sodium bicarbonate

Adult Dosing .

Dosage forms:  TAB: 325 mg, 650 mg; EFFERV TAB: 650 mg; PWDR: 2616 mg/0.5 tsp; INJ: various

Special Note

[strength clarification]

Info: 1 mEq = approx. 84 mg

metabolic acidosis, acute

[2-5 mEq/kg/dose IV x1]

Info: subsequent doses based on response and acid-base status

metabolic acidosis, chronic

[chronic renal failure]

Dose: 1625-2925 mg/day PO divided q4-6h; Info: adjust dose based on serum HCO3 levels

[distal renal tubular acidosis]

Dose: 42-168 mg/kg/day PO divided q4-6h; Info: adjust dose based on serum HCO3 levels

[proximal renal tubular acidosis]

Dose: 420-840 mg/kg/day PO divided q4-6h; Info: adjust dose based on serum HCO3 levels

urinary alkalinization

[975-1950 mg PO q4h]

Start: 3900 mg PO x1; Max: 15.6 g/day; Info: adjust dose based on urinary pH; max 7.8 g/day in pts 60 yo and older

dyspepsia

[<60 yo]

Dose: 650-2600 mg PO q4h prn; Max: 15.6 g/day; Alt: 2616 mg pwdr in 4 oz water PO q2h prn

[60 yo and older]

Dose: 650-1300 mg PO q4h prn; Max: 7800 mg/day; Alt: 2616 mg pwdr in 4 oz water PO q2h prn

salicylate overdose

[1-2 mEq/kg/dose IV x1]

Info: for pts w/ urinary pH <7.5; subsequent doses based on response and urinary pH

tricyclic antidepressant overdose (off-label)

[1-2 mEq/kg/dose IV x1]

Info: for pts w/ QRS >100ms or serum pH <7.45; subsequent doses based on response and serum pH

renal dosing

[see below]

renal impairment: not defined, caution advised; Info: may cause sodium retention

HD/PD: not defined

hepatic dosing

[not defined]

Peds Dosing .

Dosage forms:  TAB: 325 mg, 650 mg; EFFERV TAB: 650 mg; PWDR: 2616 mg/0.5 tsp; INJ: various

Special Note

[strength clarification]

Info: 1 mEq = approx. 84 mg

metabolic acidosis, acute

[individualize dose IV x1]

Dose: dose (mEq) = 0.3 x wt (kg) x base deficit (mEq/L); Alt: dose (mEq) = 0.5 x wt (kg) x (24 - serum HCO3 (mEq/L)); Info: subsequent doses based on response and acid-base status

metabolic acidosis, chronic

[chronic renal failure]

Dose: 84-252 mg/kg/day PO divided q4-6h; Info: adjust dose based on serum HCO3 levels

[distal renal tubular acidosis]

Dose: 168-252 mg/kg/day PO divided q4-6h; Info: adjust dose based on serum HCO3 levels

[proximal renal tubular acidosis]

Dose: 420-840 mg/kg/day PO divided q4-6h; Info: adjust dose based on serum HCO3 levels

urinary alkalinization

[84-840 mg/kg/day PO divided q4-6h]

Max: 15.6 g/day; Info: adjust dose based on urinary pH

dyspepsia

[6 yo and older]

Dose: 2616 mg pwdr in 4 oz water PO q2h prn; Max: 15.6 g/day

renal dosing

[not defined]

renal impairment: consider adult renal dosing for guidance

HD/PD: not defined

hepatic dosing

[not defined]