Key Facts
- Drug Class
- Electrolyte replacement solution
- Prescription
- Over the counter
- NAFDAC Status
- NAFDAC Registered
- Forms
- Powder sachet (to dissolve in water)
- Price Range
- ₦50 - ₦500
- WHO Essential
- Yes
What is Oral Rehydration Salts (ORS)?
Oral Rehydration Salts (ORS) is one of the most important and life-saving medical interventions ever developed, and it is arguably the single most critical medication in Nigeria's fight against diarrhoeal disease. ORS is a precisely balanced mixture of glucose (sugar), sodium chloride (salt), potassium chloride, and trisodium citrate that, when dissolved in clean water, creates a solution that the body can absorb rapidly to replace fluids and electrolytes lost through diarrhoea and vomiting. The science behind ORS is elegantly simple: glucose enhances the absorption of sodium and water in the small intestine through a process called sodium-glucose co-transport, allowing the body to rehydrate even when the gut is inflamed and leaking fluid. This discovery has been described by The Lancet as potentially the most important medical advance of the 20th century. In Nigeria, ORS is available in virtually every pharmacy, patent medicine store, health centre, and many market stalls across all 36 states and the FCT.
Diarrhoeal diseases remain one of the leading causes of death among children under five in Nigeria, killing tens of thousands of Nigerian children every year. Most of these deaths are not caused by the diarrhoea itself, but by the dehydration it causes — the catastrophic loss of water and essential electrolytes from the body. ORS prevents and treats this dehydration simply, safely, and cheaply. The WHO and UNICEF recommend ORS combined with zinc supplementation as the standard treatment for all cases of acute diarrhoea in children and adults. In Nigeria, major public health campaigns by the Federal Ministry of Health, UNICEF, and organisations like the Society for Family Health have promoted ORS use, particularly in states with high child mortality such as Jigawa, Zamfara, Bauchi, and Kebbi. ORS sachets are often distributed free of charge at government primary health care centres, immunisation drives, and during cholera outbreaks, which periodically affect states across Nigeria.
The standard WHO/UNICEF ORS formulation contains sodium chloride (2.6g), glucose anhydrous (13.5g), potassium chloride (1.5g), and trisodium citrate dihydrate (2.9g) per litre sachet. When dissolved in 1 litre of clean drinking water, it produces a solution with an osmolarity of 245 mOsm/L, which is the reduced osmolarity formula proven to be more effective and better tolerated than the older formulation. Popular brands in Nigeria include UNICEF ORS (often distributed through public health programmes), Emzor ORS (locally manufactured and widely available), ORS-Zinc by Fidson Healthcare (combining rehydration salts with zinc), and Dioralyte. Prices are remarkably affordable — as low as N50 to N100 per sachet for generic ORS, and up to N500 for branded products — making it one of the most cost-effective medical interventions available. Despite its life-saving potential, ORS usage rates in Nigeria remain lower than they should be, with many caregivers still relying on inappropriate remedies or not seeking treatment at all.
What is Oral Rehydration Salts (ORS) used for?
In Nigeria, Oral Rehydration Salts (ORS) is commonly used for:
- Treatment and prevention of dehydration caused by acute watery diarrhoea — the primary and most important use, especially in children under five years of age
- Rehydration during cholera outbreaks — ORS is the cornerstone of cholera treatment in Nigeria, where outbreaks occur periodically in states like Borno, Yobe, Kano, and Bauchi
- Fluid and electrolyte replacement during vomiting and gastroenteritis — even when a patient is vomiting, small frequent sips of ORS can be absorbed
- Rehydration in cases of dehydration from fever, malaria, and other febrile illnesses — common in Nigeria, particularly during the malaria season
- Prevention of dehydration during episodes of food poisoning — ORS should be started at the first sign of diarrhoea, before dehydration sets in
- Supportive fluid replacement during heat exhaustion and excessive sweating, particularly relevant in the hot climate of northern Nigeria
Dosage
IMPORTANT
Always follow your doctor's or pharmacist's instructions. The information below is for general reference only.
