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, Calcium Chloride Dihydrate, the active ingredients in Multibic, are an electrolyte solution presented as an IV solution for intravenous use. It restores electrolyte and fluid balance during haemodialysis in patients requiring renal replacement therapy.

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 in renal replacement therapy to manage electrolyte balance during haemodialysis.

  • Haemodialysis: Maintains sodium, chloride, calcium, magnesium, and bicarbonate levels to support fluid and electrolyte homeostasis.
  • Chronic kidney disease (CKD) patients on dialysis: Provides essential electrolytes required for safe dialysis sessions.
  • Acute renal failure requiring dialysis: Assists in rapid correction of electrolyte disturbances during treatment.

How It Works

  • Multibic delivers sodium, chloride, calcium, magnesium, and bicarbonate ions directly into the bloodstream via the dialysis circuit. The supplied ions replace those removed during diffusion and ultrafiltration, helping to maintain plasma osmolarity, acid‑base balance, and myocardial electrical stability. By matching the composition of plasma, the solution supports hemodynamic stability throughout the haemodialysis session.

Side Effects

Adverse reactions to Multibic may occur, ranging from mild to serious.

Common Side Effects

  • Hypernatremia: Elevated serum sodium levels causing thirst or confusion.
  • Hypocalcemia: Low calcium leading to muscle cramps or tingling.
  • Hypermagnesemia: Excess magnesium resulting in flushing or hypotension.
  • Metabolic alkalosis: Increased bicarbonate causing respiratory compensation.

Serious or Rare Side Effects

  • Severe electrolyte imbalance: Potential cardiac arrhythmias.
  • Anaphylactoid reaction: Rare hypersensitivity with rash, dyspnea.
  • Volume overload: Pulmonary edema in susceptible patients.
  • Contamination-related infection: Sepsis if solution sterility compromised.

Precautions & Warnings

When using Multibic, clinicians should observe specific precautions to ensure patient safety.

  • Patient assessment: Review baseline electrolyte levels and acid‑base status before initiation.
  • Fluid balance monitoring: Track ultrafiltration volume to avoid overload or depletion.
  • Cardiac monitoring: Observe ECG for arrhythmias during rapid electrolyte shifts.
  • Compatibility check: Ensure solution compatibility with dialysis machine and other IV fluids.
  • Contraindications: Avoid use in patients with known hypersensitivity to any component.
  • Store at ambient temperature: Keep below 25°C, protect from light and moisture, and retain in original packaging.

Avoid Interactions

Multibic may interact with certain medications or solutions administered during dialysis.

Major Interactions (Avoid)

  • Calcium channel blockers: May potentiate hypercalcemia when combined with high calcium dialysate.
  • Sodium bicarbonate infusions: Excess bicarbonate can cause severe metabolic alkalosis.
  • Magnesium-containing laxatives: Risk of hypermagnesemia.

Moderate Interactions (Monitor Closely)

  • ACE inhibitors or ARBs: May enhance potassium shifts, requiring electrolyte monitoring.
  • Diuretics: Can alter fluid status, necessitating careful volume assessment.
  • Anticoagulants used in dialysis circuit: Monitor for bleeding if electrolyte shifts affect coagulation.

Frequently Asked Questions

Multibic is an intravenous electrolyte solution employed during haemodialysis and other forms of renal replacement therapy. It supplies sodium, chloride, calcium, magnesium, and bicarbonate ions to help maintain plasma electrolyte concentrations and acid‑base balance while patients undergo dialysis.

Sodium Hydrogen Carbonate provides bicarbonate ions that buffer excess hydrogen ions, helping to correct metabolic acidosis that often occurs during dialysis. By contributing to the overall electrolyte composition, it supports plasma pH stability and works together with the other ions to preserve cardiovascular and neuromuscular function.

The prescribed volume and concentration of Multibic are determined by the treating physician or dialysis specialist based on the patient’s individual electrolyte profile, treatment duration, and the specifications of the dialysis machine. No standard dose can be quoted without a clinical order.

Safety data for Multibic in pregnant or lactating women are limited. Because the product is intended for use in a controlled dialysis setting, it should only be administered during pregnancy or breastfeeding if the potential benefits outweigh any possible risks, as assessed by the treating clinician.

To request 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 the necessary import documentation.

Multibic contains a balanced mix of sodium, chloride, calcium, magnesium, and bicarbonate, matching typical plasma concentrations. Compared with solutions that lack one or more of these ions, Multibic offers more comprehensive electrolyte replacement, potentially reducing the need for supplemental additives during a dialysis session.

Multibic should be stored at ambient temperature, preferably below 25 °C, protected from direct light and moisture. Keep the container sealed in its original packaging until use, and avoid exposure to extreme temperatures that could affect solution stability.

Multibic is added to the dialysis circuit as an intravenous solution, either pre‑mixed with the dialysate or infused directly through the blood line according to the dialysis machine’s programming. Administration is performed by trained dialysis personnel under sterile conditions.

Serious risks include severe electrolyte imbalances such as hypernatremia, hypercalcemia, or hypermagnesemia, which can precipitate cardiac arrhythmias, and rare anaphylactoid reactions. Continuous monitoring of serum electrolytes, ECG, and patient symptoms is essential to detect these events promptly.

Multibic should be avoided in patients with known hypersensitivity to any of its components, in those with uncontrolled severe electrolyte disturbances that cannot be corrected safely, and in individuals where the clinical team determines that the risks outweigh the benefits, such as certain pediatric cases without appropriate dosing data.

Published by

GNH India Pharmaceuticals Limited

Licensed pharmaceutical supplier

Last updated:

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