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ammonium chloride (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 26.75%
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Hypochloremic States & Metabolic Alkalosis

Determined on the basis of patient's CO2 combining power

mEq of chloride ion (as ammonium chloride) = chloride deficit in mEq/L × 0.2 × kg body weight

Safety & efficacy not established

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Interactions

Interaction Checker

ammonium chloride and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Metabolic acidosis

            Potassium depletion

            Injection site reactions

            Ammonia toxicity symptoms

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            Warnings

            Contraindications

            Severe hepatic impairment

            Cautions

            Pulmonary insufficiency, cardiac edema, severe renal impairment (do not give NH4Cl alone if concomitant Na loss)

            Risk of ammonia toxicity

            Monitor pt's CO2 combining power prior to IV administration to avoid serious acidosis

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: N/A

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Metabolism: ammonium ion is converted to urea in the liver; chloride ion replaces bicarbonate

            Excretion: urine

            Mechanism of Action

            Replaces bicarbonate ions with chloride ions

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            Administration

            IV Incompatibilities

            Additive: dimenhydrinate(?), levorphanol

            Y-site: warfarin(?)

            IV Preparation

            Dilute the 26.75% concentrate by adding 100 or 200 mEq (20 or 40 mL) of NH4Cl to 500 or 1000 mL of NS

            IV Administration

            NMT 5 mL/min in adults

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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