From the FDA Drug Label
The dosage of Sodium Chloride Oral Solution 23.4% is predicated on the specific requirements of the patient based on clinical and laboratory information. The amount of oral sodium chloride required to correct hyponatremia is not specified in the drug label, as it is based on the specific requirements of the patient.
- The label provides a serving size of 4 ml (equivalent to 936 mg of Sodium Chloride) for ages 9 to 50.
- For children under 9 years and adults over 50 years, it is recommended to consult a physician. 1
From the Research
The recommended dose of oral sodium chloride to correct hyponatremia is typically 1-2 grams taken 3-4 times daily, for a total of 3-8 grams per day, as supported by the most recent and highest quality study 2. This dose should be adjusted based on the severity of hyponatremia, the patient's weight, and ongoing monitoring of serum sodium levels.
- Sodium chloride tablets are commonly available in 1 gram strength.
- The correction should be gradual, aiming for an increase of no more than 8-10 mEq/L in 24 hours to avoid osmotic demyelination syndrome, as recommended by recent guidelines 2.
- Patients should be monitored regularly during treatment, with serum sodium levels checked every 4-6 hours in severe cases.
- Adequate fluid intake should be maintained unless fluid restriction is specifically indicated. This approach works because oral sodium chloride provides sodium ions that directly increase serum sodium concentration while the chloride component helps maintain acid-base balance. In cases of severe hyponatremia (sodium <120 mEq/L) or when symptoms like seizures or altered mental status are present, intravenous hypertonic saline would be preferred over oral supplementation, as indicated by recent studies 3, 2. The management of hyponatremia should be based on the underlying cause and the patient's volume status, with treatment options including fluid restriction, urea, vaptans, and hypertonic saline, as discussed in recent reviews 4, 2.