Consists of Potassium sulfate, sodium bicarbonate, sodium sulfate, tartaric acid
Potassium sulfate indications
1. For the treatment of patients with hypokalemia with or without metabolic alkalosis, in digitalis intoxication, and in patients with hypokalemic familial periodic paralysis. If hypokalemia is the result of diuretic therapy, consideration should be given to the use of a lower dose of diuretic, which may be sufficient without leading to hypokalemia.
2. For the prevention of hypokalemia in patients who would be at particular risk if hypokalemia were to develop, eg, digitalized patients or patients with significant cardiac arrhythmias.
The use of potassium salts in patients receiving diuretics for uncomplicated essential hypertension is often unnecessary when such patients have a normal dietary pattern and when low doses of the diuretic are used. Serum potassium should be checked periodically, however, and if hypokalemia occurs, dietary supplementation with potassium-containing foods may be adequate to control milder cases. In more severe cases, and if dose adjustment of the diuretic is ineffective or unwarranted, supplementation with potassium salts may be indicated.
Potassium sulfate description
A white crystal or crystalline powder used as an electrolyte replenisher, in the treatment of hypokalemia, in buffer solutions, and in fertilizers and explosives.
Potassium sulfate dosage
1 pack to be dissolved in water to make about 2 L soln.
Orally administer 2-4 L of the soln at a rate of 1 L/hr. Discontinue dosing at the time excretion liqd becomes clear.
Potassium sulfate interactions
Disturbs absorption of orally administered drugs.
Potassium sulfate side effects
One of the most severe adverse effects is hyperkalemia. There have also been reports of upper and lower gastrointestinal conditions including obstruction, bleeding, ulceration, and perforation.
The most common adverse reactions to oral potassium salts are nausea, vomiting, flatulence, abdominal pain/discomfort, and diarrhea. These symptoms are due to irritation of the gastrointestinal tract and are best managed by diluting the preparation further, taking the dose with meals or reducing the amount taken at one time.
Potassium sulfate contraindications
Potassium supplements are contraindicated in patients with hyperkalemia since a further increase in serum potassium concentration in such patients can produce cardiac arrest. Hyperkalemia may complicate any of the following conditions: chronic renal failure, systemic acidosis such as diabetic acidosis, acute dehydration, extensive tissue breakdown as in severe burns, adrenal insufficiency, or the administration of a potassium-sparing diuretic (e.g., spironolactone, triamterene, amiloride).
Controlled-release formulations of potassium chloride have produced esophageal ulceration in certain cardiac patients with esophageal compression due to an enlarged left atrium. Potassium supplementation, when indicated in such patients, should be given as an immediate-release liquid preparation.
All solid oral dosage forms of potassium chloride are contraindicated in any patient in whom there is structural, pathological (e.g., diabetic gastroparesis) or pharmacologic (use of anticholinergic agents or other agents with anticholinergic properties at sufficient doses to exert anticholinergic effects) cause for arrest or delay in tablet or capsule passage through the gastrointestinal tract.
What is Sodium bicarbonate?
Sodium bicarbonate, also known as baking soda, is used to relieve heartburn, sour stomach, or acid indigestion by neutralizing excess stomach acid. When used for this purpose, it is said to belong to the group of medicines called antacids. It may be used to treat the symptoms of stomach or duodenal ulcers. Sodium bicarbonate is also used to make the blood and urine more alkaline in certain conditions.
Antacids should not be given to young children (up to 6 years of age) unless prescribed by their doctor. Since children cannot usually describe their symptoms very well, a doctor should check the child before giving sodium bicarbonate. The child may have a condition that needs other treatment. If so, antacids will not help and may even cause unwanted effects or make the condition worse.
Sodium bicarbonate for oral use is available without a prescription.
