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Chemistry

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Also known as: 7681-49-4, Zymafluor, Sodium fluoride (naf), Fluoride, sodium, Florocid, Pediaflor

Molecular Formula

FNa

Molecular Weight

41.9881724 g/mol

InChI Key

PUZPDOWCWNUUKD-UHFFFAOYSA-M

FDA UNII

8ZYQ1474W7

A source of inorganic fluoride which is used topically to prevent dental caries.

1 2D Structure

Sodium Fluoride

2 Identification

2.1 Computed Descriptors

2.1.1 IUPAC Name

sodium;fluoride

2.1.2 InChI

InChI=1S/FH.Na/h1H;/q;+1/p-1

2.1.3 InChI Key

PUZPDOWCWNUUKD-UHFFFAOYSA-M

2.1.4 Canonical SMILES

[F-].[Na+]

2.2 Other Identifiers

2.2.1 UNII

8ZYQ1474W7

2.3 Synonyms

2.3.1 MeSH Synonyms

1. Fluoride, Sodium

2. Fluorides, Sodium

3. Fluoristat

4. Fluoristats

5. Ossin

6. Ossins

7. Sodium Fluorides

8. Zymafluor

9. Zymafluors

2.3.2 Depositor-Supplied Synonyms

1. 7681-49-4

2. Zymafluor

3. Sodium Fluoride (naf)

4. Fluoride, Sodium

5. Florocid

6. Pediaflor

7. Pergantene

8. Ossin

9. Sodium;fluoride

10. Sodium Flouride

11. Duraphat

12. Antibulit

13. Floridine

14. Fluonatril

15. Fluoraday

16. Fluorident

17. Fluorigard

18. Fluorinse

19. Flurexal

20. Karidium

21. Koreberon

22. Liquiflur

23. Villiaumite

24. Xaridium

25. Fluorol

26. Flursol

27. Luride

28. Ossalin

29. Flura

30. Flux

31. Roach Salt

32. Flura Drops

33. Neutra Care

34. Minute-gel

35. Osteopor-f

36. T-fluoride

37. Fungol B

38. Les-cav

39. Sodium Monofluoride

40. Sodium Hydrofluoride

41. Alcoa Sodium Fluoride

42. Sodium Fluorure

43. Fluorid Sodny

44. Sodium Fluoride [iso]

45. Fluorure De Sodium

46. Sodium Fluoride (na2f2)

47. Sodium Fluoride Cyclic Dimer

48. Dentalfluoro

49. Natrum Fluoratum

50. Nci-c55221

51. Fda 0101

52. Fluor-a-day

53. Naf

54. Chebi:28741

55. Mfcd00003524

56. Nsc-77385

57. Chembl1528

58. 8zyq1474w7

59. Chemifluor

60. Flozenges

61. Fluorineed

62. Fluoritab

63. Fluorocid

64. Flurcare

65. Gelution

66. Iradicav

67. Karigel

68. Lemoflur

69. Nufluor

70. Pedident

71. Pennwhite

72. Predent

73. Rafluor

74. Studafluor

75. Nafeen

76. Credo

77. Gleem

78. Rescue Squad

79. Kari-rinse

80. Nafpak

81. Super-dent

82. Thera-flur

83. Cavi-trol

84. Flura-gel

85. Flura-loz

86. Na Frinse

87. Natrium Fluoride

88. Point Two

89. Luride Lozi-tabs

90. Phos-flur

91. Stay-flo

92. Fluor-o-kote

93. Thera-flur-n

94. Luride Sf

95. Luride-sf

96. Lea-cov

97. So-flo

98. Trisodium Trifluoride

99. F1-tabs

100. Caswell No. 769

101. Osteofluor

102. Duofluorid

103. Fluorid Sodny [czech]

104. Apoflux

105. Ethedent

106. Fludent

107. Gel Ii

108. Zooby

109. Sodium Fluorure [french]

110. Fluorure De Sodium [french]

111. Sodium Fluoride, Solid (dot)

112. Ccris 1573

113. Hsdb 1766

114. Fluorure De Sodium [iso-french]

115. Prevident 5000 Plus

116. Einecs 231-667-8

117. Nsc 77385

118. Un1690

119. Epa Pesticide Chemical Code 075202

120. Sodium Fluoride [usp:jan]

121. Dentiplus

122. Sodium Fiuoride

123. Unii-8zyq1474w7

124. Ai3-01500

125. Natrii Fluoridum

126. Fluorigard Daily

127. Fluor Ret

128. Point-two

129. Fluorigard Weekly

130. Nafril Ret

131. Fluorinse (tn)

132. En-de-kay

133. Pediaflor; Zymafluor

134. Fluoride (as Sodium)

135. Sodium Fluoride, Solid

136. Neutral Sodium Fluoride

137. Sodium Fluoride Acs Grade

138. Wln: Na F

139. Ec 231-667-8

140. Sodium Fluoride (jan/usp)

141. Sodium Fluoride [mi]

142. Fluoride (as Sodium Fluoride)

143. Sodium Fluoride [jan]

144. Sodium Fluoride [hsdb]

145. Sodium Fluoride [inci]

146. Sodium Fluoride, Optical Grade

147. Natrum Fluoratum [hpus]

148. Sodium Fluoride [vandf]

149. Dtxsid2020630

150. Sodium Fluoride [mart.]

151. Sodium Fluoride [usp-rs]

152. Sodium Fluoride [who-dd]

153. Sodium Fluoride [who-ip]

154. Amy37012

155. Hy-b1766

156. Nsc77385

157. Bdbm50209223

158. Sodium Fluoride [orange Book]

159. Akos024438093

160. Fluoride (as Sodium) [vandf]

161. Sodium Fluoride [ep Monograph]

162. Cs-5131

163. Db09325

164. Sodium Fluoride [usp Monograph]

165. Natrii Fluoridum [who-ip Latin]

166. Sodium Fluoride [un1690] [poison]

167. Sodium Fluoride, 200mm Aqueous Solution

168. Sodium Fluoride, 99.995% (metals Basis)

169. Ft-0645095

170. Ft-0688141

171. Colgate Total Component Sodium Fluoride

172. Fluoride (as Sodium Fluoride) [vandf]

173. C08142

174. D00943

175. P00019

176. Sodium Fluoride, Trace Metals Grade, 99.99%

177. A838842

178. Q407520

179. Sodium Fluoride Component Of Colgate Total

180. Sodium Fluoride, 99.99% (metals Basis), 3-6mm Pieces

2.4 Create Date

2005-03-25

3 Chemical and Physical Properties

Molecular Formula	FNa
Molecular Weight	41.9881724 g/mol
Hydrogen Bond Donor Count	0
Hydrogen Bond Acceptor Count	1
Rotatable Bond Count	0
Exact Mass	41.98817244 g/mol
Monoisotopic Mass	41.98817244 g/mol
Topological Polar Surface Area	0 Å²
Heavy Atom Count	2
Formal Charge	0
Complexity	2
Isotope Atom Count	0
Defined Atom Stereocenter Count	0
Undefined Atom Stereocenter Count	0
Defined Bond Stereocenter Count	0
Undefined Bond Stereocenter Count	0
Covalently Bonded Unit Count	2

4 Drug and Medication Information

4.1 Therapeutic Uses

Fluorides, Topical

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)

Sodium fluoride is indicated as a dietary supplement for prevention of dental caries in children in those areas where the level of naturally occurring fluoride in the drinking water is inadequate. In optimally fluoridated communities, sodium fluoride supplementation may be necessary in infants that are totally breast-fed or receive ready-to-use formulas or in children consuming nonfluoridated bottled water rather than tap water. Sodium fluoride supplementation may also be indicated in those situations where home water filtration systems remove fluoride. This usually occurs with reverse osmosis or distillation units, but not with carbon charcoal filters. Evidence that oral systemic fluoride supplements reduce dental caries in adults is lacking. /Included in US product labeling/

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006., p. 2711

Sodium fluoride has been used to treat osteoporosis and otospongiosis in adults; however, its use is controversial and further studies are needed. The doses used in osteoporosis and otospongiosis have potential for toxicity, including skeletal fluorosis, osteomalacia, widening of unmineralized osteoid seams, and upper gastrointestinal ulceration.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006.

Sodium fluoride is commercially available in multivitamin or multivitamin/iron preparations for use as oral fluoride supplements in infants and children.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006.

For more Therapeutic Uses (Complete) data for SODIUM FLUORIDE (8 total), please visit the HSDB record page.

4.2 Drug Warning

... Sodium fluoride is used in tablets and drops to supplement intake in children and is also contained in mouth washes at such high levels, 200 to 900 ppm as to represent ... a hazard if large volumes are ingested.

