Adult Dosing

Hypochloremic state/ metabolic alkalosis

• Dosage depends upon severity of the alkalosis and the tolerance of the patient
• Dilute 100-200 mEq of ammonium chloride in 500-1000 mL of isotonic (0.9%) sodium chloride injection
• Administer 5 mL/minute IV infusion

Note:

• Monitor the dose by repeated serum bicarbonate determinations

Pediatric Dosing

• Safety and effectiveness in pediatric patients have not been established

• Treatment of hypochloremic states
• Treatment of metabolic alkalosis

• Hypersensitivity to any of the ingredients of the product
• Severe renal impairment
• Severe hepatic impairment
• Ammonium chloride should not be administered when metabolic alkalosis due to vomiting of hydrochloric acid is accompanied by loss of sodium (excretion of sodium bicarbonate in the urine).

• N/A

Renal Dose Adjustment

• Renal impairment: Contraindicated

Hepatic Dose Adjustment

• Hepatic impairment: Contraindicated

• Administer IV infusion slowly to avoid local irritation and toxic effects
• Before administration, ammonium chloride injection should be diluted to a concentration of 1-2% of ammonium chloride
• Monitor the patients receiving ammonium chloride for symptoms of ammonia toxicity manifested as pallor, sweating, retching, irregular breathing, bradycardia, cardiac arrhythmias, local and general twitching, tonic convulsions and coma
• Use cautiously in patients with high total CO2 and buffer base secondary to primary respiratory acidosis
• Concentrated solutions of ammonium chloride may crystallize, when exposed to low temperatures. Warm the vial to room temperature in a water bath prior to use, if crystals are observed

Cautions: Use cautiously in

• Primary respiratory acidosis

Pregnancy Category:C

Breastfeeding: Safety unknown

• LOCAL: Pain/irritation at IV site, infection, extravasation, venous thrombosis, phlebitis
• METABOLIC: Hypervolemia, ammonia toxicity
• MUSC: Local and general twitching
• MISC: Fever

• Electrolyte replenisher and systemic acidifier; maintains acid-base balance, ammonium ion is converted to urea in the liver, liberating hydrogen and chloride into the extracellular fluid
• Metabolized by liver to urea
• Renally excreted
• Half-life: Unknown

US Trade Name(s)

• Only generic available

US Availability

ammonium chloride (generic)

• INJ: 5 mEq/ml (20 mL plastic container)

Canadian Trade Name(s)

• N/A

Canadian Availability

• N/A

UK Trade Name(s)

• N/A

UK Availability

• N/A

Australian Trade Name(s)

• N/A

Australian Availability

• N/A

Miscellaneous

Uncategorized Agents

Drug Name: UROEZE 200 MG Oral Tablet

Ingredient(s): Ammonium Chloride

Imprint: N/A

Color(s): White

Shape: Round

Size (mm): 7.00

Score: 2

Inactive Ingredient(s): N/A

Drug Label Author:
Virbac AH, Inc.

DEA Schedule:
Non-Scheduled

Drug Name: UROEZE 400 MG Oral Tablet

Ingredient(s): Ammonium Chloride

Imprint: N/A

Color(s): White

Shape: Round

Size (mm): 9.00

Score: 2

Inactive Ingredient(s): N/A

Drug Label Author:
Virbac AH, Inc.

DEA Schedule:
Non-Scheduled