acid base balance during prolonged parenteral therapy or whenever the condition of the patient or the rate of administration warrants such evaluation.

Administer 0.9% Sodium Chloride Injection, USP with particular caution, to patients with or at risk for hypernatremia, hyperchloremia, or metabolic acidosis.

The infusion of solutions with 0.45% Sodium Chloride Injection, USP may result in hyponatremia. Close clinical monitoring may be warranted. Hyponatremia can lead to headache, nausea, seizures, lethargy, coma, cerebral edema and death. The risk for hyponatremia is increased, for example, in children, elderly, women, postoperatively, in persons with psychogenic polydipsia, and in patients treated with medications that increase the risk of hyponatremia (such as certain antiepileptic and psychotropic medications). The risk for developing hyponatremic encephalopathy is increased, for example, in pediatric patients (≤16 years of age), women (in particular pre-menopausal women), in patients with hypoxemia, and in patients with underlying central nervous system disease. Acute symptomatic hyponatremic encephalopathy is considered a medical emergency.

Administer Sodium Chloride Injection, USP with particular caution, to patients with or at risk for hypervolemia or with conditions that may cause sodium retention, fluid overload and edema; such as patients with primary hyperaldosteronism, or secondary hyperaldosteronism [e.g., associated with hypertension, congestive heart failure, liver disease (including cirrhosis), renal disease (including renal artery stenosis, nephrosclerosis) or pre-eclampsia]. Certain medications may increase risk of sodium and fluid retention, see Drug Interactions.

Administer Sodium Chloride Injection, USP with particular caution, to patients with severe renal impairment. In such patients, administration of Sodium Chloride Injection, USP may result in sodium retention.

What should I discuss with my healthcare provider before taking Sodium chloride?

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For sodium chloride, the following should be considered:

Allergies

Tell your doctor if you have ever had any unusual or allergic reaction to sodium chloride or any other medicines. Also tell your health care professional if you have any other types of allergies, such as to foods, dyes, preservatives, or animals. For non-prescription products, read the label or package ingredients carefully.

Pregnancy

Pregnancy Category Explanation
All Trimesters C Animal studies have shown an adverse effect and there are no adequate studies in pregnant women OR no animal studies have been conducted and there are no adequate studies in pregnant women.

Breast Feeding

Studies in women suggest that this medication poses minimal risk to the infant when used during breastfeeding.

Interactions with Medicines

Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.

Interactions with Food/Tobacco/Alcohol

Certain medicines should not be used at or around the time of eating food or eating certain types of food since interactions may occur. Using alcohol or tobacco with certain medicines may also cause interactions to occur. Discuss with your healthcare professional the use of your medicine with food, alcohol, or tobacco.

Other Medical Problems

The presence of other medical problems may affect the use of sodium chloride. Make sure you tell your doctor if you have any other medical problems, especially:

Sodium chloride precautions

Certain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.

General

Do not connect flexible plastic containers of intravenous solutions in series connections. Such use could result in air embolism due to residual air being drawn from one container before administration of the fluid from a secondary container is completed. Pressurizing intravenous solutions contained in flexible plastic containers to increase flow rates can result in air embolism if the residual air in the container is not fully evacuated prior to administration.

Use of a vented intravenous administration set with the vent in the open position could result in air embolism. Vented intravenous administration sets with the vent in the open position should not be used with flexible plastic containers.

Laboratory Tests

Clinical evaluation and periodic laboratory determinations are necessary to monitor changes in fluid balance, electrolyte concentrations, and acid base balance during prolonged parenteral therapy or whenever the condition of the patient warrants such evaluation.

Carcinogenesis and Mutagenesis and Impairment of Fertility

Studies with Sodium Chloride (sodium chloride (sodium chloride injection) injection) Injection, USP have not been performed to evaluate carcinogenic potential, mutagenic potential, or effects on fertility.

Pregnancy

Teratogenic Effects

Pregnancy Category C

Animal reproduction studies have not been conducted with Sodium Chloride Injection, USP. It is also not known whether Sodium Chloride (sodium chloride (sodium chloride injection) injection) Injection, USP can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Sodium Chloride (sodium chloride (sodium chloride injection) injection) Injection, USP should be given to a pregnant woman only if clearly needed.

Labor and Delivery

Studies have not been conducted to evaluate the effects of Sodium Chloride (sodium chloride (sodium chloride injection) injection) Injection, USP on labor and delivery. Caution should be exercised when administering this drug during labor and delivery.

Nursing Mothers

It is not known whether this drug is excreted in human milk. Because many drugs are excreted in human milk, caution should be exercised when Sodium Chloride (sodium chloride (sodium chloride injection) injection) Injection, USP is administered to a nursing woman.

Pediatric Use

Safety and effectiveness of Sodium Chloride (sodium chloride (sodium chloride injection) injection) Injection, USP in pediatric patients have not been established by adequate and well controlled trials, however, the use of sodium chloride (sodium chloride (sodium chloride injection) injection) solutions in the pediatric population is referenced in the medical literature. The warnings, precautions and adverse reactions identified in the label copy should be observed in the pediatric population.

Geriatric Use

Clinical studies of Sodium Chloride (sodium chloride (sodium chloride injection) injection) Injection, USP did not include sufficient numbers of subjects aged 65 and over to determine whether they respond differently from younger subjects. Other reported clinical experience has not identified differences in the responses between elderly and younger patients. In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or drug therapy.

This drug is known to be substantially excreted by the kidney, and the risk of toxic reactions to this drug may be greater in patients with impaired renal function. Because elderly patients are more likely to have decreased renal function, care should be taken in dose selection, and it may be useful to monitor renal function.

What happens if I miss a dose of Sodium chloride?

When you miss a dose, you should take it as soon as you remember, but you should take care that it should be well spaced from the next dose. You should not take an extra dose at the time of the second dose as it will become a double dose. The double dose can give unwanted side effects, so be careful. In chronic conditions or when you have a serious health issue, if you miss a dose, you should inform your health care provider and ask his suggestion.

Since sodium chloride inhalation is sometimes used only as needed, you may not be on a dosing schedule. If you are using the medication regularly, use the missed dose as soon as you remember. Skip the missed dose if it is almost time for your next scheduled dose. Do not use extra medicine to make up the missed dose.



References

  1. DailyMed. "AMINO ACIDS; CALCIUM ACETATE; GLYCERIN; MAGNESIUM ACETATE; PHOSPHORIC ACID; POTASSIUM CHLORIDE; SODIUM ACETATE; SODIUM CHLORIDE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DailyMed. "MAGNESIUM CHLORIDE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  3. DrugBank. "Magnesium chloride". http://www.drugbank.ca/drugs/DB09407 (accessed September 17, 2018).

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