Adult Dosing
Antacid
- <60 yrs
- 650 mg-2600 mg PO q4 hrs
- 1-4 tabs (of 650 mg) or 2-8 tabs (of 325 mg) PO q4 hrs
- Max: 24 tabs (of 650 mg)/day or 48 tabs (of 325 mg)/day
- >60 yrs
- 650 mg-1300 mg PO q4 hrs
- 1-2 tabs (of 650 mg) or 2-4 tabs (of 325 mg) PO q4 hrs
- Max: 12 tabs (of 650 mg)/day or 24 tabs (of 325 mg)/day
Notes:- Tablets may be swallowed whole or dissolved in water
- Do not exceed the recommended dosages
Alkalinization of urine
- Start 48 mEq (4g) PO, continue with 12-24 mEq (1-2 g) q4 hrs
Renal tubular acidosis
- Chronic renal failure
- 20-36 mEq/day PO in 4-5 divided doses
- Distal renal tubular acidosis
- 0.5-2 mEq/kg/day PO in 4-5 divided doses
- Proximal renal tubular acidosis
- 4-10 mEq/kg/day PO in 4-5 divided doses
Note: Individualize dosage based on serum bicarbonate level
Pediatric Dosing
Antacid
- >12 yrs
- 650 mg-2600 mg PO q4 hrs
- 1-4 tabs (of 650 mg) or 2-8 tabs (of 325 mg) PO q4 hrs
- Max: 24 tabs (of 650 mg)/day or 48 tabs (of 325 mg)/day
Notes:
- Tablets may be swallowed whole or dissolved in water
- Do not exceed the recommended dosages
Alkalinization of urine
- 1-10 mEq/kg/day or 84-840 mg/kg/day PO in divided doses
Renal tubular acidosis
- Chronic renal failure
- 1-3 mEq/kg/day PO in 4-5 divided doses
- Distal renal tubular acidosis
- 2-3 mEq/kg/day PO in 4-5 divided doses
- Proximal renal tubular acidosis
- 5-10 mEq/kg/day PO in 4-5 divided doses
Note: Individualize dosage based on serum bicarbonate level
[Outline]
See Supplemental Patient Information
- Use cautiously in patients with CHF, severe renal impairment and in patients with conditions involving edema and sodium retention, as it may cause sodium retention, overhydration, dilution of electrolytes, fluid overload, congestion and pulmonary edema
- Use cautiously in patients with oliguria or anuria
- Therapy may cause potassium depletion, predisposing patients to metabolic alkalosis. Existing hypocalcemia may result in carpopedal spasm due to increase in plasma pH. Correction of electrolyte imbalances before or during bicarbonate therapy can minimize such risks
- Periodic monitoring of CO2 content and blood pH is recommended to prevent risk of overdosage
- Avoid use in presence of symptoms of appendicitis such as abdominal pain, nausea, vomiting
- Advise patients to avoid use of sodium bicarbonate if they are on a sodium restricted diet, unless directed by physician
- Advise patients to consult their physician/pharmacist if they are currently using prescription medications, as antacids may potentially interact with some drugs
- Advise patients to seek medical attention if symptoms of hyperacidity last for more than two weeks. Use beyond 2 weeks is not recommended unless specified by physician
- Recommended dosage should not be exceeded. In case of overdosage, advise patients to contact poison control center or seek medical help promptly
Cautions: Use cautiously in
- CHF
- Severe renal impairment
- Edema
- Sodium retention
- Oliguria
- Anuria
- Hypocalcemia
- Hypokalemia
- Hypernatremia
- Elderly
- Children <2 yrs
Supplemental Patient Information
- Advise patients to consult their physician/pharmacist if they are using other medications, as antacids may interact with some drugs
- Advise patients to keep the drug out of reach of children
- Advise patients to avoid use if they are on a sodium restricted diet, unless directed by physician
- Advise patients to seek medical attention if symptoms of hyperacidity last for more than two weeks
- In case of overdosage, advise patients to contact poison control center or seek medical help promptly
Pregnancy Category:C
Breastfeeding: Safety unknown. Manufacturer recommends consultation with a health professional before use, if mother is breastfeeding an infant
US Trade Name(s)
US Availability
sodium bicarbonate (generic)
Canadian Trade Name(s)
Canadian Availability
UK Trade Name(s)
- Boots Gripe Mixture 1 Month Plus
- Boots Sodium Bicarbonate
UK Availability
Boots Gripe Mixture 1 Month Plus
Boots Sodium Bicarbonate
Australian Trade Name(s)
Australian Availability
Sodbic
[Outline]