Natriumklorid Fresenius Kabi (Sodium Chloride)
Isotonic solution for intravenous infusion – fluid replacement and electrolyte restoration
Natriumklorid Fresenius Kabi is a sterile, isotonic sodium chloride solution (0.9% NaCl, also known as normal saline) used for intravenous infusion. It is one of the most widely used medical solutions worldwide, essential for treating dehydration, correcting sodium deficiency, and serving as a vehicle for diluting other intravenous medications. This product is administered by healthcare professionals in hospital and clinical settings.
Quick Facts
Key Takeaways
- Sodium chloride 0.9% (normal saline) is an isotonic solution that matches the salt concentration of blood plasma and is used to treat dehydration and electrolyte imbalances.
- It is administered intravenously by healthcare professionals and is also commonly used as a diluent for other medications before IV administration.
- The solution should not be given to patients with hypernatraemia, hyperchloraemia, fluid overload, or severe cardiac or renal impairment.
- Rapid infusion of large volumes may cause hyperchloremic acidosis; careful monitoring of electrolytes and fluid balance is essential.
- It can be used during pregnancy and breastfeeding with appropriate clinical supervision, though extra caution is needed in pre-eclampsia.
What Is Natriumklorid Fresenius Kabi and What Is It Used For?
Quick Answer: Natriumklorid Fresenius Kabi is a sterile 0.9% sodium chloride (normal saline) solution for intravenous infusion, used to treat dehydration, correct sodium deficiency, and dilute other medications for IV administration.
Natriumklorid Fresenius Kabi is an isotonic intravenous solution containing sodium chloride at a concentration of 9 mg/ml (0.9%). This concentration is known as “normal saline” or “physiological saline” because it closely matches the osmolarity of human blood plasma, making it safe for direct intravenous administration without causing damage to blood cells.
The solution is presented as a clear, colourless liquid free of visible particles, supplied in flexible polypropylene bags (Freeflex) or polyethylene bottles (KabiPac) in volumes ranging from 50 ml to 1000 ml. It is manufactured under strict aseptic conditions by Fresenius Kabi, one of the world’s largest producers of infusion therapies and clinical nutrition products.
Sodium chloride 0.9% is listed on the WHO Model List of Essential Medicines, reflecting its critical importance in global healthcare. It is used in virtually every medical setting, from emergency departments and intensive care units to surgical theatres and general medical wards.
Primary Clinical Indications
The main clinical uses of sodium chloride 0.9% infusion include:
- Fluid replacement in dehydration: When the body has lost significant amounts of water due to illness, surgery, or inadequate fluid intake, normal saline helps restore circulating blood volume and tissue hydration.
- Sodium deficiency (hyponatraemia): In patients with low blood sodium levels, isotonic saline provides controlled sodium replacement to gradually normalise electrolyte balance.
- Drug dilution and reconstitution: Many injectable medications require dilution before intravenous administration. Normal saline is the most commonly used compatible diluent for this purpose.
- Perioperative fluid management: During and after surgical procedures, normal saline maintains hydration and blood pressure stability.
- Resuscitation in hypovolaemia: In emergency situations involving blood loss, burns, or septic shock, rapid infusion of normal saline helps maintain critical organ perfusion.
Other brands containing the same active substance include Natriumklorid B. Braun, Natriumklorid Abboxia, Natriumklorid Evolan, Natriumklorid Noridem, Natriumklorid Abcur, and Addens-Natriumklorid B. Braun. All contain the same standardised 0.9% sodium chloride solution and are therapeutically equivalent.
What Should You Know Before Receiving Natriumklorid Fresenius Kabi?
Quick Answer: Sodium chloride infusion must not be used in patients with high blood sodium, high blood chloride, fluid overload, or severe heart or kidney failure. Special caution is required in heart failure, hypertension, oedema, and conditions involving sodium retention.
Contraindications
Natriumklorid Fresenius Kabi must not be administered if you have any of the following conditions:
- Hypernatraemia – abnormally high levels of sodium in the blood
- Hyperchloraemia – abnormally high levels of chloride in the blood
- Hyperhydration – excessive fluid in the body (fluid overload)
- Severe cardiac insufficiency – severely impaired heart function where additional fluid would place dangerous strain on the heart
- Severe renal insufficiency – severely impaired kidney function that prevents adequate excretion of sodium and water
- Hypersensitivity – known allergy to sodium chloride or any excipients
Your treating physician will check for these contraindications before initiating treatment. Blood tests to assess sodium, chloride, and kidney function are typically performed prior to infusion.
