SODIUM BICARBONATE

Sodium salt used to control metabolic acidosis (pH < 7.1) especially that caused by loss of bicarbonate through urine or excessive gastrointestinal losses

Dosage Forms

Solution for injection

8.4%

Uses

  • Correcting acidosis
  • Alkalinisation of urine

Dose and Duration

Correcting acidosis due to volume depletion unresponsive to fluid replacement

Adult and child: administer an amount appropriate to the body base deficit by continuous intravenous infusion of a weaker solution, usually 1.26% over 3−4 hours.

Correcting acidosis due to severe shock e.g. in cardiac arrest

Adult and child: administer an amount appropriate to the body base deficit by slow IV injection.

Alkalinisation of urine

Adult: by mouth, 3 g in water every 2 hours until urinary pH exceeds 7; maintenance of alkaline urine 5–10 g daily.

Contra-indications

  • Hypersensitivity to sodium bicarbonate
  • Metabolic or respiratory alkalosis
  • Hypocalcaemia
  • Hypochlorhydria
  • Congestive heart failure

Side Effects

  • Stomach cramps, flatulence, vomiting, belching
  • Malaise, alkalosis with prolonged use

Pregnancy

  • Can be used

Breast-feeding

  • Can be used

⚠️ Caution

  • Mild acidosis due to volume depletion should first be resolved by appropriate fluid replacement as acidosis usually resolves as tissue and renal perfusion are restored
  • Use with caution in patients with cardiac disease, patients on sodium-restricted diets and the elderly
  • Restrict use in impaired renal function
  • Avoid prolonged use