Sodium Bicarbonate

Adult dosage

1. When using the prescribed acetate-containing dialysate (Solution A), this product can prepare approximately 180L of bicarbonate dialysate containing 38mEq/L of HCO3-. 2. When using Solution A at a dilution ratio of 1: (this product + purified water) 34 for hemodialysis, it is used as the dialysate. 3. The dialysate for one-time use (based on 6 hours) per patient is prepared using the following mixing ratio.

This medication should not be used in patients with very low blood pressure or rapid heartbeat. It may also be dangerous for patients with pulmonary edema or abnormal ECG. Caution is advised for patients with high blood potassium levels or problems with blood coagulation. It should be used with caution in patients with severely impaired liver function or metabolic disorders due to diabetes. Patients taking digitalis preparations should be administered cautiously due to the risk of drug toxicity from low blood potassium levels. When used in patients with high serum calcium and phosphorus levels before dialysis, this medication may cause calcification, thus caution is required. Those with insufficient caloric intake or dietary restrictions due to diabetes should be careful of the risk of hypoglycemia. When used during or after dialysis, there is a possibility of hypoglycemia, so if symptoms appear, glucose injection or sugar supplementation may be needed. Since the medication can increase blood calcium levels, if hypercalcemia occurs, the dialysate should be changed to a low calcium concentration. Bone-related complications such as osteoporosis or osteomalacia may occur, and active vitamin D3 preparations should be administered if necessary. Additionally, ectopic calcification may occur, requiring treatment to maintain serum phosphorus levels within the normal range. Symptoms of dialysis disequilibrium syndrome, including headache, nausea, vomiting, convulsions, and altered consciousness, may appear, so the rate of dialysis should be adjusted. Due to potential cardiovascular effects, hypotension or shock symptoms may occur, and in such cases, dialysis should be stopped or fluids and vasopressors should be administered. Rarely, elevated blood pressure may occur, necessitating antihypertensive medication or changes to the dialysate. This medication is used in hemodialysis for chronic renal failure, especially when using bicarbonate dialysate of high acetate concentration is inadequate for improving metabolic acidosis or when disequilibrium syndrome or significant hypotension occurs. It is suitable for hyperglycemic patients with carbohydrate metabolism disorders, as it does not contain glucose. During treatment, it is important to regularly check electrolytes, acid-base balance, blood sugar levels, etc. through blood tests. Women who are pregnant or may become pregnant should only be administered this medication if the benefits outweigh the risks, as its safety has not been established. Safety in pediatric patients has not been fully confirmed, so caution is needed. In elderly patients, the characteristics of this medication should be well understood, and regular monitoring and administration of vitamin D3 preparations are necessary when used over a long period to prevent bone complications. Dialysis diluent water should be strictly purified, and care should be taken regarding dialysis membrane damage and bleeding tendencies. During preparation, the electrolyte solution for hemodialysis should not be directly mixed with sodium bicarbonate solution, but should be accurately prepared with the prescribed dilution. If the dilution concentration is too high or low, symptoms such as headache, blood pressure abnormalities, or limb paralysis may occur, so caution is needed. Before using the dialysate, ensure appropriate electrolyte concentrations and pH are confirmed, and the dialysate should be used immediately after preparation, maintaining a temperature close to body temperature. This medication may contain trace amounts of metallic elements, but these are within acceptable standards, and discoloration may occur without compromising safety. This medication is only compatible with specific dialysis systems and care should be taken to avoid excessive pressure or negative pressure exposure.

Serious side effects

• Altered consciousness
• headache (in case of severe headache)
• convulsions
• elevated blood pressure
• hypotension
• shock symptoms

Mild side effects

• Hypoglycemia
• hypercalcemia
• osteoporosis
• osteomalacia
• fibrous osteitis
• headache
• nausea
• vomiting
• convulsions
• altered consciousness

This medication should be stored in a tightly closed container to prevent air or moisture ingress. The storage temperature should be maintained at room temperature between 1 to 30 degrees Celsius.

Appearance

A white crystalline or crystalline powder contained in a polypropylene container with no odor and a distinct salty taste.

Package unit

650 grams/container, 720 grams/container