Dosing & Uses
Dosage Forms & Strengths
injectable solution
- 4%
- 4.2%
- 7.5%
- 8.4%
tablet
- 325mg
- 650mg
Cardiac Arrest
Initial: 1 mEq/kg/dose IV x1; base subsequent doses on results of arterial blood pH and PaCO2 as well as calculation of base deficit
Repeat doses may be considered in the setting of prolonged cardiac arrest only after adequate alveolar ventilation has been established
Hyperkalemia
50 mEq IV over 5 minutes
Metabolic Acidosis
Non-life-threatening: 2-5 mEq/kg IV infusion over 4-8 hr depending on the severity of acidosis as judged by the lowering of total CO2 content, clinical condition and pH
Severe (except hypercarbic acidosis): 90-180 mEq/L (~7.5-15 g) at a rate of 1-1.5 L (first hour); adjust for further management as needed
Dosing Considerations
Monitor pH, serum potassium, and CO2
Dosage Forms & Strengths
injectable solution
- 4%
- 4.2%
- 7.5%
- 8.4%
tablet
- 325mg
- 650mg
Cardiac Arrest
Infants, <2 years (use 4.2% solution)
- Initial: 1 mEq/kg/min given over 1-2 minutes IV/IO, THEN
- 1 mEq/kg IV q10min of arrest
- Not to exceed 8 mEq/kg/day
≥2 years
- Initial: 1 mEq/kg/dose IV x1; base subsequent doses on results of arterial blood pH and PaCO2 as well as calculation of base deficit
- Repeat doses may be considered in the setting of prolonged cardiac arrest only after adequate alveolar ventilation has been established
Metabolic Acidosis (Non-Life-Threatening)
Older children: 2-5 mEq/kg IV infusion over 4-8 hr depending on the severity of acidosis as judged by the lowering of total CO2 content, clinical condition and pH
0.25-2mEq/kg IV infusion can be considered for acidosis with a pH <7.0-7.2
Dosing Considerations
Monitor serum potassium
Interactions
Interaction Checker
No Results
Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor
Contraindicated (0)
Serious - Use Alternative (22)
- atazanavir
sodium bicarbonate will decrease the level or effect of atazanavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- dapsone
sodium bicarbonate will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- dasatinib
sodium bicarbonate will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- demeclocycline
sodium bicarbonate decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- digoxin
sodium bicarbonate will increase the level or effect of digoxin by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- doxycycline
sodium bicarbonate decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- eltrombopag
sodium bicarbonate decreases levels of eltrombopag by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Separate by at least 4 hours.
- fleroxacin
sodium bicarbonate decreases levels of fleroxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- gemifloxacin
sodium bicarbonate decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- indinavir
sodium bicarbonate will decrease the level or effect of indinavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- itraconazole
sodium bicarbonate will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- ketoconazole
sodium bicarbonate will decrease the level or effect of ketoconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- levofloxacin
sodium bicarbonate decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- levoketoconazole
sodium bicarbonate will decrease the level or effect of levoketoconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- minocycline
sodium bicarbonate decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- moxifloxacin
sodium bicarbonate decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- nimodipine
sodium bicarbonate will increase the level or effect of nimodipine by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- nisoldipine
sodium bicarbonate will increase the level or effect of nisoldipine by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- nitrendipine
sodium bicarbonate will increase the level or effect of nitrendipine by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.
- ofloxacin
sodium bicarbonate decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- oxytetracycline
sodium bicarbonate decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
- tetracycline
sodium bicarbonate decreases levels of tetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.
Monitor Closely (94)
- acebutolol
sodium bicarbonate decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- alendronate
sodium bicarbonate decreases levels of alendronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- allopurinol
sodium bicarbonate decreases levels of allopurinol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- amantadine
sodium bicarbonate will increase the level or effect of amantadine by Other (see comment). Modify Therapy/Monitor Closely. Urine pH changes towards alkalinic conditions may lead to an accumulation of amantadine with a possible increase in adverse reactions. Monitor for adverse reactions of amantadine.
- ampicillin
sodium bicarbonate will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- atenolol
sodium bicarbonate decreases levels of atenolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- azithromycin
sodium bicarbonate decreases levels of azithromycin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- bearberry
sodium bicarbonate will increase the level or effect of bearberry by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- benazepril
sodium bicarbonate decreases effects of benazepril by unspecified interaction mechanism. Use Caution/Monitor.
- benzphetamine
sodium bicarbonate will increase the level or effect of benzphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- betaxolol
sodium bicarbonate decreases levels of betaxolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- bisoprolol
sodium bicarbonate decreases levels of bisoprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- captopril
sodium bicarbonate decreases effects of captopril by unspecified interaction mechanism. Use Caution/Monitor. Sodium bicarbonate may decrease absorption of captopril.
