Sodium Bicarbonate information from DrugsUpdate
P - Caution when used during pregnancy
L - Caution when used during lactation
Sodium bicarbonate or sodium hydrogen carbonate is the chemical compound with the formula NaHCO3. Sodium bicarbonate is a white solid that is crystalline but often appears as a fine powder. It can be used to experiment and is not very dangerous. It has a slight alkaline taste resembling that of washing soda (sodium carbonate). It is a component of the mineral natron and is found dissolved in many mineral springs. The natural mineral form is known as nahcolite. It is found in its dissolved form in bile, where it serves to neutralize the acidity of the hydrochloric acid produced by the stomach, and is excreted into the duodenum of the small intestine via the bile duct. It is also produced artificially.
Pharmacodynamics
Pharmacokinetics
Sodium bicarbonate raises blood and urinary pH by dissociation to provide bicarbonate ions, which neutralises the hydrogen ion concentration. It also neutralises gastric acid via production of carbon dioxide.
Onset
Oral: Rapid; IV: 15 minutes.
Duration
Oral: 8-10 minutes; IV: 1-2 hours.
Sodium Bicarbonate Indications / Sodium Bicarbonate Uses
Information Not Available
Sodium Bicarbonate Adverse Reactions / Sodium Bicarbonate Side Effects
Metabolic alkalosis; mood changes, tiredness, shortness of breath, muscle weakness, irregular heartbeat; muscle hypertonicity, twitching, tetany; hypernatraemia, hyperosmolality, hypocalcaemia, hypokalaemia; stomach cramps, flatulence. Tissue necrosis at injection site.
Precautions
Do not use unless solution is clear and the container or seal is intact. Discard unused portion.
The potentially large loads of sodium given with bicarbonate require that caution be exercised in the use of Sodium Bicarbonate in patients with congestive heart failure or other edematous or sodium-retaining states, as well as in patients with oliguria or anuria.
Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ions, to patients receiving corticosteroids or corticotropin.
Potassium depletion may predispose to metabolic alkalosis and coexistent hypocalcemia may be associated with carpopedal spasm as the plasma pH rises. These dangers can be minimized if such electrolyte imbalances are appropriately treated prior to or concomitantly with bicarbonate infusion.
Special Precautions
Epilepsy, CHF, renal impairment, liver cirrhosis, hypertension, oedema, eclampsia, aldosteronism. Monitor serum electrolyte concentrations and acid-base status regularly during treatment of acidosis. Pregnancy; lactation.
Other Drug Interactions
Increases toxicity of amphetamines, ephedrine, pseudoephedrine, flecainide, quinidine and quinine. Decreases effects of lithium, chlorpropamide and salicylates due to increased clearance. May affect the absorption of certain drugs due to raised intra-gastric pH.
Other Interactions
Information Not Available
Dosage
Oral
Urine Alkalinisation
Adult: To prevent development of uric-acid renal calculi in the initial stages of uricosuric therapy for hyperuricaemia in chronic gout: Up to 10 g daily in divided doses, to be taken with a liberal amount of fluid.
Elderly: Dosage adjustments may be required.
Renal impairment: Dosage adjustments may be required.
Hepatic impairment: Dosage adjustments may be required.
Oral
Chronic Metabolic Acidosis
Adult: Doses providing 57 mmol (4.8 g sodium bicarbonate) or more daily as required.
Elderly: Dosage adjustments may be required.
Renal impairment: Dosage adjustments may be required.
Hepatic impairment: Dosage adjustments may be required.
Oral
Dyspepsia
Adult: 1-5 g in water, may be taken as required.
Elderly: Dosage adjustments may be required.
Renal impairment: Dosage adjustments may be required.
Hepatic impairment: Dosage adjustments may be required.
Intravenous
Severe Metabolic Acidosis
Adult: By slow injection of a hypertonic solution of up to 8.4% (1000 mmol/L), or by continuous infusion of a weaker solution, usually 1.26% (150 mmol/L). For correction of acidosis during advanced cardiac life support procedures, 50 ml of an 8.4% solution may be given.
Elderly: Dosage adjustments may be required.
Renal impairment: Dosage adjustments may be required.
Hepatic impairment: Dosage adjustments may be required.
Food(before/after)
Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).
List of Contraindications
Sodium Bicarbonate and Pregnancy
Caution when used during pregnancy
Sodium Bicarbonate and Lactation
Caution when used during lactation
Sodium Bicarbonate and Children
Newborns and children younger than 2 years
Administration of at least 10 mL/min of hypertonic sodium bicarbonate may produce hypernatremia, decreased CSF pressure, and possible intracranial hemorrhage.
Special Risk Patients
Use drug with caution in edematous sodium-retaining states, CHF, liver cirrhosis, toxemia of pregnancy, or renal impairment.
Sodium content
May be significant, especially in patients with hypertension or CHF or in patients on low-sodium diets.
Sodium Bicarbonate and Geriatic
In general, dose selection for an elderly patient should be cautious, usually starting at the low end of the dosing range, reflecting the greater frequency of decreased hepatic, renal, or cardiac function and of concomitant disease or other drug therapy.
Sodium Bicarbonate and Other Contraindications
Metabolic or respiratory alkalosis; hypernatraemia, severe pulmonary oedema; hypocalcaemia, hypochlorhydria.
Storage
Information Not Available
Lab interference
Information Not Available
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