Niprokart (Sodium Bicarbonate)

Adult dosage

1. When using the specified acetate-containing dialysis solution (Solution A), this formulation produces approximately 180L of bicarbonate-type hemodialysis solution containing 38 mEq/L of HCO3-. 2. The dilution preparation ratio for acetate-containing dialysis solution (Solution A) is 1 : (this drug + purified water) 34, and hemodialysis is performed using the bicarbonate-type dialysis supply device. 3. For preparing dialysis solution for one patient (based on 6 hours), the mixing ratio is as follows. A

This drug should not be used in patients with low blood pressure and rapid heart rate. It should also be avoided in individuals with pulmonary edema, abnormalities in cardiac electrical activity, elevated serum potassium levels, and those with blood coagulation issues. It must be used with caution in patients with severe liver disease or metabolic disorders due to diabetes, as hypotensive symptoms may occur in these cases. Individuals taking digitalis preparations should be cautious due to the risk of drug toxicity resulting from changes in serum potassium levels. Care must be taken when administering this medication to patients with elevated serum calcium or very high serum phosphorus levels as it may induce metastatic calcification. Patients with inadequate calorie intake or dietary restrictions due to diabetes, as well as those using blood sugar-lowering medications, should also be monitored for hypoglycemia. If hypoglycemic symptoms occur, appropriate measures such as glucose injection or sugar supply are required. Since serum calcium levels may rise, if hypercalcemia is suspected, it is necessary to switch to dialysis solution with lower calcium concentration. The management of bone-related complications such as osteoporosis, osteomalacia, and fibrous osteitis may require the administration of vitamin D3 preparations. If metastatic calcification occurs, it is important to regulate serum phosphorus levels by administering phosphorus binders. Symptoms of dialysis disequilibrium syndrome such as headache, nausea, vomiting, seizures, and altered consciousness may arise, and in such cases, the dialysis speed must be reduced. Hypotension or shock symptoms due to a significant drop in blood volume may occur, requiring the cessation or adjustment of the dialysis speed, as well as the administration of fluids and blood pressure-raising agents. Blood pressure may increase, so it may be necessary to use antihypertensive medications or adjust the dialysis solution. This medication is used for hemodialysis in patients with chronic renal failure and is suitable when metabolic acidosis improvement is insufficient or during episodes of hypotension or disequilibrium syndrome during dialysis. It does not contain glucose, which may assist in blood sugar control for patients with metabolic disorders. Regular blood tests to monitor electrolytes, acid-base balance, and blood glucose levels are advisable. Women who are pregnant or may become pregnant should carefully consider the benefits and risks of using this medication. The safety for pediatric patients has not been adequately established. Elderly patients must understand the characteristics of the medication, and regular examinations and vitamin D3 administration are necessary to prevent bone complications during prolonged use. The dilution water for dialysis must be purified water, and special care should be taken regarding the potential for membrane damage and postoperative bleeding. During preparation, sodium bicarbonate solutions should not be directly mixed with electrolyte solutions and should be precisely prepared with specified diluents. Care must be taken as concentrations that are too high or too low can lead to symptoms such as headache, palpitations, blood pressure changes, and altered consciousness. It is recommended to check the electrolyte concentration and pH of the dialysis solution before use, and it should be used immediately after dilution. It should not be used for injection or peritoneal dialysis, and the balance between serum osmolality in dialysis patients and the osmolarity of the dialysis solution should be maintained. The dialysis solution should be warmed to body temperature for use, and care should be taken as insoluble materials may develop with prolonged storage.

Serious side effects

Altered consciousness, consciousness disturbance.

Mild side effects

• Hypoglycemia
• hypercalcemia
• osteoporosis
• osteomalacia
• fibrous osteitis
• headache
• nausea
• vomiting
• malaise
• fatigue

This medication may be sensitive to air and moisture, so it should be stored in a sealed container. It is best to maintain a storage temperature between 1 to 30 degrees Celsius to preserve the medication's effectiveness.

Appearance

White crystalline or crystalline powder

Package unit

1 container - 1 container/package [650g]