Product image of Multibic (Sodium Hydrogen Carbonate, Magnesium Chloride Hexahydrate, Sodium Chloride, Calcium Chloride Dihydra) supplied by GNH India

Multibic

Active Ingredient:
Sodium Hydrogen Carbonate, Magnesium Chloride Hexahydrate, Sodium Chloride, Calcium Chloride Dihydra
Origin:
EU

Multibic (Sodium Hydrogen Carbonate, Magnesium Chloride Hexahydrate, Sodium Chloride, Calcium Chloride Dihydra)

Sodium hydrogen carbonate, the active ingredient in Multibic, is an excipient (electrolyte dialysis solution) presented as a solution for injection for haemodialysis and intravenous use. It provides bicarbonate buffering and electrolyte balance during renal replacement therapy in patients undergoing haemodialysis.

GNH India supplies Multibic as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals and dialysis centres worldwide.

Manufacturer / TM Owner

Fresenius Medical Care Deutschland Gmbh

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Indications & Clinical Uses

Multibic is used as an electrolyte and bicarbonate supplement in renal replacement therapy and related clinical settings.

  • Haemodialysis: restores sodium, chloride, calcium and magnesium levels while buffering acid‑base balance.
  • Acute metabolic acidosis during dialysis: supplies bicarbonate to correct pH.
  • Intravenous electrolyte repletion in renal failure: replaces lost electrolytes safely.
  • Adjunct to renal replacement therapy: supports overall fluid and electrolyte homeostasis.

How It Works

  • Multibic delivers a balanced mixture of sodium hydrogen carbonate, magnesium chloride hexahydrate, sodium chloride and calcium chloride dihydrate. The bicarbonate component buffers excess hydrogen ions, while the chloride, magnesium and calcium salts replenish their respective electrolytes, maintaining plasma osmolarity and supporting normal cellular function during haemodialysis or intravenous administration.

Side Effects

Multibic may be associated with a range of adverse reactions, most of which are related to its electrolyte composition.

Common Side Effects

  • Mild hypernatremia: transient elevation of serum sodium.
  • Transient hyperchloremia: increased chloride levels.
  • Mild hypermagnesemia: elevated magnesium concentration.
  • Mild hypercalcemia: raised calcium levels.
  • Local irritation at infusion site.
  • Nausea or mild gastrointestinal discomfort.

Serious or Rare Side Effects

  • Severe electrolyte imbalance leading to cardiac arrhythmia.
  • Metabolic alkalosis from excess bicarbonate.
  • Hypotension due to rapid infusion.
  • Allergic reaction or anaphylaxis.
  • Pulmonary edema from fluid overload.
  • Hemolysis in patients with incompatible solutions.

Precautions & Warnings

When using Multibic, clinicians should consider patient-specific factors and monitor relevant parameters.

  • Renal function: assess baseline electrolytes and acid‑base status.
  • Cardiac history: watch for arrhythmias in patients with pre‑existing conduction disorders.
  • Fluid balance: avoid rapid large-volume infusions in patients at risk of overload.
  • Concomitant electrolyte therapies: adjust doses to prevent cumulative excess.
  • Pregnancy and lactation: use only if clearly needed, as safety data are limited.
  • Store at 2-8°C: keep refrigerated, protect from light, do not freeze.

Avoid Interactions

Multibic can interact with other agents that affect electrolyte or acid‑base balance.

Major Interactions (Avoid)

  • High‑dose bicarbonate agents: risk of severe metabolic alkalosis.
  • Calcium channel blockers combined with high calcium loads: potential hypercalcemia.
  • Magnesium‑containing laxatives or antacids: may cause dangerous hypermagnesemia.

Moderate Interactions (Monitor Closely)

  • Loop diuretics: may exacerbate electrolyte shifts.
  • ACE inhibitors or ARBs: monitor potassium and renal function.
  • NSAIDs: can affect renal perfusion and electrolyte handling.
  • Blood transfusions: watch for citrate‑related calcium changes.

Frequently Asked Questions

Multibic is an electrolyte dialysis solution used during haemodialysis and intravenous therapy to replace sodium, chloride, magnesium and calcium while providing bicarbonate buffering. It helps maintain electrolyte balance and correct acid‑base disturbances in patients undergoing renal replacement therapy.

Sodium hydrogen carbonate acts as a bicarbonate source that neutralises excess hydrogen ions, raising blood pH toward normal. Together with magnesium, calcium and sodium chloride, it restores the electrolyte composition of plasma, supporting cellular function during dialysis or intravenous administration.

The dose of Multibic is determined by the prescribing clinician based on the patient’s electrolyte levels, acid‑base status, and the specific dialysis protocol. Dosage is individualized and should follow the healthcare provider’s instructions.

Safety data for Multibic in pregnancy and lactation are limited. It should only be used when clearly indicated and when the potential benefits outweigh any potential risks. The prescribing clinician must evaluate each case individually.

To order Multibic, submit an enquiry on the product page at gnhindia.com with the required quantity. GNH India supplies hospitals, pharmacies and procurement teams worldwide, verifies trade or institutional credentials, and then provides pricing, availability, shipping details (including cold‑chain if needed) and import documentation.

Multibic combines sodium hydrogen carbonate with magnesium, calcium and sodium chloride in a single formulation, offering both buffering and comprehensive electrolyte replacement. Compared with solutions that provide only bicarbonate or single electrolytes, Multibic simplifies administration and reduces the need for multiple infusions, while achieving similar clinical goals.

Multibic should be stored at 2‑8 °C. Keep the vials refrigerated, protect them from light, and do not freeze or shake the solution. Maintain the original packaging to ensure stability.

Multibic is supplied as a sterile solution for injection. It is administered intravenously either directly into a peripheral line or as part of the dialysate circuit during haemodialysis, according to the prescribing clinician’s protocol.

Serious risks include severe electrolyte imbalances such as hypernatremia, hypercalcemia, hypermagnesemia, or metabolic alkalosis, which can lead to cardiac arrhythmias, hypotension, or pulmonary edema. Prompt monitoring of serum electrolytes and acid‑base status is essential.

Multibic should be avoided in patients with known hypersensitivity to any of its components, uncontrolled severe electrolyte disturbances, or those for whom rapid fluid overload poses a risk. Clinicians should also exercise caution in patients with severe cardiac disease or uncontrolled hypertension.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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