Sodium Bicarbonate is a systemic and urinary alkalinizing agent. It is a white, crystalline powder that dissociates to provide bicarbonate (HCO3-) and sodium (Na+) ions. Bicarbonate is a normal constituent of body fluids and the primary buffer in the blood. It acts to neutralize excess acid, correct metabolic acidosis, and alkalinize urine. In the Indian context, it is widely used for gastric hyperacidity, as an adjunct in management of metabolic acidosis, and for urinary alkalinization.
Adult: As an antacid: 0.5 to 2 grams (1 to four 500mg tablets) dissolved in a glass of water, 1-4 times daily, 1-2 hours after meals and at bedtime. Maximum 16 grams/day. For systemic alkalinization: As directed by physician, typically 4-8 grams daily in divided doses.
Note: Tablets must be completely dissolved in a full glass (120-240 mL) of water before ingestion. Do not swallow tablets whole. Take 1-2 hours after meals and at bedtime for antacid effect. For urinary alkalinization, doses are often taken at bedtime. Do not take with large amounts of milk or dairy products.
Sodium bicarbonate dissociates in water to provide sodium ions (Na+) and bicarbonate ions (HCO3-). The bicarbonate ion is a component of the body's primary buffering system (HCO3-/H2CO3). It neutralizes hydrogen ions (H+) to form carbonic acid (H2CO3), which rapidly dissociates into water and carbon dioxide (CO2). This reaction increases blood and urinary pH, thereby correcting acidosis and reducing acidity in the stomach lumen.
Pregnancy: Pregnancy Category C (US FDA). Use during pregnancy only if clearly needed. Short-term use for dyspepsia is generally considered safe. Chronic or high-dose use should be avoided due to risks of fluid retention and metabolic disturbances.
Driving: No known effects on driving ability.
| Ketoconazole, Itraconazole | Increased gastric pH reduces absorption of these azole antifungals. | Major |
| Aspirin and other Salicylates | Alkalinization of urine increases renal excretion of salicylates, reducing their effect. Conversely, used intentionally to treat salicylate overdose. | Moderate |
| Quinolone Antibiotics (e.g., Ciprofloxacin) | Reduced absorption due to chelation with divalent cations in antacids; administer at least 2 hours apart. | Moderate |
| Tetracycline Antibiotics | Reduced absorption; administer at least 2-3 hours apart. | Moderate |
| Lithium | Increased urinary pH may decrease lithium excretion, potentially increasing lithium levels and risk of toxicity. | Moderate |
| Methotrexate | Alkalinization of urine can reduce renal clearance of methotrexate, increasing risk of toxicity. | Moderate |
| Anticholinergics (e.g., Atropine) | Increased risk of systemic alkalosis due to delayed gastric emptying. | Minor |
| Digoxin | Hypokalemia induced by alkalosis can potentiate digoxin toxicity. | Major |
| Chlorpropamide | May potentiate chlorpropamide-induced facial flushing. | Minor |
Same composition (Sodium Bicarbonate (500mg)), different brands: