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, magnesium chloride hexahydrate, sodium chloride and calcium chloride dihydrate, the active ingredients in Multibic, are an electrolyte solution presented as a solution for intravenous use for haemodialysis and intravenous administration. It provides essential electrolytes and buffering capacity for patients with renal failure requiring haemodialysis and for electrolyte replacement during intravenous therapy.

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

Manufacturer / TM Owner

Fresenius Medical Care Deutschland Gmbh

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Indications & Clinical Uses

Multibic is an electrolyte solution used in renal replacement therapy and intravenous fluid management.

  • Renal failure requiring haemodialysis: restores electrolyte balance and acid‑base status during dialysis sessions.
  • Intravenous electrolyte replacement: supplies sodium, chloride, calcium, magnesium and bicarbonate to correct deficits.
  • Acute kidney injury with need for renal replacement: supports fluid and electrolyte homeostasis while renal function recovers.

How It Works

  • Multibic delivers sodium, chloride, calcium, magnesium ions and bicarbonate directly into the bloodstream, helping to maintain plasma osmolarity, extracellular fluid volume and acid‑base equilibrium. During haemodialysis the solution buffers metabolic acids, prevents rapid shifts in electrolytes, and supplies essential minerals that are otherwise removed by the dialysis process, thereby stabilising cardiovascular and neuromuscular function.

Side Effects

Multibic may be associated with electrolyte‑related reactions and infusion‑site responses.

Common Side Effects

  • Hypernatremia: elevated serum sodium levels.
  • Hyperchloremia: increased chloride concentration.
  • Hypercalcemia: excess calcium in blood.
  • Hypermagnesemia: raised magnesium levels.
  • Infusion site irritation: redness or discomfort at catheter site.
  • Fluid overload: signs of volume excess such as edema.

Serious or Rare Side Effects

  • Severe electrolyte imbalance leading to cardiac arrhythmia.
  • Anaphylactic or severe hypersensitivity reaction.
  • Metabolic alkalosis from excess bicarbonate.
  • Severe hypotension during rapid infusion.
  • Pulmonary edema due to fluid overload.
  • Acute kidney injury exacerbation if improperly managed.

Precautions & Warnings

When using Multibic, clinicians should observe several safety measures.

  • Monitor serum electrolytes: check sodium, chloride, calcium, magnesium and bicarbonate levels regularly.
  • Adjust infusion rate in patients with cardiac disease or fluid‑overload risk.
  • Use aseptic technique: ensure sterile handling of the solution and infusion set.
  • Avoid in patients with known hypersensitivity to any component of the formulation.
  • Use caution in patients with severe liver disease or metabolic disorders.
  • Store below 25°C: keep in original container, protect from light and moisture.

Avoid Interactions

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

Major Interactions (Avoid)

  • Concurrent high‑dose calcium‑containing solutions: may precipitate hypercalcemia.
  • Additional sodium bicarbonate infusions: risk of metabolic alkalosis.
  • Potassium‑sparing diuretics combined with high potassium intake: potential hyperkalemia.

Moderate Interactions (Monitor Closely)

  • Loop diuretics: may require electrolyte monitoring to avoid depletion.
  • ACE inhibitors or ARBs: watch for additive effects on potassium and renal function.
  • Anticoagulants used during dialysis: monitor for bleeding if fluid shifts affect hemodynamics.

Frequently Asked Questions

Multibic is an intravenous electrolyte solution employed primarily in renal replacement therapy. It supplies sodium, chloride, calcium, magnesium and bicarbonate to patients undergoing haemodialysis or requiring intravenous electrolyte correction during acute kidney injury or other conditions that cause electrolyte disturbances.

Sodium hydrogen carbonate provides bicarbonate ions that act as a physiological buffer, helping to neutralise metabolic acids. In the context of haemodialysis, it assists in maintaining the blood’s pH within the normal range while also contributing sodium and chloride to support overall electrolyte balance.

The dose of Multibic is individualized by the prescribing clinician based on the patient’s electrolyte profile, fluid status, and the specifics of the dialysis prescription. Healthcare professionals calculate the volume and rate of infusion to achieve the desired electrolyte and acid‑base targets.

Safety data for Multibic in pregnancy and lactation are limited. It should only be used when the potential benefit to the mother outweighs any possible risk to the fetus or infant, and the decision must be made by a qualified healthcare provider.

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

Multibic combines four key electrolytes and a bicarbonate buffer in a single formulation, which can simplify fluid management compared with using separate sodium chloride, calcium chloride or bicarbonate solutions. This integrated approach may reduce the number of infusion bags needed and help maintain a more stable acid‑base balance during dialysis.

Multibic should be stored below 25 °C, in its original packaging, protected from direct light and moisture. Before use, inspect the solution for any particulate matter or discoloration, and ensure aseptic technique when connecting it to the infusion set to avoid contamination.

Multibic is administered intravenously, either as a component of the dialysis fluid circuit during haemodialysis or as a separate infusion for electrolyte replacement. The infusion rate and total volume are set by the treating clinician according to the patient’s clinical parameters and treatment goals.

Serious risks include severe electrolyte imbalances such as hypernatremia, hypercalcemia or hypermagnesemia, which can precipitate cardiac arrhythmias, as well as metabolic alkalosis from excess bicarbonate. Anaphylactic reactions, severe hypotension during rapid infusion, and fluid overload leading to pulmonary edema are also critical concerns.

Multibic should be avoided in patients with known hypersensitivity to any of its components, in those with uncontrolled fluid overload, severe uncontrolled hypertension, or in individuals where rapid shifts in electrolytes could exacerbate cardiac instability. Clinical judgment is required for each case.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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