Ammonium Chloride

Ammonium chloride is a treatment option for severe cases of metabolic alkalosis.

Adult and Pediatric Dosage Forms and Strengths

Injectable solution

• 5 mEq/mL

Injectable solution

• 1 mg/mL

Dosage Considerations – Should be Given as Follows:

Hypochloremic States and Metabolic Alkalosis

• mEq of chloride ion (as ammonium chloride-NH4Cl) = [0.2 L/kg X BW (kg)] X [103 - observed serum chloride]; administer 50% of dose over 12 hours and reevaluate
• 103 is the average normal serum chloride concentration (mEq/L) and 0.2 L/kg is the estimated chloride volume of distribution

Side effects of ammonium chloride include:

• Metabolic acidosis
• Rash
• EEG abnormalities
• Seizures
• Mental confusion
• Irritability
• Drowsiness
• Injection site reactions
• Ammonia toxicity symptoms (sweating, altered breathing, slow heart rate, irregular heartbeats, and coma)
• Calcium-deficient leading to tetany
• Low blood potassium (hypokalemia)
• High chloride levels in the blood (hyperchloremia)
• Abdominal pain
• Nausea/vomiting
• Hyperventilation
• Encephalopathy

This document does not contain all possible side effects and others may occur. Check with your physician for additional information about side effects.

If your doctor has directed you to use this medication, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider or pharmacist first.

Ammonium Chloride has no known severe interactions with other drugs.

Moderate interactions of ammonium chloride include:

• amphetamine
• dextroamphetamine
• dichlorphenamide
• lisdexamfetamine
• methamphetamine
• methylenedioxymethamphetamine

Mild interactions of ammonium chloride include:

• spironolactone

This document does not contain all possible interactions. Therefore, before using this product, tell your doctor or pharmacist of all the products you use. Keep a list of all your medications with you, and share the list with your doctor and pharmacist. Check with your physician if you have health questions or concerns.

Warnings

• This medication contains ammonium chloride. Do not take ammonium chloride if you are allergic to ammonium chloride or any ingredients contained in this drug.
• Keep out of reach of children. In case of overdose, get medical help or contact a Poison Control Center immediately.

Contraindications

• Severe hepatic or renal impairment

Effects of Drug Abuse

• None

Short-Term Effects

• See "What Are Side Effects Associated with Using Ammonium Chloride?"

Long-Term Effects

• See "What Are Side Effects Associated with Using Ammonium Chloride?"

Cautions

• Pulmonary insufficiency, cardiac edema, severe renal impairment (do not give NH4Cl alone if concomitant sodium loss).
• Risk of ammonia toxicity (monitor).
• Monitor patients CO2 combining power prior to intravenous (IV) administration to avoid serious acidosis.

Pregnancy and Lactation

• Use ammonium chloride with caution during pregnancy if benefits outweigh risks. Animal studies show risk and human studies are not available or neither animal nor human studies were done.
• There is no information available about use of ammonium chloride while breastfeeding. Consult your doctor.