Questions about Atrial Fibrillation? Get answers from our expert.

sodium bicarbonate

Pronunciation

Generic Name: sodium bicarbonate (sew dee uhm buy car bo nayt)
Brand Name: Neut

What is sodium bicarbonate?

Sodium bicarbonate is an antacid that neutralizes stomach acid.

Sodium bicarbonate is used to relieve heartburn and indigestion.

Sodium bicarbonate may also be used for purposes not listed in this medication guide.

What is the most important information I should know about sodium bicarbonate?

Ask a doctor or pharmacist before taking this medicine if you are on a low-salt diet, or if you have high blood pressure.

Slideshow: Worried About Ebola? You’re More Likely to Get These 10 Serious Infections

What should I discuss with my healthcare provider before taking sodium bicarbonate?

Ask a doctor or pharmacist if it is safe for you to take this medicine if you have other medical conditions, especially:

  • kidney disease;

  • liver disease;

  • heart disease;

  • high blood pressure; or

  • if you are on a low salt diet.

FDA pregnancy category C. It is not known whether sodium bicarbonate will harm an unborn baby. Do not use this medicine without a doctor's advice if you are pregnant.

It is not known whether sodium bicarbonate passes into breast milk or if it could harm a nursing baby. Do not use this medicine without a doctor's advice if you are breast-feeding a baby.

How should I take sodium bicarbonate?

Use exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended.

Sodium bicarbonate tablets are usually dissolved completely in water before swallowing. Follow al directions on the product label.

Call your doctor if your symptoms do not improve, or if they get worse while using sodium bicarbonate.

Store at room temperature away from moisture and heat.

What happens if I miss a dose?

Since sodium bicarbonate is used when needed, you may not be on a dosing schedule. Do not take more of this medicine than recommended on the product label.

What happens if I overdose?

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222.

What should I avoid while taking sodium bicarbonate?

Avoid taking this medicine without a doctor's advice if you regularly take other medicines.

Sodium bicarbonate side effects

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Stop using sodium bicarbonate and call your doctor at once if you have:

  • severe stomach pain;

  • swelling, rapid weight gain; or

  • shortness of breath (even with mild exertion).

Common side effects may include:

  • dry mouth;

  • increased thirst; or

  • urinating more than usual.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

See also: Side effects (in more detail)

Sodium bicarbonate dosing information

Usual Adult Dose for Metabolic Acidosis:

Parenteral:
If acid-base status is available, dosages should be calculated as follows: 0.2 x weight (kg) x base deficit.

Alternatively:

HCO3 (mEq) required = 0.5 x weight (kg) x [24 - serum HCO3 (mEq/L)].

or

Moderate metabolic acidosis: 50 to 150 mEq sodium bicarbonate diluted in 1 L of D5W to be intravenously infused at a rate of 1 to 1.5 L/hour during the first hour.

Severe metabolic acidosis: 90 to 180 mEq sodium bicarbonate diluted in 1 L of D5W to be intravenously infused at a rate of 1 to 1.5 L/hour during the first hour.

If acid-base status is not available, dosages should be calculated as follows: 2 to 5 mEq/kg IV infusion over 4 to 8 hours; subsequent doses should be based on patient's acid-base status.

Oral:

Moderate metabolic acidosis: 325 to 2000 mg orally 1 to 4 times a day. One gram provides 11.9 mEq (mmoL) each of sodium and bicarbonate.

Usual Adult Dose for Diabetic Ketoacidosis:

Although sodium bicarbonate is approved for the treatment of metabolic acidosis, data have shown that the use of this drug may be harmful in certain clinical settings such as lactic acidosis, acidosis with tissue hypoxia, uremia, severe cardiac dysfunction or arrest, and diabetic ketoacidosis.

Most experts only allow for its use when tissue perfusion and ventilation are maximized and the arterial pH is 7.1 or lower.

If sodium bicarbonate is used to treat diabetic ketoacidosis, the initial dosage is 50 mEq sodium bicarbonate in 1 L of appropriate IV solution to be given once.

Insulin therapy may obviate the need for bicarbonate therapy since it will promote glucose utilization and decrease the production of ketoacids.

Usual Adult Dose for Urinary Alkalinization:

Parenteral:

50 to 150 mEq sodium bicarbonate diluted in 1 L of D5W to be intravenously infused at a rate of 1 to 1.5 L/hour.

Oral:

325 to 2000 mg orally 1 to 4 times a day. One gram provides 11.9 mEq (mmoL) each of sodium and bicarbonate.