Warnings and Precautions
Healthcare professionals will exercise special caution and may require additional monitoring if you have any of the following conditions:
- Heart failure (cardiac insufficiency): Even mild to moderate heart failure increases the risk of fluid overload. The heart may not be able to handle the additional circulating volume, potentially worsening symptoms of breathlessness and oedema.
- Hypertension (high blood pressure): Sodium contributes to elevated blood pressure. Additional sodium infusion may exacerbate pre-existing hypertension.
- Peripheral or pulmonary oedema: Fluid accumulation in tissues or lungs may worsen with additional intravenous fluids.
- Renal impairment: Reduced kidney function affects the body’s ability to excrete excess sodium and water. Electrolyte levels in the blood will be closely monitored during and after infusion.
- Hypokalaemia (low potassium): Large volumes of sodium chloride without potassium supplementation may further dilute blood potassium levels.
- Metabolic acidosis: The chloride content of normal saline may exacerbate pre-existing acidosis, particularly with large-volume infusion.
- Hyperaldosteronism: Excess aldosterone production from the adrenal glands promotes sodium retention, and additional sodium may worsen fluid and electrolyte imbalance.
- Corticosteroid therapy: Concurrent use of corticosteroids promotes sodium and water retention, increasing the risk of fluid overload.
In patients with hypertonic dehydration (dehydration with elevated blood sodium), the infusion rate must be carefully controlled. Overly rapid correction of sodium levels can cause central pontine myelinolysis, a rare but serious neurological condition involving damage to nerve cells in the brainstem.
Use in Children and Neonates
Newborn infants, particularly premature neonates, have immature kidneys that may not efficiently excrete excess sodium. This creates a heightened risk of hypernatraemia (elevated blood sodium levels). Healthcare professionals will measure plasma sodium concentrations before initiating sodium chloride infusion in neonates and will continue monitoring throughout treatment.
Paediatric dosing is carefully calculated based on body weight and clinical condition, with close attention to fluid balance and electrolyte levels.
Pregnancy and Breastfeeding
Sodium chloride infusion can be used during pregnancy and breastfeeding when clinically indicated. It does not pose specific risks to the developing foetus or nursing infant at standard therapeutic doses. However, special caution is required in pregnant women with pre-eclampsia (a condition characterised by high blood pressure and protein in the urine), as excessive sodium administration may worsen hypertension and fluid retention associated with this condition.
If you are pregnant, breastfeeding, or planning to become pregnant, inform your healthcare team so they can take appropriate precautions with fluid management.
Effects on Driving and Operating Machinery
Natriumklorid Fresenius Kabi has no known effect on the ability to drive or operate machinery. As this product is administered in clinical settings, driving is not typically relevant during treatment.
How Does Sodium Chloride Interact with Other Drugs?
Quick Answer: Sodium chloride has relatively few direct drug interactions, but concurrent use with corticosteroids may increase sodium retention and fluid overload risk. It may also affect lithium clearance and should be used cautiously with other sodium-containing preparations.
While sodium chloride 0.9% is generally considered a safe and inert infusion fluid, certain drug interactions and compatibility issues should be considered. Always inform your healthcare team of all medications you are currently taking, including prescription drugs, over-the-counter medicines, and herbal supplements.
Clinically Significant Interactions
| Interacting Drug | Type | Effect | Clinical Significance |
|---|---|---|---|
| Corticosteroids (e.g., prednisolone, dexamethasone) | Pharmacodynamic | Increased sodium and water retention; elevated risk of oedema and hypertension | Monitor fluid balance and blood pressure closely |
| Lithium | Pharmacokinetic | Changes in sodium intake affect renal lithium clearance; high sodium may reduce lithium levels | Monitor lithium serum levels |
| ACE inhibitors / ARBs | Pharmacodynamic | Large-volume saline may partially counteract antihypertensive effect | Monitor blood pressure |
| Diuretics (loop, thiazide) | Pharmacodynamic | May counteract the sodium-excreting effect of diuretics | Assess clinical indication; adjust as needed |
| Other sodium-containing preparations | Additive | Cumulative sodium load may increase risk of hypernatraemia | Account for total sodium intake from all sources |
Compatibility as a Drug Diluent
Sodium chloride 0.9% is the most widely used diluent for intravenous medications. However, not all drugs are compatible with normal saline. Some medications may precipitate, lose potency, or undergo chemical degradation when mixed with sodium chloride solution. Healthcare professionals must always verify compatibility before adding any medication to the infusion bag using current compatibility references and the specific drug’s prescribing information.
