{"product_id":"sodium-bicarbonate-injection-4-2-single-dose-vials-5-ml-x-25-tray-by-pfizer-rx","title":"Sodium Bicarbonate 4.2% Injection Hospira, Single Dose 5 ml x 25\/Tray (RX)","description":"\u003ch1\u003eSodium Bicarbonate 4.2% Injection\u003c\/h1\u003e\n\u003cp\u003eSodium bicarbonate 4.2% injection is a \u003cstrong\u003esterile intravenous electrolyte solution\u003c\/strong\u003e used to \u003cstrong\u003etreat metabolic acidosis\u003c\/strong\u003e and other conditions requiring systemic alkalinization. The 4.2% solution contains a high concentration of sodium bicarbonate (about 42 mg\/mL, providing 0.5 mEq each of Na⁺ and HCO₃⁻ per mL). This solution is hypertonic and has a near-alkaline pH (~7.0–8.5). When given IV, it \u003cstrong\u003eincreases blood bicarbonate levels, buffers excess hydrogen ions\u003c\/strong\u003e, and \u003cstrong\u003eraises blood pH\u003c\/strong\u003e, thereby correcting acidosis. In the body, bicarbonate combines with hydrogen ions to form carbonic acid, which then converts to carbon dioxide (exhaled by the lungs).\u003c\/p\u003e\n\u003ch2\u003eUses (Indications)\u003c\/h2\u003e\n\u003cp\u003eAccording to official prescribing information, sodium bicarbonate injection is indicated for \u003cstrong\u003etreatment of metabolic acidosis\u003c\/strong\u003e in various critical settings. For example, it is used in severe acidosis associated with:\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eRenal failure:\u003c\/strong\u003e When kidneys cannot reabsorb bicarbonate, patients develop acidosis that needs correction.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eUncontrolled diabetes (DKA):\u003c\/strong\u003e Ketoacidosis can cause dangerously low pH (though insulin is primary treatment). Bicarbonate may be given if pH is extremely low.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eCirculatory shock or severe dehydration:\u003c\/strong\u003e Shock (from bleeding, sepsis, etc.) and dehydration can lead to lactic acidosis. Bicarbonate may be used as a \u003cstrong\u003ebridge\u003c\/strong\u003e while restoring circulation or fluids.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eCardiac arrest:\u003c\/strong\u003e During CPR, severe acidosis (from low perfusion) can occur. Sodium bicarbonate may help neutralize acid during resuscitation.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eExtracorporeal circulation:\u003c\/strong\u003e Procedures like cardiopulmonary bypass or hemodialysis can disturb acid–base balance; bicarbonate is used to counteract acidosis.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003eIt is also indicated for \u003cstrong\u003ecertain poisonings or toxin exposures\u003c\/strong\u003e where alkalinizing the blood or urine is beneficial. These include:\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eAspirin (salicylate) overdose:\u003c\/strong\u003e Bicarbonate can help ionize the drug and reduce CNS uptake.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eBarbiturate poisoning:\u003c\/strong\u003e Raises blood\/urine pH to promote excretion of barbiturates (which are weak acids).\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eMethanol or ethylene glycol poisoning:\u003c\/strong\u003e Helps slow conversion of toxins to acids and increases excretion.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eHemolytic reactions:\u003c\/strong\u003e In patients with massive hemolysis, bicarbonate is given to alkalinize the urine and prevent kidney damage from hemoglobin breakdown products.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003eFurthermore, sodium bicarbonate injection may be used for \u003cstrong\u003esevere acidosis from other causes\u003c\/strong\u003e (e.g. prolonged seizures, severe diarrhea with bicarbonate loss) where urgent correction of pH is needed. In all cases, treating the underlying cause (e.g. giving insulin for DKA, fluid for shock) must be done in parallel.\u003c\/p\u003e\n\u003ch2\u003eAdministration and Dosage\u003c\/h2\u003e\n\u003cp\u003eThis medication is \u003cstrong\u003egiven intravenously only\u003c\/strong\u003e under medical supervision (usually in a hospital). The dose and rate depend on the patient’s blood pH, plasma CO₂ (bicarbonate) level, and body size. Common principles:\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eConcentration and equivalence:\u003c\/strong\u003e 4.2% solution means 4.2 grams per 100 mL. Each mL contains 0.5 mEq of bicarbonate. For reference, a full 50 mL vial of 4.2% contains 2.1 grams (approximately 25 mEq) of bicarbonate.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eDosing:\u003c\/strong\u003e Often, doctors may give 1–2 ampules (50–100 mL) of 4.2% solution IV as a bolus or over 10–20 minutes, then reassess. Larger, slower infusions may be needed for ongoing therapy. (In emergent cases like cardiac arrest, 1 ampule may be given rapidly, but caution is needed.)\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eAdministration:\u003c\/strong\u003e Only use a \u003cstrong\u003enew sterile syringe\u003c\/strong\u003e and needle. Draw up the required volume (discard any unused portion, as it’s meant for single-dose use). Inject or infuse \u003cstrong\u003eslowly\u003c\/strong\u003e—rapid injection can cause severe hypotension. It is often diluted in IV fluid (e.g. with normal saline or D5W) and infused with a pump. The medical team will monitor blood gases, electrolytes, and vital signs during administration.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eMonitoring:\u003c\/strong\u003e Expect the patient to have frequent blood gas checks (pH, bicarbonate levels) to see if acidosis is corrected. Doses are often split into 4–6 hour intervals if needed, since infusion shifts the buffer system gradually.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003eThe goal is to raise blood bicarbonate to a safe level (often targeting a pH in the low 7s). \u003cstrong\u003eOvercorrection is dangerous\u003c\/strong\u003e, so it’s given in fractional doses and labs are rechecked. Medical staff will also watch fluid balance, as the solution adds significant sodium and volume.