Actions of Sodium Bicarbonate in details
Sodium Bicarbonate is a systemic alkalizer, which increases plasma bicarbonate, buffers excess hydrogen ion concentration, and raises blood pH, thereby reversing the clinical manifestations of acidosis. It is also a urinary alkalizer, increasing the excretion of free bicarbonate ions in the urine, thus effectively raising the urinary pH. By maintaining an alkaline urine, the actual dissolution of uric acid stones may be accomplished. Sodium Bicarbonate acts as an antacid and reacts chemically to neutralize or buffer existing quantities of stomach acid but has no direct effect on its output. This action results in increased pH value of stomach contents, thus providing relief of hyperacidity symptoms. [PharmGKB]
How should I take Sodium Bicarbonate?
For safe and effective use of Sodium Bicarbonate:
- Follow your doctor's instructions if Sodium Bicarbonate was prescribed.
- Follow the manufacturer's package directions if you are treating yourself.
For patients taking Sodium Bicarbonate for a stomach ulcer :
- Take it exactly as directed and for the full time of treatment as ordered by your doctor, to obtain maximum relief of your symptoms.
- Take it 1 and 3 hours after meals and at bedtime for best results, unless otherwise directed by your doctor.
Dosing
The dose of Sodium Bicarbonate will be different for different patients. Follow your doctor's orders or the directions on the label. The following information includes only the average doses of Sodium Bicarbonate. If your dose is different, do not change it unless your doctor tells you to do so.
The amount of medicine that you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depend on the medical problem for which you are using the medicine.
- For Sodium Bicarbonate effervescent powder:
- To relieve heartburn or sour stomach:
- Adults and teenagers—3.9 to 10 grams (1 to 2½ teaspoonfuls) in a glass of cold water after meals. However, the dose is usually not more than 19.5 grams (5 teaspoonfuls) a day.
- Children up to 6 years of age—Dose must be determined by your doctor.
- Children 6 to 12 years of age—1 to 1.9 grams (¼ to ½ teaspoonful) in a glass of cold water after meals.
- To relieve heartburn or sour stomach:
- For Sodium Bicarbonate powder:
- To relieve heartburn or sour stomach:
- Adults and teenagers—One-half teaspoonful in a glass of water every two hours. Your doctor may change the dose if needed.
- Children—Dose must be determined by your doctor.
- To make the urine more alkaline (less acidic):
- Adults and teenagers—One teaspoonful in a glass of water every four hours. Your doctor may change the dose if needed. However, the dose is usually not more than 4 teaspoonfuls a day.
- Children—Dose must be determined by your doctor.
- To relieve heartburn or sour stomach:
- For Sodium Bicarbonate tablets:
- To relieve heartburn or sour stomach:
- Adults and teenagers—325 milligrams (mg) to 2 grams one to four times a day.
- Children up to 6 years of age—Dose must be determined by your doctor.
- Children 6 to 12 years of age—The dose is 520 mg. The dose may be repeated in thirty minutes.
- To make the urine more alkaline (less acidic):
- Adults and teenagers—At first, four grams, then 1 to 2 grams every four hours. However, the dose is usually not more than 16 grams a day.
- Children—The dose is based on body weight and must be determined by your doctor. The usual dose is 23 to 230 mg per kilogram (kg) (10.5 to 105 mg per pound) of body weight a day. Your doctor may change the dose if needed.
- To relieve heartburn or sour stomach:
Missed Dose
If you miss a dose of Sodium Bicarbonate, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.
Storage
Store the medicine in a closed container at room temperature, away from heat, moisture, and direct light. Keep from freezing.
Keep out of the reach of children.
Do not keep outdated medicine or medicine no longer needed.
Sodium Bicarbonate administration
IV: For direct IV infusion in emergencies, administer slowly; for infusion, dilute to a maximum concentration of 0.5 mEq/mL in dextrose solution and infuse over at least 2 hours (maximum rate of administration: 1 mEq/kg/hour).
Vesicant (at concentrations ≥8.4%); ensure proper needle or catheter placement prior to and during IV infusion. Avoid extravasation.
Extravasation management: If extravasation occurs, stop infusion immediately and disconnect (leave needle/cannula in place); gently aspirate extravasated solution (do NOT flush the line); initiate hyaluronidase antidote; remove needle/cannula; apply dry cold compresses (Hurst 2004; Reynolds 2014); elevate extremity.
Hyaluronidase: Intradermal or SubQ: Inject a total of 1 to 1.7 mL (15 units/mL) as five separate 0.2 to 0.3 mL injections (using a 25-gauge needle) into area of extravasation at the leading edge in a clockwise manner (Reynolds 2014).
Oral product should be administered 1 to 3 hours after meals.
Infiltration (dental use; Onpharma): Add specified volume of 8.4% Sodium Bicarbonate directly with lidocaine and epinephrine injection and mix; use immediately after mixing.
Sodium Bicarbonate pharmacology
Intravenous Sodium Bicarbonate therapy increases plasma bicarbonate, buffers excess hydrogen ion concentration, raises blood pH and reverses the clinical manifestations of acidosis.
Sodium Bicarbonate in water dissociates to provide sodium (Na+) and bicarbonate (HCO3-) ions. Sodium (Na+) is the principal cation of the extracellular fluid and plays a large part in the therapy of fluid and electrolyte disturbances. Bicarbonate (HCO3-) is a normal constituent of body fluids and the normal plasma level ranges from 24 to 31 mEq/liter. Plasma concentration is regulated by the kidney through acidification of the urine when there is a deficit or by alkalinization of the urine when there is an excess. Bicarbonate anion is considered “labile” since at a proper concentration of hydrogen ion (H+) it may be converted to carbonic acid (H2CO3) and thence to its volatile form, carbon dioxide (CO2) excreted by the lung. Normally a ratio of 1:20 (carbonic acid; bicarbonate) is present in the extracellular fluid. In a healthy adult with normal kidney function, practically all the glomerular filtered bicarbonate ion is reabsorbed; less than 1% is excreted in the urine.
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).
- NCIt. "Sodium Bicarbonate: NCI Thesaurus (NCIt) provides reference terminology for many systems. It covers vocabulary for clinical care, translational and basic research, and public information and administrative activities.". https://ncit.nci.nih.gov/ncitbrowser... (accessed September 17, 2018).
- EPA Safer Choice. "EPA Safer Chemical Ingredients Classification: Safer Choice of the U.S. Environmental Protection Agency (EPA) helps consumers, businesses, and purchasers find products that perform and are safer for human health and the environment. This classification is created based on the use classes of each chemical ingredient from the EPA Safer Choice.". https://www.epa.gov/saferchoice (accessed September 17, 2018).
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Information checked by Dr. Sachin Kumar, MD Pharmacology
