sodium bicarbonate

CLINICAL USE

Metabolic acidosis Alkalinisation of urine Renoprotection against contrast media

DOSE IN NORMAL RENAL FUNCTION

Oral: 0.5–1.5 g 3 times daily (or more may be required)IV: 8.4%, 60–120 mL per hour; 4.2%, up to 120 mL per hour; 1.26% or 1.4% - see ‘Other Information’

PHARMACOKINETICS

Molecular weight :84

%Protein binding :0

%Excreted unchanged in urine : <1

Volume of distribution (L/kg) :Dependent on the physical state of the patient at the time

half-life – normal/ESRD (hrs) :No data

DOSE IN RENAL IMPAIRMENT

GFR (mL/MIN)

20 to 50 : Dose as in normal renal function

10 to 20 : Dose as in normal renal function

<10 : Dose as in normal renal function

DOSE IN PATIENTS UNDERGOING RENAL REPLACEMENT THERAPIES

CAPD :Dialysed. Dose as in normal renal function

HD :Dialysed. Dose as in normal renal function

HDF/high flux :Dialysed. Dose as in normal renal function

CAV/VVHD :Dialysed. Dose as in normal renal function

IMPORTANT DRUG INTERACTIONS

Potentially hazardous interactions with other drugsIncreases lithium excretion

ADMINISTRATION

Reconstition

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Route

Oral, IV, central administration for undiluted infusion

Rate of Administration

–

Comments

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OTHER INFORMATION

Caution – may result in sodium retention and oedemaSodium bicarbonate 1.26% or 1.4% may be given IV to prevent the nephrotoxicity associated with scans or procedures involving radiological contrast media. A typical hydration regimen is 3 ml/kg/hour for 1 hour prior to the procedure, followed by 1 mL/kg/hour for 6 hours afterwards8.4% ≡ 1 mmol bicarbonate + 1 mmol sodium per mL500 mg sodium bicarbonate tablet ≡ 6 mmol sodium + 6 mmol bicarbonateSodium bicarbonate reduces serum potassium concentrations by inducing a shift of potassium ions into the cellA sugar free raspberry flavoured oral solution of 8.4% sodium bicarbonate is available from Martindalesodium bicarbonate.

See how to identify renal failure stages according to GFR calculation

See how to diagnose irreversible renal disease

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