Sodium bicarbonate indications
Sodium Bicarbonate (sodium bicarbonate 5% injection) Injection may be indicated in the treatment of metabolic acidosis which can occur in severe renal disease, uncontrolled diabetes, circulatory insufficiency due to shock, anoxia or severe dehydration, extracorporeal circulation of blood and severe primary lactic acidosis. Sodium Bicarbonate (sodium bicarbonate 5% injection) Injection is further indicated in the treatment of certain drug intoxications, including barbiturates, in poisoning by salicylates or methyl alcohol, and in hemolytic reactions requiring alkalinization of the urine to diminish nephrotoxicity of blood pigments. Sodium Bicarbonate (sodium bicarbonate 5% injection) Injection may also be indicated in severe diarrhea which is often accompanied by a significant loss of bicarbonate.
How should I use Sodium bicarbonate?
Use sodium bicarbonate as directed by your doctor. Check the label on the medicine for exact dosing instructions.
- Sodium bicarbonate is usually administered as an injection at your doctor's office, hospital, or clinic. If you are using sodium bicarbonate at home, carefully follow the injection procedures taught to you by your health care provider.
- If sodium bicarbonate contains particles or is discolored, or if the vial is cracked or damaged in any way, do not use it.
- Keep this product, as well as syringes and needles, out of the reach of children and away from pets. Do not reuse needles, syringes, or other materials. Dispose of properly after use. Ask your doctor or pharmacist to explain local regulations for proper disposal.
- If you miss a dose of sodium bicarbonate, contact your doctor immediately.
Ask your health care provider any questions you may have about how to use sodium bicarbonate.
Uses of Sodium bicarbonate in details
Use: Labeled Indications
Management of metabolic acidosis; gastric hyperacidity; alkalinization of the urine; treatment of hyperkalemia; management of overdose of certain drugs, including tricyclic antidepressants and aspirin
Neutralizing additive (dental use): Improves onset of analgesia and reduces injection site pain by adjusting lidocaine with epinephrine solution to a more physiologic pH.
Off Label Uses
Contrast-induced nephropathy (CIN) (prevention)
Evidence from controlled trials supports the use of isotonic sodium bicarbonate as an effective option in the prevention of contrast-induced nephropathy (CIN), demonstrating reduced incidence compared to sodium chloride.
Kidney Disease Improving Global Outcomes (KDIGO) guidelines state that in patients at increased risk of contrast-induced acute kidney injury (CI-AKI), IV volume expansion with either isotonic sodium chloride or isotonic sodium bicarbonate solutions is recommended rather than no IV volume expansion. Isotonic sodium bicarbonate is not commercially available, and thus carries a risk for compounding error during preparation. Based on the potential for harm and additional burden of preparing bicarbonate solutions, no preference is given to one solution; either agent can be used, with ease of use recognized for isotonic saline (KDIGO 2012a). European Society of Urogenital Radiology (ESUR) Contrast Media Safety Committee guidelines state that IV isotonic sodium bicarbonate appears to provide protection equal or superior to IV isotonic saline, but either regimen may be used (ESUR [Stacul 2011]).
Sodium bicarbonate description
Sodium bicarbonate is a white, crystalline powder that is commonly used as a pH buffering agent, an electrolyte replenisher, systemic alkalizer and in topical cleansing solutions.
Sodium bicarbonate dosage
One vial (5 mL) of Sodium bicarbonate added to a liter (1000 mL) of any of the following Hospira parenteral solutions will increase the pH to a more physiologic range. Specific pH may vary slightly from lot to lot.
Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. See PRECAUTIONS.
Addition of one vial of Sodium bicarbonate to one-half liter (500 mL) is recommended to achieve a more physiologic pH of the following Hospira parenteral solutions:
Note: Some products, e.g., Amniosyn® solutions and those lonosol® and Normosol® formulas containing dextrose will NOT be brought to near physiologic pH by the addition of Sodium bicarbonate. This is due to the relatively high buffer capacity of these fluids.
