Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Pharmacy Guide
Patient leaflets and SmPCs, drug interaction checker, official dosages and NHS pharmacy opening hours — all in one place.
Sodium Bicarbonate 8.4% w/v Solution for Injection
⚠ This medicine appears to have been discontinued
The electronic medicines compendium (emc) no longer publishes a Summary of Product Characteristics for this product, which usually means it is no longer marketed in the UK. The patient leaflet below is kept for reference, but the product may not be available.
If you were prescribed this medicine, other products containing Sodium bicarbonate may still be available. Do not stop your treatment — ask your pharmacist or GP what to use instead.
What it is and what it is used for
for The name of your medicine is Sodium Bicarbonate 8.4% w/v Solution for Injection. This will be referred to as Sodium Bicarbonate Injection throughout this leaflet. Sodium bicarbonate is a simple chemical which is used in medicine when your blood contains too much acid. Sodium bicarbonate is used to reduce the amount of acid in the body after a heart attack in patients who have the following conditions: too much acid in their body or too much potassium in their blood. It can also be used to treat patients who have taken too much tricyclic antidepressant medicine. Sodium Bicarbonate Injection will only be used after other resuscitation methods have been attempted.
What you need to know before you take it
Sodium Bicarbonate Injection You will be given Sodium Bicarbonate Injection in hospital by a doctor or nurse. Do not use Sodium Bicarbonate Injection if • • • • • • •
you are allergic to sodium bicarbonate or any of the other ingredients of this medicine (listed in section 6) your breathing is slower or more shallow than usual (hypoventilation) you have any blood abnormalities such as high levels of sodium, low levels of calcium, potassium or chloride, or your blood is less acidic than usual (your doctor will need to check this) you have high blood pressure you have kidney failure you have heart failure you suffer from fluid retention
If any of the above apply to you please tell your doctor or nurse before you are given Sodium Bicarbonate Injection. Warnings and precautions Talk to your doctor, pharmacist or nurse before you are given Sodium Bicarbonate Injection. Your doctor or nurse may want to regularly check your blood acid levels during the course of treatment with this medicine. Other medicines and Sodium Bicarbonate Injection Tell your doctor, pharmacist or nurse if you are taking, have recently taken or might take any other medicines. Talk to your doctor if you are taking: • • • • • • • • • • • •
corticosteroids or corticotropin (medicines used to reduce swelling or to treat hormone problems) medicines of an acidic nature (e.g. tetracycline, doxycycline or methenamine) quinidine, flecainide (medicines used to treat heart problems) amphetamines (medicines used to treat certain mental disorders and drowsiness) ephedrine and pseudoephedrine (medicines used to treat colds and asthma) potassium supplements medicines used to treat water retention and problems with passing urine such as ethacrynic acid, bumetanide, thiazides or frusemide medicines used to treat high blood pressure (e.g mecamylamine) medicines used to treat Alzheimers disease (e.g. memantine) medicines used to treat diabetes mellitus (e.g. chlorpropamide) medicines used to treat mood disorders (e.g. lithium) aspirin (acetylsalicylic acid)
Pregnancy and breast-feeding If you are pregnant or breast-feeding, think you may be pregnant or are planning to have a baby, ask your doctor or pharmacist for advice before taking this medicine. Sodium Bicarbonate Injection will only be given to you if your doctor considers the treatment necessary. Driving and using machines This medicine is unlikely to affect your ability to drive or use machines. Sodium Bicarbonate Injection contains sodium This medicine contains 23 mg sodium (main component of cooking/table salt) in each mL. This is equivalent to 1.15% of the recommended maximum daily dietary intake of sodium for an adult.
The following information is intended for healthcare professionals only: Therapeutic indications Sodium Bicarbonate Injection is indicated in adults and children for: • • • •
Correction of metabolic acidosis associated with cardiac arrest in patients with pre-existing metabolic acidosis Cardiac arrest associated with hyperkalaemia with pre-existing metabolic acidosis Life threatening hyperkalaemia with pre-existing metabolic acidosis Tricyclic antidepressant overdose
Sodium bicarbonate should only be used after other resuscitative measures such as cardiac compression, ventilation, adrenaline and antiarrhythmic agents have been attempted. In neonates, Sodium Bicarbonate Injection is indicated for: • • •
Correction of metabolic acidosis associated with cardiac arrest in patients with pre-existing metabolic acidosis Cardiac arrest associated with hyperkalaemia with pre-existing metabolic acidosis Life threatening hyperkalaemia with pre-existing metabolic acidosis
No benefits have been demonstrated from the routine use of sodium bicarbonate in resuscitation of neonates. In neonates, sodium bicarbonate is recommended in resuscitation only in cases of prolonged cardiac arrest, irresponsive to other therapy, after establishment of adequate ventilation and circulation. Posology and method of administration Posology The posology depends largely on the extent of the acid-base imbalance. This should be checked regularly. Adults: The usual dose is 1 mmol/kg (1 mL/kg 8.4% solution) followed by 0.5 mmol/kg (0.5 mL/kg 8.4% solution) given at 10-minute intervals. Paediatric population: The usual dose is 1 mmol/kg by slow iv injection (1 mL/kg 8.4% solution) In premature infants and neonates, the 8.4% solution should be diluted 1:1 with 5% w/v dextrose. Elderly: As for adults. Method of administration For intravenous administration only.