Haddad, L.M. and Winchester, J.F. Clinical Management of Poisoning and Drug Overdosage. Philadelphia, PA: W.B. Saunders Co., 1983., p. 691

Food and Environmental Agents: Effect on Breast-Feeding: Reported Sign or Symptom in Infant or Effect on Lactation: Fluorides: None. /from Table 7/

Report of the American Academy of Pediatrics Committee on Drugs in Pediatrics 93 (1): 142 (1994)

Because young children usually cannot perform the rinse process necessary with oral rinsing solutions, sodium fluoride and acidulated phosphate fluoride oral rinsing solutions generally should not be used in children younger than 6 years of age, unless otherwise directed by a dentist or physician; children 6-12 years of age should be instructed and/or supervised carefully regarding the proper use of these preparations.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006.

Sodium fluoride and acidulated phosphate fluoride oral solutions and sodium fluoride oral tablets are contraindicated for use as dietary supplements when the fluoride ion concentration in drinking water is greater than 0.6 ppm (mg/L). Sodium fluoride tablets containing 1 mg of fluoride ion should not be used in children younger than 6 years of age and are contraindicated when the fluoride ion concentration in drinking water is 0.3 ppm (mg/L) or greater.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2006.

For more Drug Warnings (Complete) data for SODIUM FLUORIDE (7 total), please visit the HSDB record page.

4.3 Minimum/Potential Fatal Human Dose

... /It was/ estimated the certainly lethal dose for a 70-kg adult to be in the range 5 to 10 g of sodium fluoride (32 to 64 mg of fluoride/kg) based on reports of fatal poisonings. Children may be more sensitive ... /It was/ reported that a dose of only 8 mg of fluoride/kg was responsible for the death of a 27-mo-old child.

Krieger, R. (ed.). Handbook of Pesticide Toxicology. Volume 2, 2nd ed. 2001. Academic Press, San Diego, California., p. 1409

4.4 Drug Indication

Sodium fluoride in the oral or topical form is indicated for the prevention and control of dental caries and for the maintenance of dental health. Fluoride supplements in the form of tablets and other formulas may be prescribed to prevent tooth decay in high-risk children aged 6 months to 16 years old whose drinking water source contains low fluoride concentrations.

5 Pharmacology and Biochemistry

5.1 Pharmacology

Sodium fluoride protects the teeth from acid demineralization while preventing tooth decay by bacteria while strengthening tooth enamel. It is important to note that excess fluoride exposure during tooth mineralization, especially in children 1-3 years old, may cause fluorosis. It is a condition manifested by white lines, pitting, or discoloration of teeth resulting from changes in tooth enamel. The risk of fluorosis can be decreased by the use of a rice-size amount of fluoridated toothpaste in children younger than 3 years old. It is recommended that no more than a pea-sized quantity of fluoridated toothpaste should be used for children from 3 to 6 years old. The American Dentistry Association (ADA) recommends that children should be closely supervised during toothpaste use to prevent excess fluoride ingestion.

5.2 MeSH Pharmacological Classification

Cariostatic Agents

Substances that inhibit or arrest DENTAL CARIES formation. (Boucher's Clinical Dental Terminology, 4th ed) (See all compounds classified as Cariostatic Agents.)

5.3 FDA Pharmacological Classification

5.3.1 Pharmacological Classes

Ascorbic Acid [CS]; Nicotinic Acid [EPC]; Nicotinic Acids [CS]; Vitamin A [CS]; Vitamin A [EPC]; Vitamin B 12 [CS]; Vitamin B 6 [Chemical/Ingredient]; Vitamin B12 [EPC]; Vitamin B6 Analog [EPC]; Vitamin C [EPC]; Vitamin D [CS]; Vitamin D [EPC]; Analogs/Derivatives [Chemical/Ingredient]

5.4 ATC Code

A - Alimentary tract and metabolism

A01 - Stomatological preparations

A01A - Stomatological preparations

A01AA - Caries prophylactic agents

A01AA01 - Sodium fluoride

A - Alimentary tract and metabolism

A12 - Mineral supplements

A12C - Other mineral supplements

A12CD - Fluoride

A12CD01 - Sodium fluoride

5.5 Absorption, Distribution and Excretion

Absorption

Sodium fluoride is 90% absorbed from the gastrointestinal tract, with 77% of absorption in the proximal intestine and about 25% in the stomach. The rate of absorption may vary according to gastric pH. Cmax is reached 20-60 minutes after ingestion. Cmax was estimated to be 848 116 ng/mL after a 20mg sodium fluoride solution was ingested, with a Tmax of 0.46 0.17 hours. The bioavailability of sodium fluoride tablets administered in the fasted state during one pharmacokinetic study approached 100%. Another resource reports a sodium fluoride AUC of 1.14 0.12 g h/mL after the ingestion of fluoridated water.

