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Inhalation with saline solution for children and adults
Last reviewed: 03.07.2025
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A solution that has the same osmotic pressure as the fluids inside and outside the body's cells is called isotonic or physiological. Do not look for a special saline solution for inhalation or a saline solution for inhalation for a nebulizer in pharmacies, since a regular isotonic solution of NaCl in distilled water (containing 9 mg of sodium chloride in 1 ml of solution) is used for direct action on the respiratory tract.
This solution has the same content of Na and Cl ions as blood plasma, and in medicine it is widely used for injections and infusions both in pure form and mixed with various medicinal substances. So 0.9% sodium chloride solution is a saline solution for inhalation.
Indications saline inhalation
The main indications for the use of saline include intravenous infusions - in cases of dehydration, poisoning, burns, blood loss and shock conditions - to maintain homeostasis by restoring water-electrolyte balance.
In addition, saline solution for inhalation is widely used in complex therapy of respiratory diseases.
In particular, saline solution is used for inhalation for coughs accompanying acute respiratory viral infections; laryngitis and tracheitis; acute and chronic forms of bronchitis; allergic bronchitis and bronchial asthma; pleurisy and pneumonia. Inhalations with sodium chloride solution are prescribed for bronchiectasis, COPD and cystic fibrosis of the lungs.
Saline solution for inhalation in case of runny nose and difficult nasal breathing helps to relieve swelling of the mucous membrane of the nasal cavity, paranasal sinuses and airways of the nasopharynx in the presence of acute respiratory infections, rhinosinusitis, nasopharyngitis, vasomotor rhinitis, sinusitis, frontal sinusitis. In such cases, as well as in case of stenosing laryngotracheitis, inhalations with saline solution are carried out for children, including inhalations with saline solution for newborns.
Regular inhalations with NaCl solution (once or twice a day, 5-10 ml) promote moisturizing and partial regeneration of the mucous epithelium in the nose in atrophic rhinitis and rhinoscleroma. Inhalation with saline solution is quite effective for preventing exacerbation of allergic rhinitis.
Release form
Pharmaceutical sodium chloride is available in the form of powder and tablets for solution (tablets of 0.9 g).
Ready-to-use 0.9% isotonic NaCl solution for injection (i.e. sterile) is available in ampoules (5 and 10 ml), as well as in hermetically sealed vials (100, 200 or 400 ml) and PP containers (250 and 500 ml – for use in hospital settings).
Any of the listed forms is suitable for inhalation, but saline solution packaged in vials or ampoules for inhalation is recommended for use in a nebulizer or compression inhalers with a spacer.
Inhalations with saline solution
The compatibility of physiological saline with most pharmacological agents allows the preparation of inhalation formulations with targeted therapeutic action with the addition of certain drugs, the pharmacodynamics of which do not change due to dilution with sodium chloride solution.
What should be added to the saline solution for inhalation? And what should be the dosage and proportions of the saline solution for inhalation?
First of all, for inhalation solutions for coughs with viscous sputum that is difficult to remove from the bronchi, agents are used to thin and facilitate expectoration of sputum.
Most often, saline solution for inhalation is used for a nebulizer with drugs whose active ingredient is ambroxol hydrochloride: Ambroxol and drugs-synonyms Ambrobene, Ambroxol, Lazolvan, etc. So, when you are prescribed Ambroxol for inhalation with saline solution, Ambroxol or Ambrobene with saline solution for inhalation, as well as saline solution with Lazolvan for inhalation, you need to know that these are simply different trade names of drugs with the same active component.
Mucolytic and expectorant agents with acetylcysteine are used: Acetylcysteine solution for inhalation that does not require dilution 20% (in ampoules of 5 ml), sterile solution Mukomist (in the same packaging), Fluimucil solution for injections and inhalations (in ampoules of 3 ml). According to the official instructions, Fluimucil for inhalation with saline is not mixed, but the contents of one ampoule are used for one procedure (the drug is not used for children under two years of age). If Fluimucil-antibiotic IT (other name: Thiamphenicol glycinate acetylcysteinate) is prescribed in the form of lyophilized powder packaged in vials for the preparation of injection and inhalation solution, then in this case, saline is not needed: water for injection (in 4 ml ampoules) is included with the drug as a solvent.
In case of bronchial spasms associated with bronchial asthma, chronic obstructive bronchitis, and in cases of bronchitis with an emphysematous component, a saline solution with Berodual can be prescribed for inhalation to expand the lumen of the bronchioles.
Patients with chronic bronchitis of an allergic nature are prescribed Budesonide or Pulmicort with saline for inhalation, as well as other drugs from the group of fluorinated corticosteroids (Dexamethasone, Beclomethasone, etc.). With increasing stenosis of the larynx, which can cause croup, not only systemic corticosteroids are used, but also inhalation with saline for children through a nebulizer.