When medications are added to the infusion solution, aseptic technique must be used, and the resulting mixture should be thoroughly mixed and visually inspected for particles or discolouration before administration.
What Is the Correct Dosage of Natriumklorid Fresenius Kabi?
Quick Answer: Dosage is individualised based on the patient’s age, weight, clinical condition, and fluid/electrolyte status. The standard maximum infusion rate is 500 ml/hour, though this may be increased in critical situations such as septic shock or severe hypovolaemia.
Natriumklorid Fresenius Kabi is always administered by or under the supervision of qualified healthcare professionals. The dose and infusion rate are determined by the treating physician based on a comprehensive assessment of the patient’s clinical status, including hydration level, electrolyte balance, cardiac function, renal function, and concurrent medications.
Adults
Standard Fluid Replacement
The typical daily fluid requirement for adults is approximately 25–30 ml per kilogram of body weight per day. For a 70 kg adult, this equates to roughly 1,750–2,100 ml per day. The actual volume of sodium chloride 0.9% infused will depend on the degree of dehydration and other fluid sources.
Maximum Infusion Rate
The standard maximum infusion rate is 500 ml per hour. In critical situations such as septic shock, acute hypovolaemia from blood loss, or severe dehydration, the rate may be increased as clinically indicated. Fluid resuscitation in such settings typically follows established protocols (e.g., Surviving Sepsis Campaign guidelines).
| Patient Group | Typical Volume | Rate | Key Considerations |
|---|---|---|---|
| Adults (maintenance) | 1,500–2,500 ml/day | Up to 500 ml/h | Adjust based on fluid balance and electrolytes |
| Adults (resuscitation) | 500–1,000 ml bolus | May exceed 500 ml/h | Reassess after each bolus; monitor haemodynamics |
| Children | Weight-based calculation | Weight-based | Use Holliday-Segar formula; monitor sodium closely |
| Neonates | Highly individualised | Carefully controlled | Immature renal function; check Na+ before and during |
| Elderly | As for adults; often lower volumes | Often slower rate | Higher risk of cardiac overload; close monitoring |
Children
Paediatric fluid requirements are calculated using the Holliday-Segar formula or similar weight-based approaches. The general guideline is:
- First 10 kg body weight: 100 ml/kg/day
- Second 10 kg body weight: 50 ml/kg/day
- Each additional kg above 20 kg: 20 ml/kg/day
Electrolyte monitoring is particularly important in paediatric patients, especially neonates and infants, whose renal function may not be fully mature.
Elderly Patients
Elderly patients are at increased risk of fluid overload due to age-related decline in cardiac and renal function. Lower volumes and slower infusion rates are often appropriate. Clinical assessment of fluid status – including monitoring for signs of pulmonary oedema, peripheral oedema, and elevated jugular venous pressure – should be performed regularly.
Overdose
Since Natriumklorid Fresenius Kabi is administered by healthcare professionals in controlled settings, accidental overdose is unlikely. However, excessive administration may lead to:
- Hypervolaemia (fluid overload) – manifesting as peripheral oedema, pulmonary oedema, or elevated blood pressure
- Hypernatraemia (elevated blood sodium) – causing thirst, confusion, seizures, or coma in severe cases
- Hyperchloremic metabolic acidosis – from excess chloride ions, particularly with rapid large-volume infusion
If overdose is suspected, the infusion will be stopped immediately and treatment directed at the specific symptoms. This may include administration of diuretics, fluid restriction, and electrolyte correction under careful monitoring.
What Are the Side Effects of Natriumklorid Fresenius Kabi?
