| Name | Sodium Bicarbonate |
| Uses | Alkalinizing agent used to help buffer acid levels in the body, support acid-base balance, and potentially assist with muscle recovery by counteracting lactic acid buildup. In wellness settings, it may be used for metabolic support, pH balance, and recovery in physically active individuals. |
| Route Of Administration | Intravenous (IV) |
| Frequency Of Use | Typically administered once every 2 to 4 weeks if clinically indicated based on symptom assessment or lab work (e.g., metabolic acidosis, high lactate levels). Frequency should be reassessed after 4 to 6 treatments. |
| Concentration(s) | Common concentration: 8.4% (1 mEq/mL). |
| Maximum Dosage (Day, Wk) (g/mL)/mL | Maximum dose per infusion: 50 mEq IV. Maximum weekly dose: 50 mEq. Excessive alkalinization may cause metabolic alkalosis or electrolyte imbalances. |
| Contraindications | Severe hypocalcemia, hypokalemia, or alkalosis. Known hypersensitivity to sodium bicarbonate. Severe renal impairment, uncontrolled hypertension, congestive heart failure (due to sodium load). Pregnancy and breastfeeding unless cleared by OB provider. |
| Possible Side Effects | Flushing, nausea, tingling sensation, or thirst during infusion. Injection site irritation. Rare: metabolic alkalosis (confusion, muscle twitching, hand tremor), or allergic reaction (rash, itching, hypersensitivity). |
| Compatibility With Other Drugs | Should not be mixed with calcium-containing solutions (may precipitate). May be incompatible with magnesium or certain vitamins (e.g., ascorbic acid). Compatibility must always be confirmed when added to multi-nutrient IVs. |
| Allergies | True allergy to sodium bicarbonate is rare, but reactions to preservatives in compounded formulations may occur. |
| Administration Time | Typical infusion time: 30 to 60 minutes when part of a multi-nutrient IV blend, or slower if given at higher doses. |
| IV Dosing | For wellness applications: 25 mEq to 50 mEq IV every 2 to 4 weeks, adjusted based on patient tolerance and clinical need. |
| IM/Push | Not recommended for IM use. IV push is possible but should be done very slowly (over at least 5 to 10 minutes) and only for acute correction of acidosis in monitored settings. |
| What To Do If Adverse Reaction Occurs | 1. Stop the infusion immediately if a reaction occurs. 2. Assess vital signs (blood pressure, heart rate, oxygen saturation). 3. If flushing, nausea, or tingling occurs, slow the infusion rate and provide supportive care. 4. For allergic reactions (rash, itching, shortness of breath), administer antihistamines and consider epinephrine if severe. 5. If metabolic alkalosis is suspected (confusion, tremor, muscle cramps), obtain blood gas and electrolyte panel. 6. If symptoms persist or worsen, arrange for emergency transfer to a higher level of care (call 911 if necessary). |