How to take it
Your doctor will give you Sodium Bicarbonate Injection by slow injection into the vein (intravenous injection). Your doctor will decide on how much Sodium Bicarbonate Injection you should be given. Adults and the elderly • •
The usual starting dose is 1 mmol for every kg you weigh Followed by 0.5 mmol/kg given at 10-minute intervals
Children • •
The usual dose is 1 mmol for every kg you weigh given by slow intravenous injection The medicine should be diluted 1:1 with 5% dextrose for premature infants and new-borns.
If you think you have been given more Sodium Bicarbonate Injection than you should As this medicine will be given to you whilst you are in hospital, it is unlikely that you will be given too little or too much. However, if you think you have been given too much of this medicine, please tell your doctor. Signs of too much sodium bicarbonate include hyperventilation (over-breathing), sensitivity to slight stimuli, twitching and high potassium levels in your blood which may cause you to feel dizzy or tired. 4. Possible side effects Like all medicines, this medicine can cause side effects, although not everybody gets them. Side effects include: • •
• • • • • • •
Low levels of potassium causing twitching, muscle weakness, 'pins and needles' in the hands or feet, irritability or abnormal heart rhythm Low levels of blood sugar and high concentration of sodium in the blood causing feeling hungry, thirsty, nervous, confused, extreme irritation, increased urination, shakiness or sweating Too much acid in the blood, which many cause an increased rate of breathing (intracellular acidosis) A blood disorder consisting of an increase in the volume of circulating blood Low levels of calcium causing involuntary contraction of your muscles Swelling due to a build-up of fluid under the skin New born babies may have bleeding inside the skull Sodium bicarbonate may leak out of the veins into the surrounding tissue. This may cause pain, redness or irritation to the skin If the medicine is not correctly injected it could cause the skin to die around the injection site.
Reporting of side effects If you get any side effects, talk to your doctor, pharmacist or nurse. This includes any
Possible side effects
not listed in this leaflet. You can also report side effects directly via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store. By reporting side effects you can help provide more information on the safety of this medicine.
How to store it
Sodium Bicarbonate Injection Keep this medicine out of the sight and reach of children. Do not use this medicine after the expiry date which is stated on the carton and the ampoule label. The expiry date refers to the last day of that month. This medicinal product does not require any special storage conditions. Do not use this medicine if you notice it has visible particles. Discard container and any unused content after use. Do not throw away any medicines via wastewater or household waste. Ask your pharmacist how to throw away medicines you no longer use. These measures will help protect the environment. This product should only be used in a hospital environment and will be safely disposed of by your doctor.
Contents of the pack and other information
What Sodium Bicarbonate Injection contains • •
The active substance is sodium bicarbonate. Each 1 mL solution for injection contains 84 mg sodium bicarbonate. The other ingredients are disodium edetate and Water for Injections.
What Sodium Bicarbonate Injection looks like and contents of the pack Sodium Bicarbonate Injection is a clear and colourless aqueous solution supplied in 10 mL glass ampoules. Each pack contains 10 ampoules. Marketing Authorisation Holder and Manufacturer Torbay Pharmaceuticals Limited Wilkins Drive Paignton Devon TQ4 7FG UK This leaflet was last revised in 06/2025. PL 56021/0005
PIL/5/1
Incompatibilities The addition of sodium bicarbonate to parenteral solutions containing calcium should be avoided except where compatibility has been previously established; precipitation or haze may result, should this occur, the solution should not be used. Administration of sodium bicarbonate is incompatible with allopurinol sodium, amiodarone hydrochloride, anileridine, ascorbic acid injection, carmustine, cefamandole, cefotaxime, codeine phosphate, dobutamine hydrochloride, dopamine hydrochloride, doxapram, epinephrine hydrochloride, esmolol, fenoldopam mesylate, glycopyrrolate, hydromorphone hydrochloride, idarubicin hydrochloride, inamrinone lactate, isoproterenol hydrochloride, labetalol hydrochloride, levofloxacin, levophanon tatrate, magnesium sulfate, methadone, metoclopramide hydrochloride, morphine sulfate, moxalactam, nicardipine hydrochloride, norepinephrine bitartrate, ondasetron hydrochloride, oxytetracycline, pentazocine lactate, sargramostin, secobarbital, streptomycin sulfate, succinylcholine chloride, tetracycline, ticarcillin disodium/clavulanate potassium, trimethaphan, tubocurarine and vinorelbine tartrate. It is also incompatible with the solutions of: alcohol 5% in dextrose 5%, dextrose 5% in lactated Ringer's injection, ionosol(R) B in invert sugar 10%, ionosol(R) D, modified in invert sugar 10%, isonosol(R) D in invert sugar 10%, and ionosol(R) G in invert sugar 10%.