Quick Answer: Side effects are uncommon with proper administration. Rare effects include central pontine myelinolysis. Reported effects of unknown frequency include fluid overload, hypernatraemia, hyperchloremic acidosis, and local injection site reactions.
Like all medicines, sodium chloride infusion can cause side effects, although not everybody gets them. When administered at appropriate doses and rates by healthcare professionals, side effects are generally uncommon. The risk increases with rapid infusion of large volumes or when used in patients with the predisposing conditions described in the warnings section.
Rare
May affect up to 1 in 1,000 patients
- Central pontine myelinolysis – damage to nerve cells in the brainstem, typically associated with overly rapid correction of low sodium levels (hyponatraemia). This is a serious but rare neurological condition that can cause difficulty speaking, swallowing, or moving.
Not Known
Frequency cannot be estimated from available data
- Hypervolaemia – excessive fluid in the circulation, leading to swelling, breathlessness, or elevated blood pressure
- Hypernatraemia – elevated blood sodium levels, particularly in patients with heart or kidney failure
- Hyperchloremic acidosis – excessive acid in the blood with elevated chloride, typically from rapid infusion of large volumes
- Fever – occasionally reported during or after infusion
- Injection site reactions – local pain, redness, or swelling at the infusion site
- Phlebitis or venous thrombosis – inflammation or blood clot formation in the vein used for infusion
- Extravasation – accidental leakage of fluid into surrounding tissue, causing local swelling and discomfort
- Infection at the injection site – rare with proper aseptic technique
When sodium chloride solution is used to dilute or reconstitute another medication, the side effects will also depend on the properties of the added drug. Your healthcare team will advise you about potential side effects specific to the combined treatment.
Reporting Side Effects
It is important to report suspected adverse reactions after a medicine has been authorised. This helps ongoing monitoring of the medicine’s benefit-risk profile. Healthcare professionals and patients can report suspected adverse reactions through their national pharmacovigilance system – for example, the FDA MedWatch program in the United States, the Yellow Card Scheme in the United Kingdom, or the EMA EudraVigilance system in the European Union.
How Should You Store Natriumklorid Fresenius Kabi?
Quick Answer: Most pack sizes require no special storage conditions. Freeflex 50 ml bags should be stored below 25°C. Do not use after the expiry date or if the solution contains visible particles or the container is damaged.
Storage of Natriumklorid Fresenius Kabi is typically managed by pharmacy and hospital staff. The following storage guidelines apply:
- Freeflex 50 ml bags: Store at or below 25°C.
- All other pack sizes: No special storage conditions required.
- Keep out of the sight and reach of children.
- Do not use after the expiry date printed on the bag and carton (marked “EXP”). The expiry date refers to the last day of that month.
- Do not use if the solution contains visible particles or if the container is damaged.
- This product is for single use only. Any unused solution should be discarded.
When medications are added to the sodium chloride solution, aseptic technique must be used and the resulting mixture should be mixed thoroughly. The shelf life of the admixture will depend on the added medication – consult the specific drug’s product information for guidance.
Unused or expired medicines should not be disposed of via wastewater or household waste. Follow local regulations for the disposal of pharmaceutical waste to protect the environment.
What Does Natriumklorid Fresenius Kabi Contain?
Quick Answer: The active substance is sodium chloride (9 mg per ml in the 0.9% formulation). Excipients include hydrochloric acid and sodium hydroxide for pH adjustment, and water for injections as the solvent.
Active Ingredient
The active substance is sodium chloride (NaCl). In the 0.9% formulation, each millilitre contains 9 mg of sodium chloride, providing approximately 154 mmol/L each of sodium ions (Na+) and chloride ions (Cl−). This concentration produces an osmolarity of approximately 308 mOsm/L, which is isotonic with blood plasma.
Excipients
- Hydrochloric acid – used for pH adjustment
- Sodium hydroxide – used for pH adjustment
- Water for injections – highly purified water serving as the solvent
Appearance and Packaging
Natriumklorid Fresenius Kabi is a sterile, clear, colourless solution without visible particles. It is available in the following container types and sizes:
- Freeflex bags (polypropylene) with needle injection port or luer-lock port: 50 ml, 100 ml, 250 ml, 500 ml, and 1000 ml
- Freeflex bags with ProDapt port: 50 ml, 100 ml, and 250 ml
- KabiPac bottles (polyethylene): 100 ml, 250 ml, 500 ml, and 1000 ml
Not all pack sizes may be marketed in every country. The manufacturer is Fresenius Kabi, with production facilities in Norway, Germany, France, and Poland.