- carbonyl iron
sodium bicarbonate will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- carvedilol
sodium bicarbonate decreases levels of carvedilol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- cefdinir
sodium bicarbonate will decrease the level or effect of cefdinir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- cefditoren
sodium bicarbonate will decrease the level or effect of cefditoren by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- cefpodoxime
sodium bicarbonate will decrease the level or effect of cefpodoxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- cefuroxime
sodium bicarbonate will decrease the level or effect of cefuroxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- celecoxib
sodium bicarbonate decreases levels of celecoxib by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- celiprolol
sodium bicarbonate decreases levels of celiprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- chenodiol
sodium bicarbonate decreases levels of chenodiol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- chloroquine
sodium bicarbonate will decrease the level or effect of chloroquine by Mechanism: inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Separate doses by at least 4 hr
- ciprofloxacin
sodium bicarbonate decreases levels of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. A large proportion of ciprofloxacin is normally excreted unchanged in the urine. When urinary alkalinizing agents such as sodium bicarbonate are used concomitantly, the solubility of ciprofloxacin can be decreased because of alkaline urine. Patients should be monitored for crystalluria and nephrotoxicity.
- crizotinib
sodium bicarbonate decreases levels of crizotinib by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor. Drugs that elevate the gastric pH may decrease the solubility of crizotinib and subsequently reduce its bioavailability. However, no formal studies have been conducted. .
- deferoxamine
deferoxamine decreases levels of sodium bicarbonate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferoxamine chelates iron; its affinity for other minerals is unknown.
- deflazacort
sodium bicarbonate and deflazacort both decrease serum potassium. Use Caution/Monitor.
- dextroamphetamine
sodium bicarbonate will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- enalapril
sodium bicarbonate decreases effects of enalapril by unspecified interaction mechanism. Use Caution/Monitor.
- ephedrine
sodium bicarbonate will increase the level or effect of ephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- erythromycin base
sodium bicarbonate increases levels of erythromycin base by unknown mechanism. Use Caution/Monitor.
- erythromycin ethylsuccinate
sodium bicarbonate increases levels of erythromycin ethylsuccinate by unknown mechanism. Use Caution/Monitor.
- erythromycin lactobionate
sodium bicarbonate increases levels of erythromycin lactobionate by unknown mechanism. Use Caution/Monitor.
- erythromycin stearate
sodium bicarbonate increases levels of erythromycin stearate by unknown mechanism. Use Caution/Monitor.
- esmolol
sodium bicarbonate decreases levels of esmolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- etidronate
sodium bicarbonate decreases levels of etidronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- ferric maltol
sodium bicarbonate will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ferrous fumarate
sodium bicarbonate will decrease the level or effect of ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ferrous gluconate
sodium bicarbonate will decrease the level or effect of ferrous gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ferrous sulfate
sodium bicarbonate will decrease the level or effect of ferrous sulfate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- flecainide
sodium bicarbonate will increase the level or effect of flecainide by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- fosamprenavir
sodium bicarbonate will decrease the level or effect of fosamprenavir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- fosinopril
sodium bicarbonate decreases effects of fosinopril by unspecified interaction mechanism. Use Caution/Monitor.
- gabapentin
sodium bicarbonate decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- gabapentin enacarbil
sodium bicarbonate decreases levels of gabapentin enacarbil by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- glipizide
sodium bicarbonate will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- glyburide
sodium bicarbonate will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- ibandronate
sodium bicarbonate decreases levels of ibandronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- imidapril
sodium bicarbonate decreases effects of imidapril by unspecified interaction mechanism. Use Caution/Monitor.
- iron dextran complex
sodium bicarbonate will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- iron sucrose
sodium bicarbonate will decrease the level or effect of iron sucrose by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- isoniazid
sodium bicarbonate decreases levels of isoniazid by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- itraconazole
sodium bicarbonate decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- ketoconazole
sodium bicarbonate decreases levels of ketoconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- labetalol
sodium bicarbonate decreases levels of labetalol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- lactulose
sodium bicarbonate decreases effects of lactulose by pharmacodynamic antagonism. Use Caution/Monitor.
- levoketoconazole
sodium bicarbonate decreases levels of levoketoconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- lisinopril
sodium bicarbonate decreases effects of lisinopril by unspecified interaction mechanism. Use Caution/Monitor.
- memantine
sodium bicarbonate will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- methscopolamine
sodium bicarbonate decreases levels of methscopolamine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.
