From the FDA Drug Label
Sodium Chloride Inhalation Solution 3% 15 mL For Respiratory Therapy INDICATIONS: Contents of these vials are for use in the induction of sputum production where specimen collection is indicated. DIRECTIONS FOR USE: To verify container integrity, squeeze the vial before use. Twist cap completely off vial, invert and squeeze prescribed volume
The recommended initial concentration for inhaled sodium chloride therapy is 3%. The administration protocol involves using a single-use vial, squeezing the prescribed volume, and discarding any unused portion 1.
From the Research
The recommended initial concentration for inhaled sodium chloride therapy is 3% (hypertonic saline) for its enhanced mucolytic properties and improved patient outcomes, as supported by the most recent and highest quality study 2. When considering the administration protocol, the solution should be delivered via a nebulizer, with a typical adult dose of 4-5 mL of 3% solution, administered 2-4 times daily. Some key points to consider when administering inhaled sodium chloride therapy include:
- Treatment duration is usually 10-15 minutes per session
- For patients with respiratory conditions like cystic fibrosis, bronchiectasis, or COPD, the 3% concentration is often preferred
- Before initiating therapy, a bronchodilator such as albuterol (2.5 mg) should be administered 5-15 minutes prior to the saline treatment to prevent potential bronchospasm, particularly with hypertonic solutions
- The first dose should be given under medical supervision to monitor for adverse reactions Hypertonic saline works by drawing water into the airways through osmosis, thinning mucus secretions and improving mucociliary clearance, while also potentially reducing airway inflammation. Normal saline helps maintain airway hydration and assists with expectoration of secretions in less severe cases, as noted in studies such as 3 and 4. However, the most recent and highest quality study 2 supports the use of 3% hypertonic saline for improved patient outcomes.