Macromineral·Vitamins & Minerals

Sodium chloride

Chronic sodium depletion, high-output stomas

MINERALSlow-Na600 mg tabletUNSCHEDULEDTGA

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At a glance

Max Dose

Titrated

Caution: GI Ulceration

HIGH RISK

Hyponatremia

CHRONIC ONLY

High risk: Heart Failure

CONTRAIND.

Cautions

Avoid / Cautions

Congestive heart failure, severe liver cirrhosis with ascites, acute symptomatic hyponatremia.

Where it stands

Rapid Summary

Overview

Oral salt tablets. Used to slowly correct chronic, asymptomatic hyponatremia. Highly irritating to the stomach.

Clinical Focus

Never use oral salt tablets for acute, symptomatic hyponatremia (seizures/coma). That requires IV Hypertonic Saline in the ICU.

Bottom Line

Sodium chloride is essential IV fluid for volume resuscitation and hyponatraemia correction, but excessive administration causes hyperchloraemic metabolic acidosis and overly rapid correction of hyponatraemia risks osmotic demyelination.

Formulation & Access

Brand Names

Slow-Na

Oral Routes

Sustained-release tablets (600 mg = 10 mmol of Sodium).

Prescribing & PBS

Over The Counter (OTC).

Indications & Use

Primary

TGA

Chronic sodium depletion, high-output stomas.

Clinical Place

Used as an adjunct to fluid restriction in SIADH.

Quick reference

Class & Role

Macromineral — Oral salt tablets.

Route / Formulation

Sustained-release tablets (600 mg = 10 mmol of Sodium). (Slow-Na)

Usual Dose & Max

PO 1-2 tablets (600 mg each) TDS. Must be swallowed whole with a full glass of water. Titrated entirely based on serum sodium levels (e.g., 2 to 6 tablets a day).

Key Indication Doses

Chronic Hyponatremia / SIADH: PO 1-2 tablets (600 mg each) TDS. Must be swallowed whole with a full glass of water. Post-Bowel Resection / Ileostomy: PO Used to replace massive salt losses from high-output stomas.

Best Uses

Key Risks

Gastrointestinal: Severe nausea, vomiting, gastric ulceration. (Salt is intensely irritating to the gastric mucosa). Neurological: Osmotic Demyelination Syndrome (ODS). If you raise the patient's blood sodium too fast (>8 mmol/L in 24 hours), their brainstem will shrink and demyelinate, causing permanent 'locked-in' paralysis. Cardiovascular: Fluid overload, acute pulmonary oedema (salt pulls water with it).

Key Interactions

Antagonises the effect of all antihypertensives and diuretics.

Monitoring

Daily U&E (Sodium). Ensure the sodium is not rising faster than 8 mmol/L in any 24-hour period. Look for the 'ghost pill' in the stool (wax matrix does not dissolve). Ensure patient takes it with a large meal.

Clinical Pearl

Because Slow-Na tablets frequently cause terrible vomiting, many physicians simply prescribe 'Bovril/Vegemite broth' or salty soups. These are far better tolerated by the stomach and provide massive amounts of oral sodium.

Access

Slow-Na600 mg tablet

Brand: Slow-Na
Formulation: Sustained-release tablets (600 mg = 10 mmol of Sodium).

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