Rice ORS500 ml

Established Uses

Rice ORS is indicated for the prevention and treatment of dehydration and associated electrolyte losses caused by diarrhea of any cause (including acute gastroenteritis and cholera) in infants, children, and adults. It is used as first-line oral fluid and electrolyte replacement therapy in mild to moderate dehydration.

Guideline-Supported Use

Rice ORS is recommended by WHO/UNICEF diarrheal disease management protocols as part of Plan A (home management to prevent dehydration) and Plan B (treatment of some dehydration), used together with continued feeding and zinc supplementation in children.

Adjunct Use

In cholera and other severe secretory diarrheas, Rice ORS is used as an adjunct alongside appropriate antimicrobial therapy (when indicated) and, in cases of severe dehydration, following initial intravenous fluid resuscitation, to complete rehydration and replace ongoing stool losses.

Rice ORS does not treat the underlying cause of diarrhea (e.g., infection); it corrects and prevents fluid and electrolyte depletion resulting from it.

Rice Based Oral Rehydration Saline is an oral rehydration salt formulation in which rice-derived carbohydrate (rice starch/rice syrup solids) replaces glucose as the carbohydrate source. Each sachet, when reconstituted with the specified volume of clean drinking water, provides a balanced solution of electrolytes and carbohydrate, typically including sodium chloride, potassium chloride, and an alkalinizing agent (such as trisodium citrate), together with rice-derived carbohydrate.

Exact electrolyte and carbohydrate content per sachet can vary by manufacturer; the reconstituted osmolarity is formulated to approximate WHO-recommended low-osmolarity oral rehydration solution standards.

Rice ORS is an oral rehydration solution (ORS) in which the carbohydrate component is derived from rice (rice starch or rice syrup solids) rather than glucose. It is supplied as a powder for reconstitution with water and is used to replace fluid and electrolytes lost through diarrhea and vomiting.

Rice-based formulations work on the same sodium-glucose cotransport principle as standard glucose-based ORS, but the complex rice carbohydrate is broken down gradually by intestinal amylase, releasing glucose more slowly. Some clinical studies, particularly in cholera, have shown modestly reduced stool output and shorter duration of diarrhea with rice-based ORS compared to standard glucose-based ORS, although both are effective and WHO-recommended options for rehydration.

Rice ORS is not an antibiotic and does not treat infections; it is a supportive fluid and electrolyte replacement therapy.

Rice ORS belongs to the therapeutic class of Oral Rehydration Salts (ORS) / fluid and electrolyte replacement agents.

Mechanism of Action

Rice Based Oral Rehydration Saline works through the sodium-glucose cotransport mechanism in the small intestinal brush border. Sodium is actively absorbed across the intestinal epithelium coupled with glucose (released from digestion of the rice-derived carbohydrate), and this co-transport drives passive absorption of water and other electrolytes (potassium, chloride), even when the intestinal secretory processes of diarrhea are still active.

The citrate (or bicarbonate) component helps correct the metabolic acidosis commonly associated with diarrheal fluid loss. Because rice starch is a complex carbohydrate digested progressively by intestinal amylases, glucose is released gradually, which may reduce stool osmotic load and, in some studies, stool output compared with standard glucose-based ORS.

Wash hands before preparing Rice ORS. Dissolve the entire contents of one sachet in the exact volume of boiled-and-cooled or otherwise safe drinking water stated on the pack label (commonly 200 mL, 500 mL, or 1 litre depending on product size); stir until fully dissolved. Do not add sugar, salt, or other substances to the solution.

Give the prepared solution by mouth in small, frequent sips using a clean cup and spoon, especially in infants and young children who cannot drink from a cup safely. If the person vomits, wait 10 minutes and then resume giving Rice ORS more slowly.

Freshly reconstituted Rice ORS solution not consumed within 24 hours must be discarded and a fresh batch prepared.

Rice ORS itself is not systemically absorbed as a drug and has few clinically significant pharmacokinetic drug interactions. However, because it alters gastrointestinal fluid and electrolyte status, the following points are clinically relevant:

• Concomitant use with other sources of added sodium or potassium (e.g., potassium-sparing diuretics, potassium supplements, ACE inhibitors/ARBs) may increase the risk of hyperkalemia or hypernatremia; monitor electrolytes when used together in patients on such therapy.
• Oral medications taken at the same time as large volumes of Rice ORS may have altered absorption due to increased gastrointestinal transit/fluid; where practical, space other oral medicines from Rice ORS administration.

Rice ORS is generally very well tolerated when reconstituted and administered correctly. Reported effects are uncommon and usually related to incorrect preparation or administration rate:

• Vomiting, if the solution is given too quickly, especially in a dehydrated or nauseated patient.
• Abdominal distension or bloating.
• Hypernatremia or hyponatremia, and other electrolyte disturbances, if the solution is prepared with too little or too much water, respectively, or given in excessive amounts to a patient with impaired renal function (see Overdose Effects and Precautions).

