Chemistry:Water for injection
 Sterile water for injection | |
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| AHFS/Drugs.com | FDA Professional Drug Information |
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| Formula | H2O |
Water for injection is water of extra high quality without significant contamination.[1] A sterile version is used for making solutions that will be given by injection.[2] Before such use other substances generally must be added to make the solution isotonic.[3] Isotonic solutions containing water for injection can be given by injection into a vein, muscle, or under the skin.[4] A non-sterile version may be used in manufacturing with sterilization occurring later in the production process.[5]
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).[6] If it is given by injection into a vein without making it approximately isotonic, breakdown of red blood cells may occur.[3] This can then result in kidney problems.[3] Excessive amount may also result in fluid overload.[4] Water for injection is generally made by distillation or reverse osmosis.[5] It should contain less than a mg of elements other than water per 100 ml.[5] Versions with agents that stop bacterial growth are also available.[5]
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.[7] Because sterile water is not isotonic, its injection causes acute pain.[8] 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.[8] A review and meta-analysis in 2009 found the benefits of its use inconclusive.[8]
History and culture
It is on the World Health Organization's List of Essential Medicines.[9][10] Water for injection is available over the counter in the United States .[3]
Other names
Water for injection is also known as aqua ad iniectabilia or aqua ad injectionem.
References
- ↑ "<1231> Water for Pharmaceutical Purposes". p. 2. https://hmc.usp.org/sites/default/files/documents/HMC/GCs-Pdfs/c1231.pdf.
- ↑ WHO Model Formulary 2008. World Health Organization. 2009. p. 493. ISBN 9789241547659.
- ↑ 3.0 3.1 3.2 3.3 "Sterile Water for Injection - FDA prescribing information, side effects and uses". https://www.drugs.com/pro/sterile-water-for-injection.html.
- ↑ 4.0 4.1 "Water for Injection - FDA prescribing information, side effects and uses". https://www.drugs.com/pro/water-for-injection.html.
- ↑ 5.0 5.1 5.2 5.3 (in en) Theory and Practice of Contemporary Pharmaceutics. CRC Press. 2004. p. 396. ISBN 9780203644478. https://books.google.com/books?id=whiC7aSFLY8C&pg=PA396.
- ↑ "Sterile Water for Injection, USP". Baxter Corporation. U.S. Food and Drug Administration. September 2014. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018632s051lbl.pdf.
- ↑ "Water jabs and burning herbs offered during natural births at NHS hospitals" (in en). The Times. November 27, 2022. ISSN 0140-0460. https://www.thetimes.co.uk/article/water-jabs-and-burning-herbs-offered-during-natural-births-at-nhs-hospitals-tfwlc2zr2.
- ↑ 8.0 8.1 8.2 "Sterile water injection for labour pain: a systematic review and meta-analysis of randomised controlled trials". BJOG 116 (9): 1158–1166. August 2009. doi:10.1111/j.1471-0528.2009.02221.x. PMID 19459860.
- ↑ World Health Organization model list of essential medicines: 21st list 2019. Geneva: World Health Organization. 2019. WHO/MVP/EMP/IAU/2019.06. License: CC BY-NC-SA 3.0 IGO.
- ↑ World Health Organization model list of essential medicines: 22nd list (2021). Geneva: World Health Organization. 2021. WHO/MHP/HPS/EML/2021.02.
External links
- "Water for Pharmaceutical Use". Inspection Technical Guides. U.S. Food and Drug Administration. 27 August 2014. https://www.fda.gov/ICECI/Inspections/InspectionGuides/InspectionTechnicalGuides/ucm072925.htm.
- "Guideline on the quality of water for pharmaceutical use (draft)". 4 Committee for Medicinal Products for Human Use (CHMP). European Medicines Agency (EMA). 13 November 2018. https://www.ema.europa.eu/en/documents/scientific-guideline/draft-guideline-quality-water-pharmaceutical-use_en.pdf.
- "Water for injection". Drug Information Portal. U.S. National Library of Medicine. 16 December 2022. https://druginfo.nlm.nih.gov/drugportal/name/water%20for%20injection.
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