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sodium bicarbonate (Rx)Brand and Other Names:

 
 
 

Dosing & Uses

AdultPediatric

Dosage Forms & Strengths

injectable solution

  • 4.2%
  • 5%
  • 7.5%
  • 8.4%

tablet

  • 325mg
  • 650mg
more...

Cardiac Arrest

Initial: 1 mEq/kg/dose IV x1

Maintenance: 0.5 mEq/kg/dose q10min PRN

Hyperkalemia

50 mEq IV over 5 minutes

Metabolic Acidosis (Non-Life-Threatening)

2-5 mEq/kg IV infusion over 4-8 hr

Other Information

Urine Alkalinization: see sodium bicarbonate AD

Monitor: serum potassium

Other Indications & Uses

Severe metabolic acidosis (except hypercarbic acidosis)

Of little value in cardiopulmonary resuscitation before circulation has been restored

Dosage Forms & Strengths

injectable solution

  • 4.2%
  • 5%
  • 7.5%
  • 8.4%

tablet

  • 325mg
  • 650mg
more...

Cardiac Arrest

Children: as adult

Infants, <2 years old (use 4.2% solution)

  • Initial: 1 mEq/kg/min given over 1-2 minutes IV/IO, THEN
  • 0.5 mEq/kg IV q10min of arrest
  • Not to exceed 8 mEq/kg/day

Other Information

Metabolic acidosis (non-life-threatening): older children: as adult

Urine Alkalinization: see sodium bicarbonate AD

Monitor: serum potassium

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Interactions

Interaction Checker

sodium bicarbonate and

No Results

     
     activity indicator 
    No Interactions Found
    Interactions Found

    Contraindicated

      Serious - Use Alternative

        Significant - Monitor Closely

          Minor

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            Adverse Effects

            Frequency Not Defined

            Aggravated CHF

            Cerebral hemorrhage

            Edema

            Hypernatremia

            Hypocalcemia

            Hypokalemia

            Tetany

            Metabolic alkalosis

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            Warnings

            Contraindications

            Hypersensitivity, metabolic or respiratory alkalosis, hypocalcemia, excessive Cl- loss from vomiting or GI suctioning

            Pts at risk of developing diuretic-induced hypochloremic alkalosis

            Hypercarbic acidosis

            Cautions

            Not first-line for resuscitation

            Edematous or Na-retaining states, history of CHF, renal impairment, cirrhosis, HTN, children w/ DKA, concurrent corticosteroid use

            May cause hypokalemia

            Avoid extravasation (may cause chemical cellulitis, tissue necrosis, ulceration & sloughing d/t alkalinity)

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            Pregnancy & Lactation

            Pregnancy Category: C

            Lactation: not known if excreted in breast milk

            Pregnancy Categories

            A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

            B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

            C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

            D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

            X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

            NA:Information not available.

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            Pharmacology

            Onset: 15 min

            Duration: 1-2 hr

            Therapeutic Range: 24-31 mEq/L

            Excretion: urine

            Mechanism of Action

            Bicarbonate reacts with H+ ions to form water & carbon dioxide. It acts as a buffer against acidosis by raising blood pH

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            Administration

            IV Incompatibilities

            Additive: ascorbic acid, carboplatin, carmustine, ciprofloxacin, cisplatin, dobutamine, dopamine, epinephrine, hydromorphone, imipenem-cilastatin, labetalol, meperidine (?), meropenem, morphine, norepinephrine, penicillin G potassium, pentazocine, pentobarbital, procaine, sodium lactate, streptomycin, succinylcholine, vancomycin(?), vit B/C

            Syringe: bupivacaine(?), epinephrine(?), etidocaine, glycopyrrolate, lidocaine(?), mepivacaine, metoclopramide, thiopental

            Y-site: allopurinol, amiodarone, ampho B cholesterylSO4, CaCl2, Ca gluconate, ciprofloxacin(?), cisatarcurium(?), doxorubicin liposomal, fenoldopam, hetastarch, idarubicin, imipenem-cilastatin, inamrinone, leucovorin, midazolam, nalbuphine, ondansetron, oxacillin, sargramostim, verapamil, vincristine, vindesine, vinorelbine

            Not spec: diazepam, tetracycline

            IV Compatibilities

            Additive: aminophylline, ampho B, atropine, Ca gluconate, clindamycin, erythromycin, heparin, hydrocortisone, KCl, verapamil

            Syringe: heparin

            Y-site: heparin, morphine, KCl, vancomycin, vit B/C

            IV Administration

            Administered IV, either undiluted or diluted in other fluids, or

            By SC if diluted to isotonicity

            Storage

            Store at controlled room temperature

            Protect from freezing & temp >40°C

            Do not use if unclear or contains a precipitate

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            Images

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            Formulary

            FormularyPatient Discounts

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            The above information is provided for general informational and educational purposes only. Individual plans may vary and formulary information changes. Contact the applicable plan provider for the most current information.

            Tier Description
            1 This drug is available at the lowest co-pay. Most commonly, these are generic drugs.
            2 This drug is available at a middle level co-pay. Most commonly, these are "preferred" (on formulary) brand drugs.
            3 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs.
            4 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            5 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            6 This drug is available at a higher level co-pay. Most commonly, these are "non-preferred" brand drugs or specialty prescription products.
            NC NOT COVERED – Drugs that are not covered by the plan.
            Code Definition
            PA Prior Authorization
            Drugs that require prior authorization. This restriction requires that specific clinical criteria be met prior to the approval of the prescription.
            QL Quantity Limits
            Drugs that have quantity limits associated with each prescription. This restriction typically limits the quantity of the drug that will be covered.
            ST Step Therapy
            Drugs that have step therapy associated with each prescription. This restriction typically requires that certain criteria be met prior to approval for the prescription.
            OR Other Restrictions
            Drugs that have restrictions other than prior authorization, quantity limits, and step therapy associated with each prescription.
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