water for injection

{{Short description|Very clean, sterile water}}

{{Use dmy dates|date=December 2019}}

{{Infobox drug

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| image = Sterilewater.jpg

| alt =

| caption = Sterile water for injection

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| Drugs.com = {{Drugs.com|pro|water-for-injection}}

| MedlinePlus =

| DailyMedID = Water_for_injection

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| CAS_number = 7732-18-5

| UNII_Ref = {{fdacite|correct|FDA}}

| UNII = 059QF0KO0R

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| ATCvet =

| ATC_prefix = V07

| ATC_suffix = AB

| PubChem =

| DrugBank =

| ChemSpiderID = 937

| chemical_formula = H2O

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Water for injection is water of extra high quality without significant contamination.{{cite web|title=<1231> Water for Pharmaceutical Purposes|url=https://hmc.usp.org/sites/default/files/documents/HMC/GCs-Pdfs/c1231.pdf |website=hmc.usp.org|access-date=14 January 2017|page=2 |url-status=dead |archive-url=https://web.archive.org/web/20150311001120/http://hmc.usp.org/sites/default/files/documents/HMC/GCs-Pdfs/c1231.pdf|archive-date=11 March 2015}} A sterile version is used for making solutions that will be given by injection.{{cite book | title = WHO Model Formulary 2008 | year = 2009 | isbn = 9789241547659 | vauthors = ((World Health Organization)) | veditors = Stuart MC, Kouimtzi M, Hill SR | hdl = 10665/44053 | author-link = World Health Organization | publisher = World Health Organization |page=493 }} Before such use other substances generally must be added to make the solution isotonic.{{cite web|title=Sterile Water for Injection - FDA prescribing information, side effects and uses|url=https://www.drugs.com/pro/sterile-water-for-injection.html|website=Drugs.com|access-date=14 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170118041201/https://www.drugs.com/pro/sterile-water-for-injection.html|archive-date=18 January 2017}} Isotonic solutions containing water for injection can be given by injection into a vein, muscle, or under the skin.{{cite web|title=Water for Injection - FDA prescribing information, side effects and uses|url=https://www.drugs.com/pro/water-for-injection.html|website=Drugs.com|access-date=14 January 2017|url-status=live|archive-url=https://web.archive.org/web/20170716181614/https://www.drugs.com/pro/water-for-injection.html|archive-date=16 July 2017}} A non-sterile version may be used in manufacturing with sterilization occurring later in the production process.

Side effects and mechanisms

The primary use of sterile water for injection is as an ingredient for dilution of other medications (aseptic preparation of parenteral solutions).{{cite web | title = Sterile Water for Injection, USP | url = https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018632s051lbl.pdf | work = Baxter Corporation | publisher = U.S. Food and Drug Administration | date = September 2014 }} If it is given by injection into a vein without making it approximately isotonic, breakdown of red blood cells may occur. This can then result in kidney problems. Excessive amount may also result in fluid overload. Water for injection is generally made by distillation or reverse osmosis. It should contain less than a mg of elements other than water per 100 ml. Versions with agents that stop bacterial growth are also available.{{cite book| vauthors = Ghosh TK, Jasti BR |title=Theory and Practice of Contemporary Pharmaceutics|date=2004|publisher=CRC Press|isbn=9780203644478|page=396|url=https://books.google.com/books?id=whiC7aSFLY8C&pg=PA396|language=en|url-status=live|archive-url=https://web.archive.org/web/20170116162803/https://books.google.ca/books?id=whiC7aSFLY8C&pg=PA396|archive-date=2017-01-16}}

In the UK, some hospitals offer subcutaneous injections of water directly for treating back pain in labour. It is controversial, with some claiming it is pseudoscience.{{Cite news | vauthors = Lintern S |date=November 27, 2022 |title=Water jabs and burning herbs offered during natural births at NHS hospitals |newspaper= The Times|language=en |url=https://www.thetimes.com/uk/healthcare/article/water-jabs-and-burning-herbs-offered-during-natural-births-at-nhs-hospitals-tfwlc2zr2 |access-date=2023-09-30 |issn=0140-0460}} Because sterile water is not isotonic, its injection causes acute pain.{{cite journal | vauthors = Hutton EK, Kasperink M, Rutten M, Reitsma A, Wainman B | title = Sterile water injection for labour pain: a systematic review and meta-analysis of randomised controlled trials | journal = BJOG | volume = 116 | issue = 9 | pages = 1158–1166 | date = August 2009 | pmid = 19459860 | doi = 10.1111/j.1471-0528.2009.02221.x | s2cid = 19914146 }} One purported mechanism of action is to induce acute local pain to compete directly with diffuse back pain through a mechanism called diffuse noxious inhibitory control; another hypothesis is instead that the acute pain releases endorphins. A review and meta-analysis in 2009 found the benefits of its use inconclusive.

History and culture

It is on the World Health Organization's List of Essential Medicines.{{cite book | vauthors = ((World Health Organization)) | title = The selection and use of essential medicines 2023: web annex A: World Health Organization model list of essential medicines: 23rd list (2023) | year = 2023 | hdl = 10665/371090 | author-link = World Health Organization | publisher = World Health Organization | location = Geneva | id = WHO/MHP/HPS/EML/2023.02 | hdl-access=free }} Water for injection is available over the counter in the United States.

Other names

Water for injection is also known as {{lang|la|aqua ad iniectabilia}} or {{lang|la|aqua ad injectionem}}.

References

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