Medications That Lower Sodium (Treat Hypernatremia)
For hypernatremia, the primary treatment is hypotonic fluid replacement (not medications per se), but when intravenous therapy is required, hypotonic fluids such as 0.45% saline or 5% dextrose in water are used to gradually lower elevated sodium levels. 1
Understanding Hypernatremia Treatment
Hypernatremia is less common than hyponatremia and represents an elevated serum sodium concentration. 1 The approach focuses on:
Primary Treatment Strategy
- Fluid replacement with hypotonic solutions is the cornerstone of hypernatremia management, not specific medications that "lower sodium" 1
- Treatment begins with addressing the underlying etiology (such as dehydration from impaired thirst mechanism or lack of water access) and correcting the fluid deficit 1
- When sodium is severely elevated, patients are symptomatic, or intravenous fluids are required, hypotonic fluid replacement becomes necessary 1
Hypotonic Fluid Options
- 0.45% saline (half-normal saline) provides free water while maintaining some sodium content 1
- 5% dextrose in water (D5W) effectively provides free water as the glucose is metabolized 1
- The goal is gradual correction to avoid cerebral edema from overly rapid sodium reduction 1
Important Clinical Caveat
There is no "medication" in the traditional sense that lowers sodium for hypernatremia treatment. The confusion in your question likely stems from the fact that many medications can cause hyponatremia (low sodium) as a side effect, but hypernatremia requires fluid management rather than pharmacologic sodium-lowering agents. 1
Common Causes to Address
- Dehydration from impaired thirst mechanism 1
- Lack of access to water 1
- Diabetes insipidus (which may require desmopressin to treat the underlying cause, not to directly lower sodium) 1
The treatment paradigm is fundamentally different from hyponatremia management, where specific medications like vaptans exist to raise sodium levels. 2