Sodium Bicarbonate

Indications
 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 inj 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.
Contraindications
 Metabolic or respiratory alkalosis; hypernatraemia, severe pulmonary oedema; hypocalcaemia, hypochlorhydria.
Warnings / 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.
Adverse Reactions
 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 inj site.
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.
See Below for More sodium bicarbonate Drug Interactions
Mechanism of Actions
 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 hr.
Administration
 Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).
ATC Classification
 B05CB04 - sodium bicarbonate ; Belongs to the class of salt solutions used as irrigating solutions.
B05XA02 - sodium bicarbonate ; Belongs to the class of electrolyte solutions used in I.V. solutions.
Available As
  • Sodium Bicarbonate 0.14 gm
  • Sodium Bicarbonate 0.250 gm
  • Sodium Bicarbonate 0.500 gm
  • Sodium Bicarbonate 1.665 gm
  • Sodium Bicarbonate 10 mg
  • Sodium Bicarbonate 100 mg
  • Sodium Bicarbonate 140 mg
  • Sodium Bicarbonate 150 mg
  • Sodium Bicarbonate 170 mg
  • Sodium Bicarbonate 2.1 mg
  • Sodium Bicarbonate 2.5 gm
  • Sodium Bicarbonate 2.91 gm
  • Sodium Bicarbonate 3.37 gm
  • Sodium Bicarbonate 34 mg
  • Sodium Bicarbonate 4.5% w/v
  • Sodium Bicarbonate 44.03%
  • Sodium Bicarbonate 5%
  • Sodium Bicarbonate 5% w/v
  • Sodium Bicarbonate 5% w/w
  • Sodium Bicarbonate 500 mg
  • Sodium Bicarbonate 550 mg
  • Sodium Bicarbonate 7.5% w/w
  • Sodium Bicarbonate 70 mg
  • Sodium Bicarbonate 700 mg
  • Sodium Bicarbonate 75 mg
  • Sodium Bicarbonate 8.4% w/v

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