Adults
Dissolve one sachet of ORS in the amount of clean water specified on the packet (usually 200ml or 1 litre, depending on sachet size). For mild dehydration: drink 200ml to 400ml of ORS solution after each loose stool, plus additional clean water as desired. For moderate dehydration: drink 2 to 4 litres of ORS solution over 4 hours, then continue 200ml to 400ml after each loose stool. Continue taking ORS until diarrhoea stops. There is no maximum limit — drink as much as needed to stay hydrated.
Children
For children with some dehydration: give 75ml of ORS per kilogram of body weight over 4 hours. For example, a 10kg child should receive approximately 750ml over 4 hours. After initial rehydration, give 50ml to 100ml of ORS after each loose stool for children under 2 years, and 100ml to 200ml for children aged 2 to 10 years. For breastfed infants, continue breastfeeding between ORS doses. Give the solution with a cup and spoon — not a bottle — and offer small, frequent sips. If the child vomits, wait 10 minutes and then resume giving ORS more slowly. Always combine with zinc supplementation (10mg daily for infants under 6 months, 20mg daily for older children) for 10 to 14 days.
Elderly
Elderly patients are particularly vulnerable to dehydration and should begin ORS at the first sign of diarrhoea or vomiting. Follow the adult dosing guidelines. Elderly patients with heart failure or kidney disease should consult a doctor before consuming large volumes of ORS, as excessive fluid and salt intake may worsen their condition. Monitor for signs of over-hydration including swollen ankles, shortness of breath, and weight gain.
ORS must be dissolved in the exact amount of clean, safe drinking water specified on the sachet — using too little water makes the solution too concentrated (which can worsen diarrhoea), and using too much water makes it too dilute (reducing effectiveness). Use boiled and cooled water if the safety of your water supply is in doubt. Once prepared, ORS solution should be used within 24 hours — discard any remaining solution after that. Do not add sugar, salt, or flavouring to the prepared ORS, as this will alter the carefully balanced composition. Store unused sachets in a cool, dry place away from moisture.
Side Effects
Common side effects
- •Mild nausea — some patients may feel slightly nauseous, especially if they drink the solution too quickly; sip slowly
- •Vomiting — can occur if the solution is taken too fast; give small, frequent sips and wait a few minutes between sips
- •Mild bloating — temporary and self-limiting
- •The taste may be unpleasant to some, especially children — this is normal and not a reason to stop; do not add extra sugar to mask the taste
Serious side effects — seek medical help immediately
- Hypernatraemia (excessively high sodium levels) — can occur if ORS is prepared with too little water, making the solution overly concentrated; this is particularly dangerous in infants and small children
- Fluid overload — extremely rare with oral administration but possible in patients with heart failure or severe kidney disease who consume excessive volumes
- Severe persistent vomiting preventing any oral intake — this is not a side effect of ORS itself but indicates the patient may need intravenous fluids; seek hospital care immediately
- Worsening dehydration despite ORS use — if the patient cannot keep ORS down or diarrhoea is extremely profuse (as in severe cholera), intravenous fluid resuscitation is needed urgently
When to see a doctor
Seek immediate medical attention if the patient (especially a child) shows signs of severe dehydration: sunken eyes, inability to drink or keep fluids down, lethargy or unconsciousness, very dry mouth and tongue, absent tears when crying, or no urination for more than 6 hours. In infants, a sunken fontanelle (soft spot on the head) is a critical warning sign. Also seek urgent medical care if diarrhoea is bloody, if there is persistent high fever, if the patient's condition is worsening despite ORS, or if diarrhoea continues for more than 3 days without improvement. In Nigeria, take the patient to the nearest health facility, primary health care centre, or hospital emergency department.
