Pronunciation: SO-dee-uhm by-CAR-boe-nate
Class: Urinary alkalinizer, System alkalinizer, Electrolyte, Antacid
- Tablets 520 mg
- Neutralizing additive solution 4% (0.48 mEq/mL)
- Injection 4.2% (0.5 mEq/mL)
- Injection 5% (0.6 mEq/mL)
- Injection 7.5% (0.9 mEq/mL)
- Injection 8.4% (1 mEq/mL)
- Neutralizing additive solution 4.2% (0.5 mEq/mL)
- Powder 120 g
- Tablets 325 mg
- Tablets 650 mg
Increases plasma bicarbonate; buffers excess hydrogen ion concentrations; raises blood pH; reverses metabolic acidosis.
Indications and Usage
Treatment of metabolic acidosis; promotion of gastric, systemic, and urinary alkalinization; replacement therapy in severe diarrhea; used to reduce incidence of chemical phlebitis (used as neutralizing additive solution).
Loss of chloride from vomiting or continuous GI suction when patient is receiving diuretics known to produce hypochloremic alkalosis; metabolic and respiratory alkalosis; hypocalcemia in which alkalosis may produce tetany, hypertension, convulsions, or CHF; when administration of sodium could be clinically detrimental.
Dosage and AdministrationAdults and Children older than 2 yr of age
IV Administration performed in concentrations ranging from 1.5% (isotonic) to 8.4% depending on clinical condition and requirements of patient.
Subcutaneous After dilution to isotonicity (1.5%). The dose depends on the clinical condition and requirements of the patient (including age and weight).
PO 325 mg to 2 g 1 to 4 times daily (patients younger than 60 yr of age, max dose 16 g/day; patients older than 60 yr of age max dose 8 g/day).Infants up to 2 yr of age
IV 4.2% solution at rate up to 8 mEq/kg/day.
Drug InteractionsAmphetamine, dextroamphetamine, ephedrine, flecainide, mecamylamine, methamphetamine, pseudoephedrine, quinidine
Sodium bicarbonate can decrease elimination of these drugs, thus increasing their therapeutic effects.Chlorpropamide, lithium, methotrexate, salicylates, tetracyclines
Sodium bicarbonate can increase elimination of these drugs, thus decreasing their therapeutic effect.Ketoconazole
PO sodium bicarbonate may decrease the dissolution of ketoconazole in the GI tract, reducing the effectiveness.
Do not mix with IV solutions containing catecholamines, such as dobutamine, dopamine, and norepinephrine.
Laboratory Test Interactions
None well documented.
Exacerbation of CHF.
Rebound hyperacidity; milk-alkali syndrome.
Extravasation with cellulitis, tissue necrosis, ulceration, and sloughing; local pain; venous irritation; tetany; edema.
Category C .
ChildrenNewborns and children younger than 2 yr
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.
May be significant, especially in patients with hypertension or CHF or in patients on low-sodium diets.
Alkalosis, hyperirritability, tetany, nausea, vomiting.
- Instruct patient not to take medication with milk because renali calculi can develop.
- Explain need to avoid OTC medications containing sodium bicarbonate, such as Alka-Seltzer . Excessive use of sodium bicarbonate can result in increase acid secretion or systemic alkalosis.
- Instruct patient not to use max dose of antacids for more than 2 wk except under supervision of health care provider.
- Advise patient not to take sodium bicarbonate on routine or long-term basis. Tell patient to notify health care provider if symptoms of gastric distress continue.
- Caution patient to report these symptoms to health care provider immediately: nausea, vomiting, anorexia.
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