PIL/5/1
Frequently asked questions about Sodium Bicarbonate 8.4% w/v Solution for Injection
How do I take Sodium Bicarbonate 8.4% w/v Solution for Injection?
Sodium Bicarbonate 8.4% w/v Solution for Injection comes as injection. Always follow the dose your doctor or pharmacist has given you, and read the leaflet that comes with the medicine.
What is the active substance in Sodium Bicarbonate 8.4% w/v Solution for Injection?
The active substance in Sodium Bicarbonate 8.4% w/v Solution for Injection is sodium bicarbonate.
Are there equivalent medicines to Sodium Bicarbonate 8.4% w/v Solution for Injection?
Medicines with the same active substance, strength and form include: Sodium Bicarbonate Injection BP 8.4% w/v. They are interchangeable only if your prescriber or pharmacist says so.
Where does this information come from?
This leaflet reproduces the patient information leaflet approved for Sodium Bicarbonate 8.4% w/v Solution for Injection, as published on the electronic medicines compendium (emc). The version printed inside your medicine’s packaging is the one that applies to you.
Can I get Sodium Bicarbonate 8.4% w/v Solution for Injection without a prescription?
Whether a medicine is available over the counter or on prescription only depends on its licence. Check the leaflet, or ask your pharmacist — they can tell you straight away.
About this leaflet
The text above reproduces the patient information leaflet approved for this medicine, restructured for easier reading.
- Source: electronic medicines compendium (emc), Datapharm
- Active substance: sodium bicarbonate
- Official document: view the original leaflet on emc →
⚕For healthcare professionals — Summary of Product Characteristics (SmPC)Full SmPC: dosage, interactions, contraindications, warnings+
4.1. Therapeutic indications
Sodium Bicarbonate Injection is indicated in adults and children for:
• Correction of metabolic acidosis associated with cardiac arrest in patients with pre-existing metabolic acidosis
• Cardiac arrest associated with hyperkalaemia with pre-existing metabolic acidosis
• Life threatening hyperkalaemia with pre-existing metabolic acidosis
• Tricyclic antidepressant overdose
Sodium bicarbonate should only be used after other resuscitative measures such as cardiac compression, ventilation, adrenaline and antiarrhythmic agents have been attempted.
In neonates, Sodium Bicarbonate Injection is indicated for:
• Correction of metabolic acidosis associated with cardiac arrest in patients with pre-existing metabolic acidosis
• Cardiac arrest associated with hyperkalaemia with pre-existing metabolic acidosis
• Life threatening hyperkalaemia with pre-existing metabolic acidosis
No benefits have been demonstrated from the routine use of sodium bicarbonate in resuscitation of neonates. In neonates, sodium bicarbonate is recommended in resuscitation only in cases of prolonged cardiac arrest, irresponsive to other therapy, after establishment of adequate ventilation and circulation.
4.2. Posology and method of administration
Posology
The posology depends largely on the extent of the acid-base imbalance. This should be checked regularly.
Adults:
The usual dose is 1 mmol/kg (1 mL/kg 8.4% solution) followed by 0.5 mmol/kg (0.5 mL/kg 8.4% solution) given at 10-minute intervals.
Paediatric population:
The usual dose is 1 mmol/kg by slow iv injection (1 mL/kg 8.4% solution)
In premature infants and neonates, the 8.4% solution should be diluted 1:1 with 5% w/v dextrose.
Elderly:
As for adults.
Method of administration
For intravenous administration only.
4.3. Contraindications
• Hypersensitivity to the active substance or to any of the excipients listed in section 6.1
• Conditions where sodium intake is restricted (e.g. renal failure, hypertension, oedema, congestive heart failure)
• Respiratory and metabolic alkalosis
• Hypoventilation
• Coexistent potassium depletion or chloride depletion, hypocalcaemia and hypernatraemia
4.4. Special warnings and precautions for use
Sodium bicarbonate should not be administered in the following situations unless it has been established that its expected benefits clearly outweigh potential risks:
- respiratory acidosis
- hypocalcaemia
- increased serum osmolarity,
- further in all situations where sodium intake must be restricted like cardiac insufficiency, oedema, hypertension, eclampsia, severe renal insufficiency.