For nasopharyngitis (rhinitis) with nasal congestion due to swelling of its mucous membrane and for sinusitis, Naphazoline or Naphthyzinum and saline solution for inhalation are used. Antiseptic Miramistin with saline solution for inhalation is used with a nebulizer for inflammation of the pharynx and larynx, as well as bacterial tonsillitis.
Ambroxol for inhalation with saline solution
The pharmacodynamics of Ambroxol, Ambrobene, Ambrohexal, Lazolvan and other drugs based on ambroxol hydrochloride consist of liquefying sputum by normalizing the secretory functions of the mucous glands in the bronchial epithelium, activating proteolytic enzymes that destroy glycoproteins of the mucous bronchial secretion, which together contributes to the restoration of mucociliary clearance.
When drugs are used by inhalation and have an effect on the mucous membranes of the respiratory tract, their pharmacokinetics are not described in the instructions.
The use of Ambroxol in the form of a solution for oral administration and inhalation during pregnancy is contraindicated during the first trimester. However, it is indicated that at 28-34 weeks, its inhalation with saline solution is effective for preventing the development of such a dangerous breathing disorder at the birth of premature babies as respiratory distress syndrome (arising from the immaturity of the lungs and insufficient production of alveolar surfactant).
Possible side effects of inhalations with Ambroxol include taste disturbances, dry mouth, nausea, and dyspepsia.
The method of using Ambroxol for inhalation with saline solution involves the use of a nebulizer or compression inhalers with a mask. The proportions of the drug and saline solution are 1:1.
Is it possible to warm up saline solution for inhalation? Saline solution should be warmed up to +38°C. For adults and children over six years of age, the dose for one inhalation is 2.5 ml of Ambroxol solution. How much saline solution is needed for inhalation? In this case, also 2.5 ml. The procedure can be performed twice a day.
Inhalation with saline for children aged two to six years is also carried out twice a day - 2 ml of Ambroxol solution (Ambrobene, Ambrogeksal or Lazolvan) plus the same amount of saline. A single dose for children under two years is 1 ml of the drug mixed with the same amount of sodium chloride solution.
Read also the article – Inhalations for bronchitis.
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Saline solution with Berodual for inhalation
The mechanism of bronchodilator (bronchodilator) action of Berodual, released in the form of a solution for inhalation use (in vials with a dropper), is provided by the β2-adrenomimetic fenoterol hydrobromide, stimulating the β2-receptors of adrenaline in the smooth muscle walls of the bronchi, and the m-anticholinergic ipratropium bromide, which blocks their parasympathetic innervation. As a result, the smooth muscles of the bronchi relax.
The use of this drug in the first and third trimesters of pregnancy is contraindicated; in the second trimester, the use of Berodual for inhalation in bronchial asthma or obstructive bronchitis requires caution.
Also among the contraindications are cardiac pathologies with heart rhythm disturbances, myocardial ischemia, aortic stenosis, elevated levels of thyroid hormones, and prostate enlargement.
The use of Berodual for inhalation may cause side effects such as increased coughing, dry mouth, blurred vision, headache and dizziness, tremors and muscle spasms, increased heart rate, increased sweating and blood pressure, bowel and bladder problems.
Method of administration and dosage
The standard single dose of Berodual for adults and children over six years of age is 10-20 drops (no more than four procedures per day); to stop an asthma attack, the dose is 20-80 drops. For children under this age, this drug is used in doses calculated by body weight, and inhalations are carried out in a medical institution (since this drug can increase bronchial obstruction and cause bronchospasm up to respiratory arrest).
The amount of saline solution needed for inhalation is determined by the number of Berodual drops: 10 drops = 0.5 ml (2.5-3.5 ml of saline solution is required); 20 drops = 1 ml (2-3 ml of saline solution is required). These proportions must not be violated.
An overdose of saline solution with Berodual for inhalation is fraught with cardiac arrhythmia, blood pressure surges, a decrease in potassium levels in the blood and a disruption of the acid-base balance with the development of metabolic acidosis.
Interactions with other drugs: saline solution with Berodual for inhalation is not used simultaneously with oral administration of other adrenergic or anticholinergic drugs, theophylline and theobromine, cardiac glycosides, corticosteroids and diuretics.
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Pulmicort with saline solution for inhalation
Pulmicort dosed suspension for inhalation is used as a means of preventing exacerbations of bronchial asthma and COPD. The corticosteroid budesonide (the active substance of the drug) affects the GCS receptors of lung tissue and prevents the release of proinflammatory cytokines and bronchial-constricting leukotrienes, and also reduces blood circulation in the bronchi, their swelling and the production of bronchial secretions.
Pharmacokinetics: budesonide is well absorbed by the respiratory mucosa and enters the bloodstream with a bioavailability of about 15% and serum protein binding of 90%; metabolized by the liver; excreted by the kidneys.
Use during pregnancy only for medical reasons.
Contraindications for use include respiratory diseases of bacterial, viral or fungal etiology. The inhalation suspension is not allowed to be used in children under six months of age.
