Formulary
Sodium bicarbonate: Indications, Dosing, Side Effects and Interactions
Sodium bicarbonate clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 3 min read
Sodium bicarbonate: Indications, Dosing, Side Effects and Interactions
Sodium bicarbonate clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Chronic acidotic states such as uraemic acidosis or renal tubular acidosis for sodium bicarbonate**
- **Neonate** (By mouth): Initially 1-2 mmol/kg daily in divided doses, adjusted according to response.
- **Child** (By mouth): Initially 1-2 mmol/kg daily in divided doses, adjusted according to response.
**Severe metabolic acidosis for sodium bicarbonate**
- **Child** (By slow intravenous injection): Administer an amount appropriate to the body base deficit, to be given using a strong solution (up to 8.4%).
- **Child** (By continuous intravenous infusion): Administer an amount appropriate to the body base deficit, to be given using a weak solution (usually 1.26%).
**Renal hyperkalaemia for sodium bicarbonate**
- **Neonate** (By slow intravenous injection): 1 mmol/kg daily.
- **Child** (By slow intravenous injection): 1 mmol/kg daily.
**Persistent cyanotic spell in a child with congenital heart disease despite optimal use of 100% oxygen and propranolol for sodium bicarbonate**
- **Child** (By intravenous infusion): 1 mmol/kg, dose given to correct acidosis (or dose calculated according to arterial blood gas results), sodium bicarbonate 4.2% intravenous infusion is appropriate for a child under 1 year and sodium bicarbonate 8.4% intravenous infusion in children over 1 year.
**Removal of earwax (with 5% ear drop solution) for sodium bicarbonate**
- **Child** (To the ear): (consult product literature).
Interactions
**Other interactions (3):**
- A time-interval of 2 hours should be considered between this medicine intake and the administration of other medicinal products, especially tetracyclines, digoxine, fluoroquinolone, iron salt,...
- Antacids reduce the absorption of certain drugs from the following groups: ACE Inhibitors, Analgesics, Antibacterials, Antiepileptics, Antifungals, Antimalarials, Antipsychotics, Bisphosphonates,...
- Due to effects at the renal level sodium bicarbonate may reduce plasma lithium levels and increase plasma quinidine levels.
Medicinal forms
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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