Sodium bicarbonate oral
- Drugs List
- Therapeutic Indications
- Dosage
- Contraindications
- Precautions and Warnings
- Pregnancy and Lactation
- Side Effects
- Monograph
Presentation
Oral formulations of sodium bicarbonate.
Drugs List
Therapeutic Indications
Uses
Dyspepsia
Heartburn
Metabolic acidosis
Unlicensed Uses
Rapid alkalinisation of urine
Dosage
Different products may recommend different dosing schedules.
Adults
Dyspepsia and Symptomatic relief of Heartburn and Peptic Ulceration
1g to 5g every 4 to 6 hours or when required.
Metabolic acidosis
Dose is calculated on an individual basis and is dependent on acid-base balance and electrolyte status. The mean dosage is 3g to 5g sodium bicarbonate per day.
Alternative sources suggest the following doses may be suitable:
Acidotic states
4.8g daily. Higher doses may be needed.
Children
Children aged over 12 years
(See Dosage; Adult)
Alternative sources suggest the following doses may be suitable:
Chronic acidotic states
Children aged 12 to 18 years: 1mmol/kg to 2mmol/kg daily in divided doses.
Children aged 1 month to 12 years (unlicensed): 1mmol/kg to 2mmol/kg daily in divided doses.
Neonates
Chronic acidotic states
Neonate (unlicensed): 1mmol/kg to 2mmol/kg daily in divided doses.
Contraindications
Children under 12 years
Restricted sodium intake
Hypernatraemia
Hypocalcaemia
Hypochlorhydria
Hypokalaemia
Metabolic alkalosis
Respiratory alkalosis
Precautions and Warnings
Children aged 12 to 18 years
Elderly
Oedema
Breastfeeding
Congestive cardiac failure
Eclampsia
Hepatic cirrhosis
Hepatic impairment
Hereditary fructose intolerance
Hyperaldosteronism
Hypertension
Pregnancy
Renal impairment
Respiratory depression
May mask symptoms of serious disease of the stomach and delay diagnosis
Sodium content of formulation may be significant
Not all available products are licensed for all age groups
Not all presentations are licensed for all indications
Presentations with sorbitol unsuitable in hereditary fructose intolerance
Some formulations contain propylene glycol
Some products may contain soya or soya derivative
Advise patient not to take other medicines within 2 hours
Monitor acid-base balance
Monitor serum electrolytes
Monitor serum osmolarity
Monitor serum sodium bicarbonate
Prolonged use may cause fluid/electrolyte imbalance and hypokalaemia
Advise patient to see doctor if symptoms persist for 7 days with treatment
Pregnancy and Lactation
Pregnancy
Use sodium bicarbonate with caution during pregnancy.
The manufacturers state that sodium bicarbonate should only be used during pregnancy if treatment is clearly necessary. Orally administered sodium bicarbonate is well absorbed and readily crosses the placental barrier. Existing blood pressure dysregulation, such as the physiological respiratory alkalosis associated with pregnancy, may also be increased due to the sodium load. The potential risk is unknown.
Lactation
Use sodium bicarbonate with caution during breastfeeding.
The manufacturers advise caution if sodium bicarbonate is used when breastfeeding. The effects of sodium administration during breastfeeding are unknown.
Side Effects
Alkalosis
Allergic reaction
Belching
Breathing difficulties
Decreased appetite
Diarrhoea
Flatulence
Fluid retention
Headache
Hypertension
Hypocalcaemic tetany
Hypokalaemia
Increased frequency of micturition
Irritability
Mental status changes
Mood changes
Muscle cramps
Muscle spasm
Nausea
Nephrolithiasis
Nervousness
Oedema of legs
Pulmonary oedema
Restlessness
Stomach pain
Stomach rupture
Tiredness
Unpleasant taste
Vomiting
Weakness
Overdosage
It is strongly recommended that the UK National Poisons Information Service be consulted on cases of suspected or actual overdose where there is doubt over the degree of risk or about appropriate management.
The following number will direct the caller to the relevant local centre (0844) 892 0111
Information may be obtained if you have access to ToxBase the primary clinical toxicology database of the National Poisons Information Service. This is available via password on the internet ( www.toxbase.org ) or if this is unavailable at the backup site ( www.toxbasebackup.org ).
Further Information
Last Full Review Date: July 2019
Reference Sources
Summary of Product Characteristics: Bidex 84mg/ml oral solution. Ennogen Healthcare Ltd. Revised January 2019.
Summary of Product Characteristics: Nephrotrans 500mg gastro-resistant capsules, soft. Medice Arzneimittel Putter GmbH & Co. KG. Revised October 2020.
Summary of Product Characteristics: Sodium Bicarbonate 500mg Capsules. Advanz Pharma. Revised June 2016.
Summary of Product Characteristics: Sodium Bicarbonate 500mg Capsules. Teva UK Limited. Revised July 2015.
Summary of Product Characteristics: Thamicarb 84mg/ml Oral solution. Thame Laboratories. Revised March 2018.
NICE Evidence Services Available at: www.nice.org.uk Last accessed: 23 April 2021.
Medscape UK | Univadis prescription drug monographs & interactions are based on FDB Multilex Content
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