Sodium bicarbonate injection is typically used to lower the amount of acid in the blood when the acid level is too high, which can happen with certain medical conditions such as kidney problems, uncontrolled diabetes, or heart conditions. It can also help restore bicarbonate levels in the body if a person experiences severe diarrhea. Sodium bicarbonate injection is infused into your veins (IV) by a healthcare provider, typically in a hospital setting. The dosage of sodium bicarbonate injection depends on your specific condition. You might experience certain side effects, such as muscle twitching or numbness, if you receive too much sodium bicarbonate.
Lower blood acid levels when it's too high (metabolic acidosis)
Reverse the toxic side effects of certain medications, such as barbituates
Restore bicarbonate levels after severe diarrhea
Sodium bicarbonate is an alkalinizing agent that neutralizes, or balances, the pH level of your blood to help reverse the effects of having acidic blood. It also serves to restore sodium and bicarbonate that your body might have lost.
Source: DailyMed
Works quickly to correct electrolyte disturbances or low acid blood levels
Dosage can be adjusted based on your response
Not recommended for people with certain medical conditions, such as high blood pressure, heart failure, and kidney problems
Given as an injection into your veins
Sodium bicarbonate injection contains sodium, which is present in table salt. Avoid this medication if you've been told to limit or restrict salt in your diet due to conditions like high blood pressure or congestive heart failure. If you have any of these health conditions, ask your healthcare provider before taking sodium bicarbonate.
There's not enough information to say whether sodium bicarbonate injection is safe during pregnancy. If you're pregnant or thinking of becoming pregnant, talk with your provider.
Let your provider know if you notice tremors, a tingling sensation, or muscle twitching, any time during your treatment. These might be symptoms of too much bicarbonate and your provider might need to adjust your dose of sodium bicarbonate injection.
Keep an eye on the site where sodium bicarbonate injection is being injected into your veins. If you notice redness, pain, or swelling, let your provider know.
Sodium bicarbonate injection can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Risk factors: Congestive heart failure | Severe kidney disease | High blood pressure
Sodium bicarbonate injection contains sodium, which can cause your body to hold on to fluid. This can be especially troublesome for people with heart failure or kidney disease because a buildup of fluid can worsen their symptoms. Hanging on to fluid can also cause your blood pressure to rise. Make sure to tell your provider about your full medical history before getting this medication.
Your provider will determine your dose of sodium bicarbonate injection (measured in milliequivalents, or mEq). The dose will depend on factors such as what you're being treated for, how serious your condition is, your weight, and certain lab results.
For example:
To lower acid levels (in less urgent situations): The typical dose is based on your weight and response to the medication, and is often added to other IV fluids that you'll receive over a 4 to 8 hour period.
People taking certain diuretics (water pills)
People who are vomiting or are getting gastric suction and are losing chloride
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Brinkman, J. E., et al. (2023). Physiology, metabolic alkalosis. StatPearls.
Hospira, Inc. (2023). Sodium bicarbonate injection, solution [package insert]. DailyMed.
Lewis, III, J. L., et al. (2023). Overview of acid-base balance. Merck Manual Consumer Version.
MedlinePlus. (2021). Alkalosis.
Mirrakhimov, A. E., et al. (2017). The role of sodium bicarbonate in the management of some toxic ingestions. International Journal of Nephrology.
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