Route of Elimination

Sodium fluoride is rapidly excreted, mainly in the urine. About 90% of fluoride is filtered by the glomerulus and reabsorbed by the renal tubules. About 10% is excreted in the feces.

Volume of Distribution

Fluoride distributes to the saliva, bones, and teeth, and is also found in lesser quantities in the breastmilk and sweat. After the ingestion of sodium fluoridated drinking water, the fluoride ions are found to distribute to the plasma and blood cells. Plasma levels of fluoride concentrations are twice as the concentrations found in blood cells. Adults have been found to retain 36% of ingested fluoride and children have been found to retain about 50% of a dose. Most of the retained fluoride is localized to bone and teeth and 1% accumulates in soft tissues. Fluoride crosses the placenta and the blood-brain barrier. The central nervous system concentrations of sodium fluoride are estimated to reach 20% the plasma concentrations. Studies conducted in communities with high levels of fluoride in water did not show any increase in birth defects. The placenta is able to regulate the accumulation of excess fluoride, possibly protecting the fetus from high levels of fluoride. Despite this, excessively high exposure to fluoride in utero may lead to skeletal fluorosis.

Clearance

Sodium fluoride is rapidly cleared by the kidneys and depends on various factors, including glomerular filtration rate, urine flow, and urine pH. According to one clinical study evaluating the pharmacokinetics of oral sodium fluoride tablets in healthy young adults, the renal clearance was determined to be 77.4 11.2mL/min for acidic urine and 78.4 6.9mL/min for alkaline urine. Another reference estimates the renal clearance of fluoride ions from sodium fluoridated water at 3545 mL/min.

During the growth phase of the skeleton, a relatively high portion of an ingested fluoride dose will be deposited in the skeleton. In infants and children with skeletal growth or individuals not consuming fluoridated drinking-water, up to 75% of the daily amount of fluoride that is absorbed may be incorporated into skeletal tissue. When a fluoride dose (e.g., a fluoride tablet or an infant formula diluted with fluoridated drinking-water) is given to infants, the retention will be strongly correlated with the absorbed fluoride dose per kilogram body weight: the higher the fluoride dose, the higher the fluoride retention. Retention of fluoride following intake of a fluoride supplement of 0.25 mg given to infants was shown to be as high as 80-90%. In a study with adults (aged 23-27 years) in which fluoride was given as a single intravenous injection, about 60% of the injected dose (3 mg fluoride as sodium fluoride) was retained.

WHO; Environ Health Criteria 227: Fluorides (2002) Available from, as of November 15,2006: https://www.inchem.org/documents/ehc/ehc/ehc227.htm#6.1

Experimental studies performed in vivo with rats and in vitro with isolated segments of dog jejunum have indicated that fluoride (as sodium fluoride) is rapidly absorbed from the stomach and intestinal tract in animals. The rate at which fluoride is absorbed from the stomach is inversely related to the pH of the stomach contents

WHO; Environ Health Criteria 227: Fluorides (2002) Available from, as of November 15,2006: https://www.inchem.org/documents/ehc/ehc/ehc227.htm#6.1

Although most of the fluoride ingested by laboratory animals is absorbed through the gastrointestinal tract, small amounts may also be absorbed from the oral cavity. In female Fischer F-344 rats intubated endotracheally (with oesophageal ligation) with 200 ul of a solution of sodium fluoride (Na18F), approximately 7% of the administered material was absorbed from the oral cavity within 2.5 hr. The absorption of fluoride (as sodium fluoride in solution) from the oral cavity of Syrian hamsters increased with decreasing pH of the solution.

WHO; Environ Health Criteria 227: Fluorides (2002) Available from, as of November 15,2006: https://www.inchem.org/documents/ehc/ehc/ehc227.htm#6.1

The ingestion of fluoride with food retards its absorption and reduces its bioavailability. When fluoride was ingested as sodium fluoride tablets on a fasting stomach, the bioavailability of fluoride was almost 100%. When the same dose was taken together with a glass of milk, the bioavailability decreased to 70%; when it was taken together with a calcium-rich breakfast, the bioavailability was further reduced to 60%). The decrease in absorption associated with the ingestion of milk or food is probably due to binding of fluoride with certain food constituents, including calcium and other divalent and trivalent cations. When this occurs, the faecal excretion of fluoride will increase. The timing of fluoride ingestion in relation to a meal is critical with respect to fluoride bioavailability. When a few grams of a fluoride dentifrice are swallowed on a fasting stomach, the plasma peak is recorded within 30 min; however, when the dentifrice is swallowed 15 min after a meal, the peak does not occur until after 1 hr. The fluoride from most dental products intended for oral application is almost completely absorbed when swallowed.