Warnings & Precautions
Do not take Oral Rehydration Salts (ORS) if you have:
- ORS should not be used as the sole treatment for severe dehydration — patients with severe dehydration (shock, unconsciousness, inability to drink) require immediate intravenous fluid resuscitation first, followed by ORS once they can drink
- Use with caution in patients with severe kidney failure (anuria/oliguria), as the kidneys may not be able to excrete the extra fluid and electrolytes
- Use with caution in patients with severe heart failure, as excessive fluid intake may worsen cardiac function
- Do not use ORS that has changed colour, has an unusual smell, or has passed its expiry date
Drug interactions
- •ORS has no significant drug interactions — it can be safely used alongside virtually all other medications
- •Zinc supplementation should be given alongside ORS for diarrhoea treatment in children as recommended by WHO — they work complementarily
- •Antibiotics (such as metronidazole for amoebic dysentery or azithromycin for cholera) can be used alongside ORS when an infectious cause of diarrhoea is identified
- •Loperamide can be used alongside ORS in adults for symptomatic relief, but ORS should always be the priority — never replace ORS with loperamide
Pregnancy & Breastfeeding
ORS is completely safe during pregnancy and breastfeeding. Diarrhoea-related dehydration during pregnancy can be dangerous for both the mother and the developing baby, so prompt rehydration with ORS is essential. Pregnant women experiencing diarrhoea should start ORS immediately and seek medical attention if symptoms persist or worsen. Breastfeeding mothers should continue breastfeeding during diarrhoea episodes (both their own and their infant's) and should take ORS to maintain their own hydration. For breastfed infants with diarrhoea, continue breastfeeding frequently and give ORS between feeds.
Brands of Oral Rehydration Salts (ORS) in Nigeria
4 brands available in Nigeria.
| Brand Name | Manufacturer | Strength | Form | NAFDAC Reg. No. |
|---|---|---|---|---|
| UNICEF ORS | UNICEF/Various | Standard WHO formula | Powder sachet | |
| Emzor ORS | Emzor Pharmaceutical | Standard WHO formula | Powder sachet | A4-8910 |
| ORS-Zinc | Fidson Healthcare | Standard WHO formula with zinc | Powder sachet | |
| Dioralyte | Sanofi | Standard WHO formula | Powder sachet |
How to Verify Your Oral Rehydration Salts (ORS) is Genuine
- 1Check for a valid NAFDAC registration number on the ORS sachet packaging — even though ORS is a simple formulation, all products sold in Nigeria must be NAFDAC-registered
- 2Verify the NAFDAC number using the NAFDAC Green Book website (www.greenbook.nafdac.gov.ng) or the NAFDAC mobile app on Android and iOS
- 3Purchase from pharmacies, patent medicine stores, primary health care centres, or hospitals — ORS from government health programmes (often marked with UNICEF or Federal Ministry of Health logos) is genuine and often free
- 4Check the expiry date on the sachet — expired ORS may have degraded glucose and electrolytes that could be less effective or potentially harmful
- 5Inspect the sachet for any signs of damage, moisture penetration, or tampering — the powder inside should be dry, white to off-white, and free-flowing; clumped or discoloured powder suggests moisture damage
- 6When dissolved correctly, ORS solution should be clear to slightly cloudy and have a mildly salty taste — if it tastes excessively salty, excessively sweet, or has an unusual flavour, do not use it
Oral Rehydration Salts (ORS) Price in Nigeria
Oral Rehydration Salts (ORS) prices in Nigeria typically range from ₦50 to ₦500 per pack, depending on the brand, strength, and where you buy it.
₦50 – ₦500
per pack
Prices vary by location and vendor. Last updated: 2026-02-01
Where to Buy
Purchase Oral Rehydration Salts (ORS) only from licensed pharmacies and verified distributors. Avoid buying medicines from unverified sources, roadside vendors, or unregistered market stalls.
Frequently Asked Questions
Sources
- •NAFDAC Greenbook — National Agency for Food and Drug Administration and Control registered products database
- •WHO Model List of Essential Medicines (23rd List, 2023)
- •British National Formulary (BNF)
- •Nigerian Standard Treatment Guidelines