Whenever sodium bicarbonate is used intravenously, arterial blood gas analyses, in particular arterial/venous blood pH and carbon dioxide levels, should be performed before and during the course of treatment to minimise the possibility of overdose and resultant alkalosis.
In long-term therapy, care is essential to prevent the risk of overdose and alkalosis. Therefore, repeat administrations of fractional doses, or an infusion, should be given while regularly monitoring the acid-base balance and electrolytes. As soon as the most severe symptoms are under control, the dose and frequency of administration must be reduced until normal values have been restored.
Whenever respiratory acidosis is concomitant with metabolic acidosis, both pulmonary ventilation and perfusion must be adequately supported to get rid of excess CO2.
Administration of sodium bicarbonate to a patient with inadequate minute ventilation can cause worsening of the acidosis.
The treatment of metabolic acidosis must, if possible, be combined with concurrent treatment to combat the primary cause of the acidosis, for example the administration of insulin in uncomplicated diabetes, or blood volume restoration in shock.
There is no evidence to support the use of bicarbonate therapy in the treatment of hypoperfusion-induced lactic acidaemia associated with sepsis.
Accidental extravascular injection of hypertonic solutions may cause vascular irritation or sloughing. The use of scalp veins should be avoided.
Excipient
This medicinal product contains 23.00 mg sodium per mL, equivalent to 1.15% of the WHO recommended maximum daily intake of 2 g sodium for an adult.
4.5. Interaction with other medicinal products and other forms of interaction
Caution should be used when administering sodium ions to patients receiving corticosteroids or corticotrophin.
Urinary alkalisation will increase the renal clearance of medicinal products which are acid in nature e.g. tetracyclines, especially doxycycline, acetylsalicylic acid, chlorpropamide, lithium, methenamine. It increases the half-life and duration of action of basic active substances such as quinidine, amphetamines, ephedrine, pseudoephedrine, memantine and flecainide. Sodium bicarbonate is known to increase renal tubular reabsorption of mecamylamine causing hypotension.
Hypochloraemic alkalosis may occur if sodium bicarbonate is used in conjunction with potassium depleting diuretics such as bumetamide, ethacrynic acid, frusemide and thiazides.
Concurrent use in patients taking potassium supplements may reduce serum potassium concentration by promoting an intracellular ion shift.
4.6. Fertility, pregnancy and lactation
There are no or limited amount of data from the use of sodium bicarbonate in pregnant women. Sodium bicarbonate should not be used during pregnancy unless the clinical condition of the woman requires treatment with sodium bicarbonate.
It is unknown whether sodium bicarbonate/metabolites are excreted in human milk. A decision must be made whether to discontinue breast-feeding or to discontinue/abstain from sodium bicarbonate therapy. A risk to the newborns/infants cannot be excluded.
4.7. Effects on ability to drive and use machines
Not applicable; this preparation is intended for use only in emergencies.
4.8. Undesirable effects
Metabolism and nutrition disorders
Alkalosis, hypokalaemia, hypernatraemia, hyperosmolarity, hypocalcaemia, hypoglycaemia, paradoxical intracellular acidosis.
Nervous system disorders
Intracranial haemorrhage (in neonates), hyperirritability or tetany.
Cardiac disorders
Deterioration of haemodynamic status associated with volume overload.
General disorders and administration site conditions
Extravasation.
Incorrect administration (intra-arterial, paravenous) may cause tissue necrosis.
Reporting of suspected adverse reactions
Reporting suspected adverse reactions after authorisation of the medicinal product is important. It allows continued monitoring of the benefit/risk balance of the medicinal product. Healthcare professionals are asked to report any suspected adverse reactions via the Yellow Card Scheme at: www.mhra.gov.uk/yellowcard or search for MHRA Yellow Card in the Google Play or Apple App Store.
4.9. Overdose
Symptoms
Metabolic alkalosis accompanied by compensatory hyperventilation, paradoxical acidosis of the cerebrospinal fluid, severe hypokalaemia, hyperirritability and tetany.
Treatment
Discontinue the administration of sodium bicarbonate, rebreathe expired air or, if more severe administer calcium gluconate especially if tetany is present. In severe alkalosis, an infusion of 2.14% ammonium chloride is recommended, except in patients with pe-existing hepatic disease. If hypokalaemia is present administer potassium chloride.
💬 Ask about this leaflet
Ask anything about Sodium Bicarbonate 8.4% w/v Solution for Injection. The assistant answers only from this leaflet — if the leaflet does not cover it, it will say so. It does not give medical advice.
Answers come from the patient leaflet published on the electronic medicines compendium (emc). They are not medical advice. Ask a pharmacist or your GP if you are unsure. For urgent help call NHS 111, or 999 in an emergency.