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Sodium bicarbonate oral


Oral formulations of sodium bicarbonate.

Drugs List

  • BIDEX 84mg/ml oral solution
  • NEPHROTRANS 500mg gastro-resistant capsules
  • SODIBIC 420mg/5ml (1mmol/1ml) oral solution
  • sodium bicarbonate 420mg/5ml (1mmol/1ml) oral solution sugar-free
  • sodium bicarbonate 500mg capsules
  • sodium bicarbonate 500mg gastro-resistant capsules
  • THAMICARB 84mg/ml oral solution
  • Therapeutic Indications


    Metabolic acidosis

    Unlicensed Uses

    Rapid alkalinisation of urine


    Different products may recommend different dosing schedules.


    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 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.


    Chronic acidotic states
    Neonate (unlicensed): 1mmol/kg to 2mmol/kg daily in divided doses.


    Children under 12 years
    Restricted sodium intake
    Metabolic alkalosis
    Respiratory alkalosis

    Precautions and Warnings

    Children aged 12 to 18 years
    Congestive cardiac failure
    Hepatic cirrhosis
    Hepatic impairment
    Hereditary fructose intolerance
    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


    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.


    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

    Allergic reaction
    Breathing difficulties
    Decreased appetite
    Fluid retention
    Hypocalcaemic tetany
    Increased frequency of micturition
    Mental status changes
    Mood changes
    Muscle cramps
    Muscle spasm
    Oedema of legs
    Pulmonary oedema
    Stomach pain
    Stomach rupture
    Unpleasant taste


    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 ( ) or if this is unavailable at the backup site ( ).

    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: Last accessed: 23 April 2021.

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