- metoprolol
sodium bicarbonate decreases levels of metoprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- mexiletine
sodium bicarbonate will increase the level or effect of mexiletine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.
- moexipril
sodium bicarbonate decreases effects of moexipril by unspecified interaction mechanism. Use Caution/Monitor.
- mycophenolate
sodium bicarbonate will decrease the level or effect of mycophenolate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- nadolol
sodium bicarbonate decreases levels of nadolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- nebivolol
sodium bicarbonate decreases levels of nebivolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- nitrofurantoin
sodium bicarbonate decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- omadacycline
sodium bicarbonate will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- pamidronate
sodium bicarbonate decreases levels of pamidronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- penbutolol
sodium bicarbonate decreases levels of penbutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- penicillamine
sodium bicarbonate decreases levels of penicillamine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- perindopril
sodium bicarbonate decreases effects of perindopril by unspecified interaction mechanism. Use Caution/Monitor.
- pindolol
sodium bicarbonate decreases levels of pindolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- polysaccharide iron
sodium bicarbonate will decrease the level or effect of polysaccharide iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- posaconazole
sodium bicarbonate will decrease the level or effect of posaconazole by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- propranolol
sodium bicarbonate decreases levels of propranolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- pseudoephedrine
sodium bicarbonate will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor. Caution advised with frequent or high dose antacids
- quinapril
sodium bicarbonate decreases effects of quinapril by unspecified interaction mechanism. Use Caution/Monitor.
- quinidine
sodium bicarbonate will increase the level or effect of quinidine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor. Elevated quinidine plasma levels, possibly with cardiac conduction disturbances and arrhythmias, may occur.
- ramipril
sodium bicarbonate decreases effects of ramipril by unspecified interaction mechanism. Use Caution/Monitor.
- rifampin
sodium bicarbonate will decrease the level or effect of rifampin by Other (see comment). Use Caution/Monitor. Concomitant antacid administration may reduce absorption of rifampin; daily doses of rifampin should be given at least 1 hr before ingestion of antacids
- riociguat
sodium bicarbonate decreases levels of riociguat by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate administration by at least 1 hour.
- risedronate
sodium bicarbonate decreases levels of risedronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- rose hips
sodium bicarbonate will decrease the level or effect of rose hips by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- rosuvastatin
sodium bicarbonate decreases levels of rosuvastatin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- sarecycline
sodium bicarbonate will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.
- sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol
sodium bicarbonate and sodium sulfate/potassium sulfate/magnesium sulfate/polyethylene glycol both decrease serum potassium. Modify Therapy/Monitor Closely.
- sotalol
sodium bicarbonate decreases levels of sotalol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- tiludronate
sodium bicarbonate decreases levels of tiludronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- timolol
sodium bicarbonate decreases levels of timolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
- tolbutamide
sodium bicarbonate will increase the level or effect of tolbutamide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.
- trandolapril
sodium bicarbonate decreases effects of trandolapril by unspecified interaction mechanism. Use Caution/Monitor.
- ursodiol
sodium bicarbonate decreases effects of ursodiol by pharmacodynamic antagonism. Use Caution/Monitor.
- zoledronic acid
sodium bicarbonate decreases levels of zoledronic acid by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.
Minor (15)
- aspirin
sodium bicarbonate, aspirin. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- aspirin rectal
sodium bicarbonate, aspirin rectal. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- aspirin/citric acid/sodium bicarbonate
sodium bicarbonate, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- balsalazide
sodium bicarbonate, balsalazide. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- blessed thistle
blessed thistle decreases effects of sodium bicarbonate by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.
- choline magnesium trisalicylate
sodium bicarbonate, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- chromium
sodium bicarbonate decreases levels of chromium by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Separate by 2 hours.
- devil's claw
devil's claw decreases effects of sodium bicarbonate by pharmacodynamic antagonism. Minor/Significance Unknown.
- diflunisal
sodium bicarbonate, diflunisal. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- mesalamine
sodium bicarbonate, mesalamine. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- salicylates (non-asa)
sodium bicarbonate, salicylates (non-asa). Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- salsalate
sodium bicarbonate, salsalate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- strontium ranelate
sodium bicarbonate decreases levels of strontium ranelate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Separate by 2 hr when possible.
- sulfasalazine
sodium bicarbonate, sulfasalazine. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
- willow bark
sodium bicarbonate, willow bark. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).