WHO; Environ Health Criteria 227: Fluorides (2002) Available from, as of November 15,2006: https://www.inchem.org/documents/ehc/ehc/ehc227.htm#6.1

For more Absorption, Distribution and Excretion (Complete) data for SODIUM FLUORIDE (13 total), please visit the HSDB record page.

5.6 Metabolism/Metabolites

Several factors can affect the metabolism of sodium fluoride. These include disorders of acid-base balance, circadian rhythm, hematocrit level, high or low altitude, the level physical activity, hormonal status, renal function, genetic predispositions in addition to the diet.

5.7 Biological Half-Life

The terminal plasma elimination half-life following the ingestion of fluoridated drinking water generally ranges from 3 to 10 hours. The half-life of sodium fluoride in the bones is 20 years.

Following oral admin of sodium fluoride to rabbits, the fluoride concn of plasma rose rapidly from a range of 0.01 to 0.07 ppm to a maximal level usually within 1 hr and then usually declined with a half-life of 4 or 5 hr.

Hayes, Wayland J., Jr. Pesticides Studied in Man. Baltimore/London: Williams and Wilkins, 1982., p. 58

5.8 Mechanism of Action

The prevention of dental caries by topical fluoride is achieved by various mechanisms. Sodium fluoride kills bacteria that cause caries, such a Streptococcus mutans and lactobacilli by interfering with their metabolic activities that result in the formation of lactic acid. Fluoride ions cause the inhibition of glycolytic and other enzymes involved in bacterial metabolism. It changes the permeability of cell membranes, lowering the pH in the cytoplasm of the cell, leading to a decrease in acidity, which is normally implicated in tooth decay. When administered at low topical doses, fluoride in both saliva and plaque and saliva prevent the demineralization of healthy tooth enamel while remineralizing teeth that have previously been demineralized. Sodium fluoride is absorbed by the surface of hydroxyapatite crystals on the teeth, which are necessary for mineralization. This renders the teeth more resistant to demineralization by changing the apatite crystal solubility. Sodium fluoride inhibits the demineralization of teeth in a pH-related manner. When used in high doses, in formulations such as the fluoride varnishes or gels, sodium fluoride forms a layer on the surface of tooth enamel. When the pH of the mouth is reduced due to acid production by bacteria such as S.mutans, fluoride is released, interfering with bacterial metabolism, and then acts to remineralize the teeth.

Fluoride ion becomes incorporated into and stabilizes the apatite crystal of bone and teeth. Fluoride acts primarily to promote remineralization of decalcified enamel and may interfere with growth and development of dental plaque bacteria. Deposition of fluoride ion in the enamel surface of teeth increases resistance to acid and to development of caries.

Thomson/Micromedex. Drug Information for the Health Care Professional. Volume 1, Greenwood Village, CO. 2006., p. 2711

In fluorosis uncomplicated by systemic illness, fluoride ion appears to be deposited in place of hydroxyl ion in the hydroxyapatite of bone. There is little or no change in the calcium ... or phosphate ... content of the bone. A part of the fluorine deposited in bone is readily excreted after fluoride feeding is stopped, but another part is more firmly held. /Fluorosis/

Krieger, R. (ed.). Handbook of Pesticide Toxicology. Volume 2, 2nd ed. 2001. Academic Press, San Diego, California., p. 1409

Fluoride is very reactive and capable of inhibiting a number of enzymes, incl preglycolytic enzymes, phosphatases, and cholinesterase. The result is inhibition of cellular glucose phosphorylation (hence subsequent glycolysis) and respiration and incr sensitivity of cholinergic mechanisms to acethycholinesterase.

Booth, N.H., L.E. McDonald (eds.). Veterinary Pharmacology and Therapeutics. 5th ed. Ames, Iowa: Iowa State University Press, 1982., p. 1014

Inhibition of one or more enzymes controlling cellular glycolysis (& perhaps resp) may result in a critical lesion. ... binding or precipitation of calcium as calcium fluoride ... suggested as mechanism underlying many diverse signs & symptoms in fluoride poisoning, particularly if death is delayed. ... at least in some species fluoride interferes with both contractile power of heart and the mechanism of beat in a way that cannot be ascribed to hypocalcemia. /Fluoride/

Gosselin, R.E., R.P. Smith, H.C. Hodge. Clinical Toxicology of Commercial Products. 5th ed. Baltimore: Williams and Wilkins, 1984., p. II-112

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