sodium bicarbonate

Generic Name: sodium bicarbonate (sew dee uhm buy car bo nayt)Brand names: 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 is also used to make the blood and urine less acidic in certain conditions

Sodium bicarbonate may also be used for purposes other than those listed in this medication guide.

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

Do not take sodium bicarbonate or any antacids without first talking to your doctor if you take any other medications.

Sodium bicarbonate contains a large amount of sodium. If you are on a sodium restricted diet or have high blood pressure talk to your health care professional before taking sodium bicarbonate.

What should I discuss with my healthcare provider before taking sodium bicarbonate?Do not take sodium bicarbonate or any antacids without first talking to your doctor if you have:

• an intestinal problem or appendicitis;

• heart problems;

• high blood pressure;

• swelling of the arms or legs;

• kidney disease;

• liver disease; or

• problems urinating;

Talk to your doctor before taking sodium bicarbonate if you are pregnant. Talk to your doctor before taking sodium bicarbonate if you are breast-feeding.

How should I take sodium bicarbonate?

Take sodium bicarbonate exactly as directed by your doctor or follow the directions on the package. If you do not understand these directions, ask your pharmacist, nurse, or doctor to explain them to you.

Take the sodium bicarbonate tablets with a full glass of water. Store sodium bicarbonate at room temperature away from moisture and heat.

See also: Sodium bicarbonate dosage in more detail

What happens if I miss a dose?

Take the missed dose as soon as you remember. However, if it is almost time for the next dose, skip the missed dose and take only the next regularly scheduled dose. Do not take a double dose of this medicine unless your doctor directs otherwise.

What happens if I overdose?

Seek emergency medical attention if an overdose is suspected.

What should I avoid while taking sodium bicarbonate?

If you take other medicines, do not take sodium bicarbonate without first talking to your doctor.

Sodium bicarbonate side effects

Stop taking sodium bicarbonate and seek emergency medical attention if you experience a rare allergic reaction (difficulty breathing; closing of the throat; swelling of the lips, tongue, or face; or hives).

Stop taking sodium bicarbonate and notify your doctor if you experience

• nausea or vomiting;

• headache;

• sever mood changes;

• muscle pain;

• swelling of feet, ankles or legs

• decreased appetite;

• unusual tiredness;

• constipation;

• dry mouth or increased thirst; or

• increased urination.

Side effects other than those listed here may also occur. Talk to your doctor about any side effect that seems unusual or that is especially bothersome. You may report side effects to FDA at 1-800-FDA-1088.

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)].orModerate 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:0 to 12 years: HCO3 (mEq) required = 0.5 x weight (kg) x base deficit.> 12 to 18 years: 0.2 x weight (kg) x base deficit.Alternatively: 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: 12 to 18 years: 2 to 5 mEq/kg IV infusion over 4 to 8 hours; subsequent doses should be based on patient's 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.> 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's acid-base status.

What other drugs will affect sodium bicarbonate?

Before taking sodium bicarbonate, tell your doctor if you are taking

• mecamylamine (Inversine);

• methenamine (Mandelamine);

• ketoconazole (Nizoral);

• antacids;

• a tetracycline antibiotic such as tetracycline (Sumycin, Achromycin V, and others), demeclocycline (Declomycin), doxycycline (Vibramycin, Monodox, Doxy, and others), minocycline (Minocin, Dynacin, and others), or oxytetracycline (Terramycin, and others).

You may not be able to take sodium bicarbonate, or you may require a dosage adjustment or special monitoring during treatment if you are taking any of the medicines listed above.

Drugs other than those listed here may also interact with sodium bicarbonate. Talk to your doctor or pharmacist before taking any other prescription or over-the-counter medicines, including vitamins, minerals, and herbal products.

Where can I get more information?

• Your doctor, pharmacist, or health care provider may have 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.
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