Version May 2024
Syndrome of inappropriate antidiuretic hormone secretion–associated hyponatremia, treatment and/or maintenance therapy:
Note: May consider in patients who do not respond to fluid restriction or are unable to be fluid restricted, or to maintain serum sodium level after successful treatment of symptomatic hyponatremia (Ref). Goal of initial therapy is to achieve a 24-hour increase in serum sodium concentration by 4 to 6 mEq/L (maximum serum sodium increase: 8 mEq/L in any 24-hour period), which is sufficient to improve most symptoms of hyponatremia. However, if patient is symptomatic (acute or chronic hyponatremia), it is recommended to increase serum sodium by 4 to 6 mEq/L within the first 6 hours, then maintain serum sodium at a constant level for the remainder of the 24-hour period. In chronic severe hyponatremia, overcorrection or too rapid correction increases the risk of iatrogenic osmotic demyelination syndrome (Ref).
Oral: Initial: 15 to 30 g daily in 1 or 2 divided doses; titrate dose based on clinical response in increments of 15 g at weekly intervals; maximum daily dose: 60 g/day (Ref). For treatment goals, refer to "Note."
There are no dosage adjustments provided in the manufacturer’s labeling.
There are no dosage adjustments provided in the manufacturer’s labeling.
Refer to adult dosing.
The following adverse drug reactions and incidences are derived from product labeling unless otherwise specified. Frequency not defined.
Endocrine & metabolic: Hypernatremia
Gastrointestinal: Mildly upset stomach
There are no contraindications listed in the manufacturer’s labeling.
Excipient information presented when available (limited, particularly for generics); consult specific product labeling.
Powder for Solution, Oral:
Ure-Na: 15 g (8s) [lemon-lime flavor]
Mix each 15 g dose with 3 to 4 ounces of water or juice.
Syndrome of inappropriate antidiuretic hormone secretion–associated hyponatremia, treatment and/or maintenance therapy: A medical food for the management of hyponatremia (euvolemic and hypervolemic).
Note: A medical food is formulated to be administered enterally under the supervision of a physician and is intended for the specific dietary management of a disease or condition for which distinctive nutritional requirements are established by medical evaluation. Medical foods are not drugs and, therefore, are not subject to any FDA regulatory requirements that specifically apply to drugs (eg, requirement for written/oral prescription prior to dispensing, premarket review or approval, proof of safety and efficacy).
Ure-Na may be confused with hydroxyurea
None known.
There are no known significant interactions.
Serum sodium
Urea normalizes serum sodium levels by inducing osmotic excretion of free water. Urea also ameliorates hyponatremia in syndrome of inappropriate antidiuretic hormone secretion by a more specific effect, diminishing the natriuresis in association with increased medullary urea content.
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