Rice ORS is considered safe for use during pregnancy and breastfeeding when reconstituted and dosed correctly; oral rehydration therapy is a standard, recommended part of managing dehydration due to diarrhea or hyperemesis in pregnant and lactating women. As with any medicinal or supplemental product, a pregnant or breastfeeding woman with diarrhea or dehydration should consult a physician, particularly if symptoms are severe, prolonged, or associated with other warning signs, so that the underlying cause can also be assessed and treated.

• Always reconstitute Rice ORS with the exact volume of clean, safe drinking water specified on the pack; a solution that is too concentrated can be harmful (risk of hypernatremia), especially in infants, while one that is too dilute may not adequately replace electrolyte losses.
• Do not add sugar, salt, or other ingredients to the prepared solution.
• Seek prompt medical attention if there are signs of severe dehydration (lethargy or unconsciousness, sunken eyes, very little or no urine output, inability to drink or keep fluids down, skin that stays pinched when pinched), blood in the stool, high fever, or diarrhea lasting more than a few days — especially in infants, young children, and the elderly.
• Use caution and seek medical advice in patients with significant renal impairment or conditions predisposing to electrolyte imbalance, as such patients are at higher risk of hyperkalemia, hypernatremia, or fluid overload with rehydration therapy (see Use in Special Populations).
• Discard any reconstituted Rice ORS solution not used within 24 hours; prepare a fresh solution.
• Rice ORS treats dehydration and electrolyte loss but does not treat the underlying cause of diarrhea (e.g., a bacterial or parasitic infection); seek medical evaluation if a specific cause needs to be identified and treated (see Contraindications for when it should not be used).

Excessive or overly concentrated intake of Rice ORS, particularly in infants, young children, or patients with impaired kidney function, can lead to electrolyte disturbances such as hypernatremia, hyperkalemia, or fluid overload, which may present as irritability, weakness, muscle twitching, seizures, or swelling.

If overdose or incorrect concentration is suspected, or if any concerning symptoms develop after taking Rice ORS, stop administration and seek immediate medical attention or contact a poison control center; do not attempt specific home treatment for suspected electrolyte overdose.

Store Rice ORS sachets/powder at room temperature (below 30°C), in a dry place away from light and moisture. Keep out of reach of children. Once reconstituted, use the solution within 24 hours and discard any unused portion thereafter; do not refrigerate for extended storage or reuse leftover solution the next day.

• Infants (including neonates): Rice ORS is appropriate for use in infants, including newborns, using age-appropriate volumes and administration by cup/spoon rather than a bottle; severe dehydration in this age group requires urgent medical care and may need intravenous fluids first.
• Elderly: No specific dose adjustment is required, but elderly patients, especially those with renal or cardiac impairment, should be monitored for fluid overload or electrolyte disturbance during rehydration.
• Renal impairment: Use with caution and under medical supervision, as impaired potassium and sodium excretion increases the risk of hyperkalemia and hypernatremia with Rice ORS.
• Hepatic impairment: No specific dose adjustment is established; use as clinically indicated.

Rice ORS should be continued for as long as diarrhea and/or vomiting persist, replacing ongoing fluid losses after each loose stool or vomiting episode, and continued for 24 hours after diarrhea stops or as advised by a physician. If diarrhea persists beyond a few days, or dehydration signs worsen despite use of Rice ORS, medical evaluation should be sought promptly.

Rice ORS is supplied as a powder that must be reconstituted before use. Empty the entire contents of one sachet into a clean container and add the exact volume of cool, previously boiled (or otherwise safe/clean) drinking water indicated on the product label (commonly 200 mL, 500 mL, or 1 litre, depending on pack size). Stir or shake until the powder is fully dissolved. Do not use hot water, milk, soup, fruit juice, or carbonated drinks to reconstitute Rice ORS, and do not add extra sugar or salt. Prepare a fresh solution at least once every 24 hours and discard any solution older than 24 hours.

Rice Based Oral Rehydration Saline is classified under Oral Rehydration Salts (ORS), within the broader category of fluid, electrolyte, and acid-base replacement products.

Rice Based Oral Rehydration Saline restores fluid and electrolyte balance via intestinal sodium-glucose cotransport: sodium absorption is coupled to absorption of glucose released from digestion of the rice-derived carbohydrate, and this active transport process osmotically drives water absorption along with it, together with potassium and chloride, even during active secretory diarrhea. The citrate component helps buffer the metabolic acidosis that accompanies significant diarrheal losses.

Rice ORS is a first-line, WHO-recommended therapy for prevention and treatment of dehydration due to diarrhea in infants and children of all ages, including neonates, and is considered a cornerstone of safe pediatric diarrheal disease management. Dosing is based on age and body weight (see Dosage and Administration/Dosage tables); administration by clean cup and spoon (not a feeding bottle) is recommended, with frequent small amounts, especially in infants. Breastfeeding and usual age-appropriate feeding should be continued alongside Rice ORS and not withheld. Caregivers should seek urgent medical care for infants and young children showing signs of severe dehydration, persistent vomiting, blood in stool, high fever, or diarrhea lasting more than a few days, as these children may require professional assessment and, in some cases, intravenous fluids in addition to or instead of Rice ORS.