RxDecoder My Rx
‹ All drugs

sodium fluoride

Sold as ACT Fluoride Rinse, Allday, Clinpro 5000, Denta 5000 Plus, Dentagel and 23 more. Class: Caries prophylactic agents; Fluoride. First FDA approval 02/24/1972: 54 years on the US market.

This grade answers one narrow question: how strong is the public evidence and safety record behind this drug, and how clean is its money trail and court record? It is not a verdict on whether the drug is right for you.

B

Score breakdown (86/100)

Safety ×35%
A
Evidence ×25%
F
Regulatory ×15%
A
Money & lawsuits ×15%
A
Options ×10%
A

Safety: 100

Evidence: 44

Regulatory history: 98

Money & lawsuits: 100

Options: 100

Independent reviews and post-approval warnings

WHO Essential Medicine

Listed on the WHO Model List of Essential Medicines: a global expert panel judged it among the medicines a health system should always have, on evidence of value, not marketing.

What the FDA label says

Approved uses

INDICATIONS AND USAGE For once daily self-applied systemic use as a dental caries preventive in pediatric patients. It has been established that ingestion of fluoridated drinking water (1 ppm F¯) during the period of tooth development results in a significant decrease in the incidence of dental caries. Sodium Fluoride Chewable Tablets were developed to provide systemic fluoride for use as a supplement in pediatric patients from age 3 years to age 16 years and older living in areas where the drinking water fluoride contents does not exceed 0.6 ppm F¯.

Contraindications

CONTRAINDICATIONS Fluoride 1.0 mg Tablets are contraindicated when the fluoride content of drinking water is >0.3 ppm F¯ and should not be administered to pediatric patients under 6 years. Fluoride 0.5 mg Tablets are contraindicated when the fluoride content of drinking water is more than 0.6 ppm F¯ and should not be administered to pediatric patients under age 6 when the fluoride content of drinking water is 0.3 ppm F¯ or more or to pediatric patients under age 3 years. Fluoride 0.25 mg Tablets are contraindicated when the fluoride content of drinking water is more than 0.6 ppm F¯ and should not be administered to pediatric patients under age 3 years when the fluoride content of drinking water is 0.3 ppm F¯ or more. Do not administer Sodium Fluoride Chewable Tablets (any strength) to pediatric patients under age 3 years. Sodium Fluoride Chewable Tablets (any strength) are not indicated for use in adults.

Warnings and precautions

WARNING Prolonged daily ingestion of quantities greater than the recommended amount may result in various degrees of dental fluorosis in pediatric patients under age 6 years, especially if the water fluoridation exceeds 0.6 ppm. Read directions carefully before using. This product, as all chewable tablets, is not recommended for children under age 3 due to risk of choking. Keep out of the reach of infants and children.

Adverse reactions (label)

ADVERSE REACTIONS Allergic rash and other idiosyncrasies have been rarely reported. Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1(800) FDA-1088.

Source: FDA SPL label for Fluoride (WINDER LABORATORIES, LLC), effective 20260105. Full label on DailyMed.

Side-effect reports sent to the FDA

These are counts of reports people filed, not rates of harm. Anyone can file one, and nobody checks whether the drug was the cause. Millions of doses are taken for every report sent, so the useful part is how this drug compares with the average across all drugs.

3,377reports that mention this drug
3,375of those blame this drug, not another one the person was taking
68%of reports describe a serious outcome, such as a hospital stay (average for all drugs: 57%)
12.7%of reports include a death, from any cause (average for all drugs: 9.1%)

Problems reported most often

Fatigue · 257Nausea · 253Diarrhoea · 222Pain · 214Pneumonia · 192Vomiting · 187Weight Decreased · 183Nasopharyngitis · 177Pyrexia · 176Rash · 170Headache · 168Weight Increased · 167Dizziness · 164Peripheral Swelling · 157Dyspnoea · 156

Reports per year

20192020202120222023202420252026
338293237302261252349103

Source: the FDA's Adverse Event Reporting System (FAERS). Reports are voluntary and unverified. Drugs that are prescribed a lot, in the news, or in lawsuits attract more reports, so the percentages are compared with the whole database to correct for that partly, not fully.

Recalls and regulatory record

4recall actions on file
2 / 24brand / generic applications
0label changes since 2021
NoREMS program
DateClassFirmReason
08/2023Class IIAVKARE LLCCases of Sodium Fluoride 1.1% Prescription Dental Toothpaste may contain cartons labeled as Capsaicin Cream 0.025% but contain correctly labeled tubes of Sodium Fluoride 1.1% Prescription Dental Toothpaste
02/2017Class IIIColgate Palmolive CoLabel Mix up; rear panel is incorrectly labeled with the PreviDent 5000 Enamel Protect rear panel.
07/2015Class IIGlaxoSmithkline Consmer HealthcarePresence of Foreign Substance: Fragments of wood found when the product was extruded onto a toothbrush.
07/2015Class IIGlaxoSmithkline Consmer HealthcarePresence of Foreign Substance: Fragments of wood found when the product was extruded onto a toothbrush.

Class I = reasonable probability of serious harm. Class II = temporary or reversible harm. Class III = unlikely to harm. Most generic recalls are manufacturing or labeling defects for one lot, not a verdict on the molecule.

Evidence base

133randomized trials (PubMed)
13systematic reviews
687registered trials
33%of completed trials posted results
3%terminated or withdrawn
40%industry-funded

Counts measure how much evidence exists and how transparent it is, not how big the benefit is. For that, ask your prescriber: if 100 people like me took this, how many would get better because of it, and how many would be harmed? (Doctors call these the "number needed to treat" and "number needed to harm.") It differs by condition and is the number drug ads leave out. Sources: PubMed, ClinicalTrials.gov.

Money and lawsuits

In 2024, drug companies reported $23,554 in payments to US physicians and hospitals tied to this drug across 1,082 transactions (Clinpro 5000 $17,074, Prevident $6,480).

No pending federal MDL names this drug or its brands.

Not named in any federal pharmaceutical settlement of $100M or more on record.

Sources: CMS Open Payments (Sunshine Act); Judicial Panel on Multidistrict Litigation pending docket list; DOJ settlements as tabulated on Wikipedia with links to the primary record. State-court and individual suits are not included.

Who takes it and what it costs

Not in the Medicare Part D spending file (typically hospital-administered or very new drugs).

Same-class alternatives

olaflursodium monofluorophosphatestannous fluoride

Same ATC pharmacological class, graded ones first, best grade at the top. Being in the same class does not make them interchangeable for your condition; it makes them worth asking about.

Questions to ask your prescriber

  1. The most-reported problems in FDA's adverse event data are fatigue, nausea, diarrhoea, pain. How would we recognize and handle those?
  2. Why this one over olaflur, sodium monofluorophosphate, stannous fluoride? What would make you pick one of those instead?
  3. What result are we expecting, by when, and what is the plan if it does not happen?
  4. If 100 people like me took this drug, how many would actually get better because of it, and how many would be harmed by it? (Doctors call these the number needed to treat and the number needed to harm.)