This saline is indicated in:

• Acute fluid and electrolyte loss conditions such as cholera, acute diarrhea, and vomiting
• Dehydration
• Severe electrolyte depletion (markedly low salt concentration in blood)

For 500 ml water: Each sachet contains:

• Sodium Chloride BP: 1.3 g
• Potassium Chloride BP: 0.75 g
• Trisodium Citrate Dihydrate BP: 1.45 g
• Processed Rice Powder (Pharma Grade): 25 g

For 250 ml water: Each sachet contains:

• Sodium Chloride BP: 0.65 g
• Potassium Chloride BP: 0.375 g
• Trisodium Citrate Dihydrate BP: 0.725 g
• Processed Rice Powder (Pharma Grade): 12.5 g

This saline contains essential electrolytes and carbohydrate (in the form of processed rice), which are important for dehydrated patients in conditions such as cholera, acute diarrhea, vomiting, and excessive sweating.

In the normal intestine, there is continuous water exchange through the intestinal wall—about 20 liters of fluid is secreted and nearly the same amount is reabsorbed every 24 hours. This mechanism allows absorption of nutrients from digested food into the bloodstream.

In diarrheal disease, this balance is disrupted, resulting in excessive fluid secretion compared to absorption, causing net fluid loss that may reach several liters per day. Along with water, chloride ions (Cl⁻), extracellular sodium (Na⁺), and intracellular potassium (K⁺) are also lost. This saline helps effectively replace these lost electrolytes.

Pharmacokinetics and therapeutic actions:

• Glucose (derived from rice) facilitates sodium absorption (and water) in a 1:1 molar ratio in the small intestine
• Sodium and potassium replace essential ions lost during diarrhea and vomiting
• Citrate helps correct metabolic acidosis caused by diarrhea and dehydration

Rice carbohydrate is converted into glucose during digestion, which is absorbed along with salts Using rice instead of pure glucose reduces solution osmolarity and helps prevent further fluid loss in stool

The dose depends on the severity of the dehydrating conditions of the patients. Recommended dose after each watery stool are as follows:

• 6 months to 2 years: 50 ml to 100 ml (10 to 20 Teaspoonfuls)
• 2 years to 9 years: 100 ml to 200 ml (20 to 40 teaspoonfuls)
• 10 years and above: 250 ml to 500 ml (1 to 2 glassfuls)

Reconstitution Procedure

• Preparation for 250 ml saline: Wash both hands with soap before preparing the saline. Add 250 ml (one glassful) hot boiled water into a jar. Then add full sachet of this saline (for 250 ml water) powder into the jar. Mix the powder well in the water until a milky white solution appears. Give the solution to the patient to drink as per the dose.
• Preparation for 500 ml saline: Wash both hands with soap before preparing the saline. Add 500 ml hot boiled water (two glassfuls) into a jar. Then add full sachet of this saline (for 500 ml water) powder into the jar. Mix the powder well in the water until a milky white solution appears. Give the solution to the patient to drink as per the dose.

Advice

• Discard any unused reconstituted saline after 5 hours of preparation
• After preparing the saline further heating or boiling is not necessary
• Feeding-bottle should not be used
• Mix the solution with a clean spoon each time before administration
• Syringe without needle may be used to put a small amount of saline into babies' mouth

No known drug interactions have been reported.

Not to be used in:

• Kidney failure with reduced urine output (oliguria)
• Kidney failure with complete absence of urine production (anuria)
• Obstruction of the stomach or intestines
• Shock (reduced blood flow to vital internal organs)
• Severe and persistent vomiting (intractable vomiting)
• Severe dehydration
• Severe diarrhea in infants

Recommended during pregnancy and lactation as no known harmful effects have been reported with its use.

Precautions should be taken in case of significant overdose, especially in:

• Children under 1 year of age
• Patients with electrolyte imbalance
• Patients with severely impaired kidney or liver function

Oral electrolyte preparations.

Store in a cool, dry place, protected from light and moisture.