SODIUM BICARBONATE

Posology The posology depends largely on the extent of the acid-base imbalance. 4% solution) given at 10-minute intervals.

Paediatric population:

The usual dose is 1mmol/kg by slow iv injection. 4% solution should be diluted 1:1 with 5% dextrose.

Elderly:

As for adults. Method of administration For intravenous administration only.

Metabolism and nutrition disorders:

Alkalosis, hypokalaemia, hypernatremia, hyperosmolarity, hypocalcemia, hypoglycemia, paradoxical intracellular acidosis.

Cardiac disorder:

Deterioration of hemodynamic status associated with volume overload.

Nervous system disorders:

Intracranial haemorrhage (in neonates), hyperirritability or tetany.

General disorders and administration site conditions:

Extravasation. Incorrect administration (intra-arterial, paravenous) may cause tissue necrosis. Reporting of suspected adverse reactions Reporting suspected adverse reactions after authorisation of the medicinal product is important.

It allows continued monitoring of the benefit/risk balance of the medicinal product. uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.

Whenever sodium bicarbonate is used intravenously, arterial blood gas analyses, in particular arterial/venous blood pH and carbon dioxide levels, should be performed before and during the course of treatment to minimise the possibility of overdosage and resultant alkalosis.

Accidental extravascular injection of hypertonic solutions may cause vascular irritation or sloughing. The use of scalp veins should be avoided. Whenever respiratory acidosis is concomitant with metabolic acidosis, both pulmonary ventilation and perfusion must be adequately supported to get rid of excess CO2.

Administration of sodium bicarbonate to a patient with inadequate minute ventilation can cause worsening of the acidosis. The treatment of metabolic acidosis must, if possible, be combined with concurrent treatment to combat the primary cause of the acidosis, for example the administration of insulin in uncomplicated diabetes, or blood volume restoration in shock.

In long-term therapy, care is essential to prevent the risk of overdose and alkalosis. Therefore, repeat administrations of fractional doses, or an infusion, should be given while regularly monitoring the acid-base balance and electrolytes.

As soon as the most severe symptoms are under control, the dose and frequency of administration must be reduced until normal values have been restored. There is no evidence to support the use of bicarbonate therapy in the treatment of hypoperfusion-induced lactic academia associated with sepsis.

15% of the WHO recommended maximum daily intake of 2 g sodium for an adult.

g. renal failure, hypertension, oedema, congestive heart failure) • Patients with hypoventilation (risk of worsening of acidosis) • Metabolic or respiratory alkalosis • Patients with a history of urinary calculi • Patients with coexistent potassium depletion or chloride depletion, hypocalcaemia and hypernatraemia.