The goal of therapy is to correct serum pH and increase the urinary pH to 8 in order to increase the renal excretion of toxic substances such as salicylates or lithium.

If the increase in urinary pH is inadequate, increasing the sodium bicarbonate in solution to 100 to 150 mEq/L may result in further alkalinization of the urine.

Usual Adult Dose for Dyspepsia:

325 to 2000 mg orally 1 to 4 times a day.

Usual Adult Dose for Hyperkalemia:

One ampule of 7.5% sodium bicarbonate (44.6 mEq HCO3 ion) may be administered slowly IV over 5 minutes and repeated at 10 to 15 minute intervals if ECG changes persist. The onset of action occurs within 30 minutes and the effect lasts for 1 to 2 hours. The resultant effect restores intracellular potassium levels to normal without decreasing total body potassium stores.

Circulatory overload and hypernatremia can occur when large volumes of hypertonic sodium bicarbonate are given. If hypocalcemia is present, seizures and tetany may occur as blood pH rises and the ionized free calcium decreases; hence, calcium should be given first. Hyponatremia will magnify the cardiac effects of hyperkalemia, and sodium bicarbonate can be used to treat this as well.

Usual Adult Dose for Asystole:

1 mEq/kg slow IV initially, may repeat with 0.5 mEq/kg 10 minutes later one time, or as indicated by the patient's acid-base status.

Usual Pediatric Dose for Metabolic Acidosis:

If acid-base status is available, dosages should be calculated as follows:
Infants and Children: HCO3 (mEq) required = 0.3 x weight (kg) x base deficit (mEq/L) OR HCO3 (mEq) required = 0.5 x weight (kg) x [24 - serum HCO3 (mEq/L)].

If acid-base status is not available, dosages should be calculated as follows:
Older children: 2 to 5 mEq/kg IV infusion over 4 to 8 hours; subsequent doses should be based on patient acid-base status.

Usual Pediatric Dose for Urinary Alkalinization:

0 to 12 years: 1 to 10 mEq (84 to 840 mg)/kg/day orally in divided doses; dose should be titrated to desired urinary pH.

Greater than 12 to 18 years: 325 to 2000 mg orally 1 to 4 times a day. One gram provides 11.9 mEq (mmol) each of sodium and bicarbonate.

The goal of therapy is to correct serum pH and increase the urinary pH to 8 in order to increase the renal excretion of toxic substances such as salicylates or lithium.

If the increase in urinary pH is inadequate, increasing the sodium bicarbonate in solution to 100 to 150 mEq/L may result in further alkalinization of the urine.

Usual Pediatric Dose for Hyperuricemia Secondary to Chemotherapy:

0 to 12 years:

Parenteral:
120 to 200 mEq/m2/day diluted in maintenance IV fluids of 3000 mL/m2/day; titrate to maintain urine pH between 6 and 7.

Oral:
12 g/m2/day divided into 4 doses; titrate to maintain urine pH between 6 and 7.

Usual Pediatric Dose for Asystole:

1 mEq/kg slow IV initially, may repeat with 0.5 mEq/kg 10 minutes later one time, or as indicated by the patient acid-base status.

What other drugs will affect sodium bicarbonate?

Other drugs may interact with sodium bicarbonate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Where can I get more information?

  • Your pharmacist can provide more information about sodium bicarbonate.
  • Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
  • Disclaimer: Every effort has been made to ensure that the information provided by Cerner Multum, Inc. ('Multum') is accurate, up-to-date, and complete, but no guarantee is made to that effect. Drug information contained herein may be time sensitive. Multum information has been compiled for use by healthcare practitioners and consumers in the United States and therefore Multum does not warrant that uses outside of the United States are appropriate, unless specifically indicated otherwise. Multum's drug information does not endorse drugs, diagnose patients or recommend therapy. Multum's drug information is an informational resource designed to assist licensed healthcare practitioners in caring for their patients and/or to serve consumers viewing this service as a supplement to, and not a substitute for, the expertise, skill, knowledge and judgment of healthcare practitioners. The absence of a warning for a given drug or drug combination in no way should be construed to indicate that the drug or drug combination is safe, effective or appropriate for any given patient. Multum does not assume any responsibility for any aspect of healthcare administered with the aid of information Multum provides. The information contained herein is not intended to cover all possible uses, directions, precautions, warnings, drug interactions, allergic reactions, or adverse effects. If you have questions about the drugs you are taking, check with your doctor, nurse or pharmacist.

Copyright 1996-2012 Cerner Multum, Inc. Version: 1.04. Revision Date: 2014-02-20, 2:35:47 PM.

Hide
(web3)