Pulmicort with saline solution for inhalation may cause side effects in the form of dermatitis, Quincke's edema, development of candidiasis of the oral cavity and pharynx, cough, hypocorticism, increased nervous excitability or depressive state.
Pulmicort inhalation suspension is used in individually calculated dosages. The standard daily dose for children over six months is 0.25-0.5 mg; for adults - 1-2 mg. The dosage and proportions of saline for inhalation are 1:1, i.e. a dose of Pulmicort 0.25 mg (this is 1 ml of suspension) should be diluted to obtain 2 ml of inhalation solution. Other doses by volume ≥ 2 ml, and there are no instructions regarding the addition of saline.
Overdose is possible with prolonged use of this drug, and its consequences over time manifest as signs of Itsenko-Cushing syndrome.
The only observed interaction of busedonide with other drugs is an increase in its therapeutic effect when preceded by inhalation with bronchodilators (Berodual, Salbutamol, Terbutaline, etc.).
Naphthyzinum and saline solution for inhalation
In order for Naphazoline or Naphthyzinum with saline solution for inhalation to act on the inflamed mucous membrane of the nasal passages, sinuses and nasopharynx, you need to use an inhaler with a mask.
The active substance, naphazoline, belongs to the group of anticongestants, i.e. decongestants that act by vasoconstricting the vasoconstrictor effect, stimulating adrenergic receptors (alpha1 and alpha2). This reduces swelling of the mucous membranes (normalizes nasal breathing), and at the same time reduces the amount of nasal mucous secretion produced.
The release form of Naphthyzinum is 0.05-0.1% solution for nasal instillation.
The use of Naphthyzinum during pregnancy and lactation is prohibited. It is not allowed to use it for children under two years of age.
Naphthyzinum and inhalations with it are contraindicated in cases of high blood pressure, atherosclerosis, glaucoma, diabetes, and chronic forms of rhinitis.
Side effects of this cold medicine include headache and tachycardia. The drug can also cause tachyphylaxis and dependence.
Dosage and proportions of saline solution for inhalation with Naphthyzinum: 1 ml of 0.05% Naphthyzinum solution is diluted with 2 ml of saline solution; 1 ml of 0.1% solution – 5 ml of saline solution.
No more than two inhalations per day are allowed.
Miramistin with saline solution for inhalation
Miramistin is an antiseptic that is not registered in the EU Pharmacopoeia and is available in the form of a 0.01% solution for topical use.
It is allowed to use it for sinusitis and tonsillitis during pregnancy and for inhalation with saline solution for children with rhinitis with purulent discharge from the nose.
The use of Miramistin may be accompanied by burning, itching and hyperemia of the mucous membranes.
The drug should be inhaled through the nose, so an inhaler equipped with a mask is required. Dilution with saline is carried out in the following ratio: 4 ml of saline solution is needed for 2 ml of Miramistin. It is recommended to do two inhalations per day for 3-5 minutes.
Saline solution and Dioxidine for inhalation
Concerns arise regarding inhalations with the bactericidal agent Dioxidine, which are recommended for adult patients for the treatment of nasopharyngeal diseases with the formation of purulent exudate.
According to the instructions, Dioxidine solution is not intended for either nasal instillation or inhalation: it is used externally (irrigation of burn surfaces and tamponade of deep wounds) and inside purulent cavities; it is administered intravenously by infusion (diluted with dextrose solution or saline) for inflammatory processes of a purulent-septic nature.
Information about the dilution proportions of Dioxidine for inhalation cannot be considered reliable.
What can replace saline solution for inhalation?
In principle, the saline solution for inhalation can be replaced with distilled water. Or you can prepare it at home by mixing 9 g of table salt - a teaspoon with a small slide - in one liter of warm boiled water. The solution should be filtered.
This solution will not be sterile, just like the one prepared from pharmacy sodium chloride powder or tablets, but this interferes with its suitability for inhalation.
Storage conditions
Unopened saline solution from the pharmacy for inhalation should be stored at room temperature. Opened and self-prepared - in the refrigerator. Can I use an opened saline solution for inhalation? If a closed opened bottle with saline solution is kept in the refrigerator, it can be used within three days. But the solution for inhalation with the addition of other drugs is not subject to storage and is used immediately after preparation.
Reviews
In most cases, reviews from patients with respiratory diseases and nasopharyngeal inflammation who used saline for inhalation, as well as inhalation formulations of the above-mentioned drugs, are positive. Inhalation therapy prescribed to adults and children often acts faster and is more effective than taking medications orally.
Attention!
To simplify the perception of information, this instruction for use of the drug "Inhalation with saline solution for children and adults" translated and presented in a special form on the basis of the official instructions for medical use of the drug. Before use read the annotation that came directly to medicines.
Description provided for informational purposes and is not a guide to self-healing. The need for this drug, the purpose of the treatment regimen, methods and dose of the drug is determined solely by the attending physician. Self-medication is dangerous for your health.