COMPATIBILITY & EFFECTIVNESS FO Sodium bicarbonate WITH ADDITIVES TO 5% DEXTROSE INJECTION (D5-W)
When medications are added to intravenous solutions, the resultant admixtures may or may not be compatible in solutions containing Sodium bicarbonate (4% sodium bicarbonate additive solution).
Following is a list of medications each added to one liter of 5% Dextrose Injection, USP (D5-W) classified according to their effect with Sodium bicarbonate (4% sodium bicarbonate additive solution).
It should be noted that the admixtures were evaluated for physical compatibility, not for pharmacological compatibility. It, therefore, would be erroneous to circumvent medical judgment which must be involved in administering any solution that appears to be compatible on the basis of having no visible haze or precipitate. The inclusion of drugsin this study of their compatibility in solution does not imply their therapeutic usefulness or safety. This matter remains the judgment of the prescribing physician.
NOTE: The compatibility information contained herein in based on the studies involving Hospira dextrose only. Variationsin compativility could occur due to lot-to-lot variations or formula changes in the additivies or dextrose solutions of other manufacturers.
Sodium bicarbonate interactions
See also:
What other drugs will affect Sodium bicarbonate?
Amphetamine, dextroamphetamine, ephedrine, flecainide, mecamylamine, methamphetamine, pseudoephedrine, quinidine
Sodium bicarbonate can decrease elimination of these drugs, thus increasing their therapeutic effects.
Chlorpropamide, lithium, methotrexate, salicylates, tetracyclines
Sodium bicarbonate can increase elimination of these drugs, thus decreasing their therapeutic effect.
Ketoconazole
PO sodium bicarbonate may decrease the dissolution of ketoconazole in the GI tract, reducing the effectiveness.
Incompatibility
Do not mix with IV solutions containing catecholamines, such as dobutamine, dopamine, and norepinephrine.
Sodium bicarbonate side effects
See also:
What are the possible side effects of Sodium bicarbonate?
Applies to sodium bicarbonate: capsule, granule, powder, solution, tablet
Along with its needed effects, sodium bicarbonate (the active ingredient contained in Sodium bicarbonate) may cause some unwanted effects. Although the following side effects occur very rarely when this medicine is taken as recommended, they may be more likely to occur if it is taken: in large doses, for a long time, or by patients with kidney disease.
Severity: Moderate
If any of the following side effects occur while taking sodium bicarbonate, check with your doctor or nurse as soon as possible:
- Frequent urge to urinate
- headache (continuing)
- loss of appetite (continuing)
- mood or mental changes
- muscle pain or twitching
- nausea or vomiting
- nervousness or restlessness
- slow breathing
- swelling of feet or lower legs
- unpleasant taste
- unusual tiredness or weakness
Minor Side Effects
Some sodium bicarbonate side effects may not need any medical attention. As your body gets used to the medicine these side effects may disappear. Your health care professional may be able to help you prevent or reduce these side effects, but do check with them if any of the following side effects continue, or if you are concerned about them:
Less common:
- Increased thirst
- stomach cramps
Sodium bicarbonate contraindications
See also:
What is the most important information I should know about Sodium bicarbonate?
Sodium Bicarbonate (sodium bicarbonate 5% injection) Injection is contraindicated in patients with metabolic and respiratory alkalosis and in patients with hypocalcemia in which alkalosis may produce tetany.
Sodium sulfate indications
constipation
Active ingredient matches for Potassium sulfate/sodium bicarbonate/sodium sulfate/tartaric acid:
Potassium sulfate/sodium bicarbonate/sodium sulfate/tartaric acid
References
- DailyMed. "SODIUM BICARBONATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- DailyMed. "POLYETHYLENE GLYCOL 3350; POTASSIUM CHLORIDE; SODIUM BICARBONATE; SODIUM CHLORIDE; SODIUM SULFATE ANHYDROUS: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
- PubChem. "Potassium". https://pubchem.ncbi.nlm.nih.gov/com... (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
