Drug reference

Sodium bicarbonate

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1121, 1122

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Alkalinisation of urine | Relief of discomfort in mild urinary-tract infections ▶BY MOUTH ▶Adult: 3 g every 2 hours until urinary pH exceeds 7, to be dissolved in water Maintenance of alkaline urine ▶BY MOUTH ▶Adult: 5–10 g daily, to be dissolved in water Chronic acidotic states such as uraemic acidosis or renal tubular acidosis ▶BY MOUTH ▶Adult: 4.8 g daily, (57 mmol each of Na+ and HCO3 –), higher doses may be required and should be adjusted according to response Severe metabolic acidosis ▶BY SLOW INTRAVENOUS INJECTION, OR BY INTRAVENOUS INFUSION ▶Adult: Administer an amount appropriate to the body base deﬁcit, to be given by slow intravenous injection of a strong solution (up to 8.4%), or by continuous intravenous infusion of a weaker solution (usually 1.26%)

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Contra Indications

▶With intravenous use Salt restricted diet

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Cautions

Avoid prolonged use in urinary conditions. cardiac disease. elderly. patients on sodium-restricted diet. respiratory acidosis

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Prescribing And Dispensing Information

▶With oral use Sodium bicarbonate 500mg capsules contain approximately 6 mmol each of Na+ and HCO3 -; Sodium bicarbonate 600mg capsules contain approximately 7 mmol each of Na+ and HCO3 -. Oral solutions of sodium bicarbonate are required occasionally; these are available from ’special-order’ manufacturers or specialist importing companies; the strength of sodium bicarbonate should be stated on the prescription. ▶With intravenous use Usual strength Sodium bicarbonate 1.26% (12.6 g, 150 mmol each of Na+ and HCO3 -/litre), various other strengths available.

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Safety

Interactions

→Appendix 1: sodium bicarbonate

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Side Effects

▶With intravenous use Skin exfoliation. soft tissue necrosis. ulcer ▶With oral use Abdominal cramps. burping. ﬂatulence. hypokalaemia. metabolic alkalosis

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Pregnancy

▶With oral use Use with caution in urinary conditions.

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Hepatic Impairment

▶With oral use Manufacturer advises caution in cirrhosis.

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Renal Impairment

▶With oral use Avoid (except for specialised role in some forms of renal disease).

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Monitoring Requirements

▶With intravenous use Plasma-pH and electrolytes should be monitored.

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Dose and formulations

Directions For Administration

▶With intravenous use For slow intravenous injection use a small volume of hypertonic solution (such as 50 mL of 8.4%). For continuous intravenous infusion a weaker solution of 1.26% solution can be infused over 3–4 hours. Blood and nutrition ▶With oral use Sodium bicarbonate may affect the stability or absorption of other drugs if administered at the same time. If possible, allow 1–2 hours before administering other drugs orally.

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Forms available from special-order manufacturers include: capsule, oral suspension, oral solution, solution for injection, liquid Tablet ▶Sodium bicarbonate (Non-proprietary) Sodium bicarbonate 600 mg Sodium bicarbonate 600mg tablets | 100 tablet G £29.75 DT = £26.79 Solution for injection ▶Sodium bicarbonate (Non-proprietary) Sodium bicarbonate 84 mg per 1 ml Sodium bicarbonate 8.4% (1mmol/ml) solution for injection 10ml ampoules | 10 ampoule P £113.59 DT = £113.59 Sodium bicarbonate 8.4% (1mmol/ml) solution for injection 250ml bottles | 10 bottle P £100.00 DT = £100.00 Sodium bicarbonate 8.4% (1mmol/ml) solution for injection 100ml bottles | 10 bottle P £100.00 DT = £100.00 Oral solution ▶Thamicarb (Thame Laboratories Ltd) Sodium bicarbonate 84 mg per 1 ml Thamicarb 84mg/1ml oral solution sugar-free | 100 ml P £39.80 DT = £39.80 sugar-free | 500 ml P £199.20 DT = £199.20 Capsule ▶Sodium bicarbonate (Non-proprietary) Sodium bicarbonate 500 mg Sodium bicarbonate 500mg capsules | 56 capsule P s DT = £1.69 Infusion ▶Sodium bicarbonate (Non-proprietary) Sodium bicarbonate 12.6 mg per 1 ml Polyfusor sodium bicarbonate 1.26% solution for infusion 500ml bottles | 1 bottle P £11.98 Sodium bicarbonate 14 mg per 1 ml Polyfusor sodium bicarbonate 1.4% solution for infusion 500ml bottles | 1 bottle P £11.98 Sodium bicarbonate 27.4 mg per 1 ml Polyfusor sodium bicarbonate 2.74% solution for infusion 500ml bottles | 1 bottle P £11.98 Sodium bicarbonate 42 mg per 1 ml Polyfusor sodium bicarbonate 4.2% solution for infusion 500ml bottles | 1 bottle P £11.98 Sodium bicarbonate 84 mg per 1 ml Polyfusor sodium bicarbonate 8.4% solution for infusion 200ml bottles | 1 bottle P £11.98 ELECTROLYTES AND MINERALS › POTASSIUM

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Clinical care

Patient And Carer Advice

▶With oral use Patients or carers should be given advice on the administration of sodium bicarbonate oral medicines.

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Dose text by age group

Adult

3 g every 2 hours until urinary pH exceeds 7, to

First-line fragment. Read the complete Indications and Dose section above.

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Adult

5–10 g daily, to be dissolved in water

First-line fragment. Read the complete Indications and Dose section above.

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Adult

4.8 g daily, (57 mmol each of Na+ and HCO3

First-line fragment. Read the complete Indications and Dose section above.

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Adult

Administer an amount appropriate to the body

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1121

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Sodium bicarbonate

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 1121, 1122

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 1121

Contra Indications

▶With intravenous use Salt restricted diet

PDF page 1121

Cautions

Avoid prolonged use in urinary conditions. cardiac disease. elderly. patients on sodium-restricted diet. respiratory acidosis

PDF page 1121

Prescribing And Dispensing Information

PDF page 1121

Safety

Interactions

→Appendix 1: sodium bicarbonate

PDF page 1121

Side Effects

▶With intravenous use Skin exfoliation. soft tissue necrosis. ulcer ▶With oral use Abdominal cramps. burping. ﬂatulence. hypokalaemia. metabolic alkalosis

PDF page 1121

Pregnancy

▶With oral use Use with caution in urinary conditions.

PDF page 1121

Hepatic Impairment

▶With oral use Manufacturer advises caution in cirrhosis.

PDF page 1121

Renal Impairment

▶With oral use Avoid (except for specialised role in some forms of renal disease).

PDF page 1121

Monitoring Requirements

▶With intravenous use Plasma-pH and electrolytes should be monitored.

PDF page 1121

Dose and formulations

Directions For Administration

PDF page 1121

Medicinal Forms

PDF pages 1121, 1122

Clinical care

Patient And Carer Advice

▶With oral use Patients or carers should be given advice on the administration of sodium bicarbonate oral medicines.

PDF page 1121

Dose text by age group

Adult

3 g every 2 hours until urinary pH exceeds 7, to

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1121

Adult

5–10 g daily, to be dissolved in water

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1121

Adult

4.8 g daily, (57 mmol each of Na+ and HCO3

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1121

Adult

Administer an amount appropriate to the body

First-line fragment. Read the complete Indications and Dose section above.

PDF page 1121

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.