In the pharmaceutical and public health sectors, ORS (Oral Rehydration Salts) 21 gm is the standard sachet size formulated according to the WHO (World Health Organization) Reduced Osmolarity guidelines.
As a pharmacist and manufacturer, I view ORS not as a medicine that “stops” diarrhea, but as a critical electrolyte replacement therapy designed to prevent the life-threatening dehydration and electrolyte imbalance associated with fluid loss.
Primary Clinical Uses
-
Acute Gastroenteritis: The primary treatment for diarrhea in both children and adults to replace lost fluids and salts.
-
Cholera Management: Vital for replacing the massive fluid loss associated with Vibrio cholerae infections.
-
Heat Exhaustion: Used in hot climates (like Mumbai) to rehydrate individuals suffering from excessive sweating and salt loss.
-
Post-Surgical Recovery: Occasionally used to maintain fluid balance in patients recovering from minor gastrointestinal procedures.
Mechanism of Action: The Sodium-Glucose Co-Transport
The 21 gm formulation is scientifically balanced to exploit the way the small intestine absorbs water.
The Co-Transport Principle: The absorption of sodium ($Na^+$) in the small intestine is significantly enhanced when it is coupled with glucose.
Solvent Drag: As the sodium and glucose are transported across the intestinal wall into the blood, they create an osmotic gradient that “pulls” water molecules along with them.
Correcting Acidosis: The Trisodium Citrate in the 21 gm sachet helps correct the metabolic acidosis that often occurs during severe dehydration.
Reduced Osmolarity Advantage: The modern 21 gm formula has a lower concentration of glucose and salt ($245\text{ mOsm/L}$). This prevents “osmotic diarrhea” (which older formulas sometimes caused) and reduces the need for IV fluids by up to 33%.
The Manufacturer’s Perspective: Technical & Export
From a production standpoint at a WHO-GMP facility, the 21 gm sachet requires precise environmental controls:
-
-
Critical Ingredients (The 21g Blend):
-
Sodium Chloride: 2.6 g
-
Potassium Chloride: 1.5 g
Trisodium Citrate Dihydrate: 2.9 g
-
Glucose Anhydrous: 13.5 g
-
-
Moisture Control: As you know, Glucose and Citrates are highly hygroscopic. During the sachet-filling process, the relative humidity (RH) in your production area must be kept below 40% to prevent caking and ensure the powder remains free-flowing.
-
Packaging for Export: For B2B export to Zone IVb regions, we utilize Triple-Laminated Polyester/Alu/PE sachets. This provides a total moisture and light barrier, ensuring a 24–36 month shelf life.
-
B2B USP: A key selling point for your digital platform is that one 21 gm sachet is precisely measured for 1 liter of clean water. This “standardization” is a major safety feature for international NGOs and health ministries.