Adverse Effects
Frequency Not Defined
Aggravated CHF
Cerebral hemorrhage
Edema
Hypernatremia
Hypocalcemia
Hypokalemia
Tetany
Metabolic alkalosis
Belching
Gastric distension
Pulmonary edema
Hypernatremia
Hyperosmolality
Intracranial acidosis
Milk-alkali syndrome
Warnings
Contraindications
Hypersensitivity
Injection
- Chloride loss due to vomiting or from continuous gastrointestinal suction
- Currently treated with diuretics
Cautions
Not first-line for resuscitation
Use with caution in patients with congestive heart failure, severe renal insufficiency, edematous or sodium-retaining states, HTN, children with DKA, and concurrent corticosteroid use
IV administration can cause fluid and/or solute overloading resulting in dilution of serum electrolyte concentrations, overhydration, congested states or pulmonary edema
Avoid extravasation (may cause chemical cellulitis, tissue necrosis, ulceration & sloughing due to alkalinity)
Potassium depletion may predispose to metabolic alkalosis and coexistent hypocalcemia may be associated with carpopedal spasm as plasma pH rises; treat appropriately before or during the infusion to minimize the risk of such electrolyte imbalance
Pregnancy & Lactation
Pregnancy
Unknown if fetal harm may occur when administered to pregnant females or can affect reproduction capacity
Use if clearly needed
Lactation
Unknown 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.Pharmacology
Mechanism of Action
Bicarbonate reacts with H+ ions to form water & carbon dioxide. It acts as a buffer against acidosis by raising blood pH
Pharmacokinetics
Onset: 15 min (IV)
Duration: 1-2 hr (IV); 8-10 min (PO)
Therapeutic range: 24-31 mEq/L
Excretion: Urine
Absorption: Well absorbed orally
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
Direct IV infusion for emergencies (eg, cardiac arrest): Rapid IV dose of 1-2 vials of 50 mL (44.6-100 mEq) initially and continued at a rate of 50 mL (44.6 to 50 mEq) every 5-10 minutes if necessary
Diluted solutions: Infuse over at least 2 hr (not to exceed 1 mEq/kg/hr)
Storage
Unused vials
- Store at controlled room temperature
- Protect from freezing & temp >40ºC
- Do not use if unclear or contains a precipitate
Tablets
- Store at 20-25ºC (68-77ºF)
- Keep out of reach of children
Images
| BRAND | FORM. | UNIT PRICE | PILL IMAGE |
|---|---|---|---|
| sodium bicarbonate oral - | 650 mg tablet |  | |
| sodium bicarbonate oral - | 650 mg tablet |  | |
| sodium bicarbonate oral - | 650 mg tablet |  | |
| sodium bicarbonate oral - | 325 mg tablet |  | |
| sodium bicarbonate oral - | 325 mg tablet |  | |
| sodium bicarbonate oral - | 650 mg tablet |  | |
| sodium bicarbonate oral - | 650 mg tablet |  | |
| sodium bicarbonate oral - | 650 mg tablet |  | |
| sodium bicarbonate oral - | 325 mg tablet |  | |
| sodium bicarbonate oral - | 325 mg tablet |  | |
| sodium bicarbonate intravenous - | 4.2 % (0.5 mEq/mL) solution |  | |
| sodium bicarbonate intravenous - | 10 mEq/10 mL (8.4 %) solution |  | |
| sodium bicarbonate intravenous - | 1 mEq/mL (8.4 %) vial |  | |
| sodium bicarbonate intravenous - | 1 mEq/mL (8.4 %) vial |  | |
| sodium bicarbonate intravenous - | 1 mEq/mL (8.4 %) vial |  | |
| sodium bicarbonate intravenous - | 4.2 % vial |  | |
| sodium bicarbonate intravenous - | 1 mEq/mL (8.4 %) vial |  | |
| sodium bicarbonate intravenous - | 8.4 % (1 mEq/mL) solution |  | |
| sodium bicarbonate intravenous - | 7.5 % (0.9 mEq/mL) solution |  |
Copyright © 2010 First DataBank, Inc.
Patient Handout
sodium bicarbonate intravenous
NO MONOGRAPH AVAILABLE AT THIS TIME
USES: Consult your pharmacist.
HOW TO USE: Consult your pharmacist.
SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.
PRECAUTIONS: Consult your pharmacist.
DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist.
OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center.
NOTES: No monograph available at this time.
MISSED DOSE: Consult your pharmacist.
STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product.
Information last revised July 2016. Copyright(c) 2023 First Databank, Inc.
IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs.
Formulary
Adding plans allows you to compare formulary status to other drugs in the same class.
To view formulary information first create a list of plans. Your list will be saved and can be edited at any time.
Adding plans allows you to:
- View the formulary and any restrictions for each plan.
- Manage and view all your plans together – even plans in different states.
- Compare formulary status to other drugs in the same class.
- Access your plan list on any device – mobile or desktop.
