Oral Rehydration Salts

Generic Name: Oral Rehydration Salts

Brand Names:

Availability: Easily Available

Drug Class: Minerals and Electrolytes

Indications

  • Prevention and treatment of dehydration from acute diarrhoea, cholera, etc.

Forms and strengths

  • Sachet of powder to be diluted in 1 litre of clean water. WHO formulation:
Formulationgrams/litre
sodium chloride2.6
glucose13.5
potassium chloride1.5
trisodium citrate2.9
 mmol/litre
sodium75
chloride65
glucose75
potassium20
citrate10
Total osmolarity245

Dosage

Prevention of dehydration (WHO - Treatment plan A)

  • Child under 24 months: 50 to 100 ml after each loose stool (approximately 500 ml daily) 
  • Child from 2 to 10 years: 100 to 200 ml after each loose stool (approximately 1000 ml daily)
  • Child over 10 years and adult: 200 to 400 ml after each loose stool (approximately 2000 ml daily)

Treatment of moderate dehydration (WHO - Treatment plan B)

Child and adult:

  • Over the first four hours:
Age

under 4

months

4 to 11 months12 to 23 months2 to 4 years5 to 14 years15 years andover
Weightunder 5 kg5to 7.9 kg8to 10.9 kg11to 15.9 kg16to 29.9 kg30 kg and over
ORS in ml200 to 400400to 600600 to 800800to 12001200 to 22002200 to 4000
  • After four hours:
    • If there are no signs of dehydration: follow Treatment plan A.
    • If there are signs of moderate dehydration: repeat Treatment plan B.
    • If there are signs of severe dehydration: start IV therapy(Treatment plan C).

Treatment of severe dehydration (WHO - Treatment plan C)

In combination with IV therapy and only to a conscious patient: 

  • Child and adult: 5 ml/kg per hour
  • After 3 hours (6 hours in infants), reassess and choose the appropriate plan A, B or C.

Duration

As long as diarrhoea and signs of dehydration persist.

Contra-indications, adverse effects, precautions

  • If the eyelids become puffy during the treatment: stop ORS, give plain water then, resume ORS according to Treatment plan A when the puffiness is gone.
  • If case of vomiting, stop ORS for 10 min and then resume at a slower rate (very small, frequent, amounts); do not stop rehydration.
  • Pregnancy: no contra-indication
  • Breast-feeding: no contra-indication

Remarks

  • A special ORS-formula, ReSoMal, is used under medical supervision, for severely malnourished children only. However, in malnourished children with cholera, standard ORS- formula is used instead of ReSoMal.

Storage

– Below 25 °C

Do not use the powder if it has turned into a yellow-brownish sticky substance. Once prepared, the solution must be used within 24 hours.