Frequently Asked Questions
Sodium chloride 0.9% is an isotonic intravenous solution used to treat dehydration, restore fluid and electrolyte balance, and replace sodium and chloride losses. It is also the most commonly used diluent for reconstituting or diluting other medications before intravenous administration. It is one of the most essential IV fluids in hospitals worldwide and appears on the WHO Model List of Essential Medicines.
Yes. Sodium chloride 0.9% solution for infusion is commonly known as “normal saline” or “physiological saline.” The 0.9% concentration means it contains 9 grams of sodium chloride per litre of water, which is isotonic with blood plasma (approximately 308 mOsm/L). Different brands such as Fresenius Kabi, B. Braun, and Baxter all produce the same standardised solution.
Side effects are uncommon when sodium chloride is administered correctly. Possible side effects include fluid overload (hypervolaemia), elevated sodium levels (hypernatraemia), and hyperchloremic acidosis with rapid infusion of large volumes. Local reactions at the injection site such as pain, redness, or vein inflammation (phlebitis) may also occur. A rare but serious effect is central pontine myelinolysis, which can occur from overly rapid correction of low sodium levels.
Sodium chloride infusion is contraindicated in patients with hypernatraemia (high blood sodium), hyperchloraemia (high blood chloride), hyperhydration (fluid overload), severely impaired cardiac function, or severely impaired renal function. Particular caution is needed in patients with heart failure, hypertension, oedema, pre-eclampsia, hyperaldosteronism, or conditions associated with sodium retention.
Yes, sodium chloride infusion can be used during pregnancy and breastfeeding when clinically indicated. It does not pose specific risks to the developing foetus or nursing infant at standard therapeutic doses. However, special caution is required in pregnant women with pre-eclampsia, as excessive sodium administration may worsen hypertension and fluid retention. Healthcare professionals will carefully monitor fluid balance in pregnant patients.
The standard maximum infusion rate for sodium chloride 0.9% is 500 ml per hour. However, in critical situations such as septic shock, acute hypovolaemia from blood loss, or severe dehydration, the infusion rate may be increased as clinically indicated. In patients with hypertonic dehydration, the rate must be carefully controlled to prevent neurological complications. The exact rate is always determined by the treating physician based on the patient’s clinical condition.
References
- World Health Organization (WHO). WHO Model List of Essential Medicines – 23rd List. Geneva: WHO; 2023.
- European Medicines Agency (EMA). Summary of Product Characteristics: Sodium Chloride 9 mg/ml Solution for Infusion. EMA; 2024.
- National Institute for Health and Care Excellence (NICE). Intravenous fluid therapy in adults in hospital. Clinical guideline CG174. Updated 2023.
- Myburgh JA, Mythen MG. Resuscitation fluids. New England Journal of Medicine. 2013;369(13):1243-1251. doi:10.1056/NEJMra1208627
- Semler MW, Self WH, Wanderer JP, et al. Balanced crystalloids versus saline in critically ill adults. New England Journal of Medicine. 2018;378(9):829-839. doi:10.1056/NEJMoa1711584
- Surviving Sepsis Campaign. International Guidelines for Management of Sepsis and Septic Shock: 2021. Intensive Care Medicine. 2021;47:1181-1247.
- British National Formulary (BNF). Sodium Chloride. National Institute for Health and Care Excellence. Accessed January 2026.
- Fresenius Kabi. Natriumklorid Fresenius Kabi 9 mg/ml – Summary of Product Characteristics. Last revised April 2024.
Medical Editorial Team
This article was written by the iMedic Medical Editorial Team, comprising licensed physicians specialising in internal medicine and clinical pharmacology. All content follows the GRADE evidence framework and is reviewed according to international guidelines from the WHO, EMA, and NICE.
Our editorial process ensures that all medical information is accurate, evidence-based, and free from commercial influence. We declare no conflicts of interest and receive no pharmaceutical industry funding.
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