Generic Name

Sodium Bicarbonate

Precaution

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.

Indication

Dyspepsia, Urine alkalinisation, Severe metabolic acidosis, Hyperkalemia

Contra Indication

Metabolic or respiratory alkalosis; hypernatraemia, severe pulmonary oedema; hypocalcaemia, hypochlorhydria.

Dose

N/A

Side Effect

Aggravated CHF, Cerebral hemorrhage, Edema, Hypernatremia, Hypocalcemia, Hypokalemia, Tetany. Tissue necrosis at inj site.

Pregnancy Category

Mode of Action

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.

Interaction

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.

Pregnancy Category Note

Pregnancy Category: C Lactation: Not known if excreted in breast milk

Adult Dose

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. Chronic metabolic acidosis Adult: Doses providing 57 mmol (4.8 g sodium bicarbonate) or more daily as required. Dyspepsia Adult: 1-5 g in water, may be taken as 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. Hepatic impairment: Dosage adjustments may be required.

Child Dose

N/A

Renal Dose

Renal impairment: Dosage adjustments may be required.

Administration

Should be taken on an empty stomach (i.e. At least one hour before food or two hours after food).