\u003c\/p\u003e\n\u003ch2\u003eSide Effects and Precautions\u003c\/h2\u003e\n\u003cp\u003eBecause sodium bicarbonate injection strongly affects pH and sodium load, it has important risks:\u003c\/p\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eAlkalosis:\u003c\/strong\u003e If too much bicarbonate is given, \u003cstrong\u003emetabolic alkalosis\u003c\/strong\u003e can occur. Symptoms of alkalosis include muscle twitching, irritability, tetany or cramps (from low calcium\/phosphate), and confusion. To avoid this, dosage is guided by blood tests. Bicarbonate therapy is usually reserved for \u003cem\u003esevere\u003c\/em\u003e acidosis, not mild cases.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eSodium and fluid overload:\u003c\/strong\u003e Each mL of 4.2% contains 0.5 mEq Na⁺. Large doses can deliver many milliequivalents of sodium, potentially leading to \u003cstrong\u003ehypernatremia\u003c\/strong\u003e or worsened edema. Patients with heart failure, kidney failure, hypertension, or fluid retention must be given this drug cautiously (if at all), because they may not handle the extra salt and water.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eInfiltration injury:\u003c\/strong\u003e The solution is highly alkaline and hypertonic. If the IV leaks into the tissue (extravascular infiltration), it can cause \u003cstrong\u003esevere tissue injury\u003c\/strong\u003e. Cases of chemical cellulitis and tissue necrosis have been reported after infiltration of sodium bicarbonate. Medical staff will ensure the IV site is well-placed and will stop infusion immediately if swelling or pain is noted. If infiltration occurs, they recommend elevating the limb and sometimes injecting saline or lidocaine around the site to dilute the bicarbonate.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eElectrolyte shifts:\u003c\/strong\u003e As blood pH rises, calcium and potassium levels can drop. Severe alkalosis can cause \u003cstrong\u003ehypokalemia\u003c\/strong\u003e (leading to arrhythmias) and \u003cstrong\u003ehypocalcemia\u003c\/strong\u003e (causing muscle cramps or spasms). Potassium and calcium levels should be monitored and replaced as needed when giving this drug. In fact, the labeling warns that potassium depletion can precipitate alkalosis, and hypocalcemia can trigger spasms as pH rises.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eVentilation\/CO₂:\u003c\/strong\u003e Although not explicitly stated in the label, it’s clinically important to know that bicarbonate administration generates CO₂ in the body (from HCO₃⁻ + H⁺ → CO₂ + H₂O). If the patient is not ventilating well (e.g. respiratory failure), the additional CO₂ can build up, which may limit the effectiveness of bicarbonate therapy. In practice, patients receiving bicarbonate infusions are often on mechanical ventilation or have good respiratory function, so CO₂ can be blown off.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cstrong\u003eContraindications:\u003c\/strong\u003e Do not give sodium bicarbonate if the patient already has metabolic alkalosis or is losing chloride (e.g. vomiting, continuous GI suction), because bicarbonate would worsen their imbalance. Also avoid use if the patient is on certain diuretics (like loop diuretics) that cause hypochloremic alkalosis.\u003c\/p\u003e\n\u003cp\u003e\u003cstrong\u003eDrug Interactions:\u003c\/strong\u003e Bicarbonate can precipitate calcium-containing solutions, so avoid mixing it with IV solutions that have calcium (like calcium gluconate) unless compatibility is confirmed. It may also interact with some vasoactive drugs; for example, norepinephrine\/dobutamine are incompatible. Always flush the IV line before and after bicarbonate administration.\u003c\/p\u003e\n\u003ch2\u003eKey Points\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003ePurpose:\u003c\/strong\u003e Sodium bicarbonate 4.2% IV is a \u003cstrong\u003estong alkalinizing solution\u003c\/strong\u003e used in hospitals for life-threatening acidosis (e.g. severe renal failure, DKA, shock, cardiac arrest) and certain poisonings. It is \u003cstrong\u003enot\u003c\/strong\u003e a routine medication or oral household remedy.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eAdministration:\u003c\/strong\u003e Given only by healthcare professionals. It must be diluted and infused or slowly injected IV, with continuous monitoring of blood pH and electrolytes. Rapid or excessive dosing can be harmful.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eRisks:\u003c\/strong\u003e Major risks include \u003cstrong\u003eovercorrection to alkalosis\u003c\/strong\u003e, high sodium load (fluid overload, high blood pressure), and tissue injury from extravasation. Beware of alkalosis symptoms (twitching, cramps) and neurological changes. Adequate ventilation is needed to clear the CO₂ produced.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eUse Wisely:\u003c\/strong\u003e The underlying cause of acidosis must also be treated (e.g. insulin for DKA, fluids for shock). Bicarbonate is a temporizing measure to raise pH quickly while definitive therapy takes effect.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003cp\u003e\u003cspan class=\"VODHU pdMy8\"\u003e\u003cem\u003eDisclaimer: The information is for general knowledge and \u003cstrong\u003enot\u003c\/strong\u003e personal medical advice.\u003c\/em\u003e\u003c\/span\u003e\u003c\/p\u003e","brand":"Pfizer Injectables","offers":[{"title":"Default Title","offer_id":53337663930686,"sku":"00409-5555-02","price":37104.99,"currency_code":"INR","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0872\/3408\/5182\/files\/Sodium-Bicarbonate-Injection-4.2-Vials-5-ml-hospira.jpg?v=1776774325","url":"https:\/\/himkhand.com\/products\/sodium-bicarbonate-injection-4-2-single-dose-vials-5-ml-x-25-tray-by-pfizer-rx","provider":"Himkhand","version":"1.0","type":"link"}