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

Multibic is used as an electrolyte and buffering solution in renal replacement therapies and acute intravenous electrolyte management.

• Hemodialysis: restores electrolyte balance and acid‑base homeostasis during the treatment session.
• Intravenous electrolyte replacement: rapidly corrects deficits of sodium, magnesium, calcium and chloride in patients with acute losses.
• Metabolic acidosis: supplies bicarbonate precursors to raise plasma pH and improve buffering capacity.

• Multibic delivers sodium hydrogen carbonate, magnesium chloride, sodium chloride and calcium chloride directly into the bloodstream, supplying essential cations and anions that participate in acid‑base regulation and osmotic balance. The bicarbonate component buffers excess hydrogen ions, while the added electrolytes replenish plasma concentrations, supporting normal cellular function and cardiac electrophysiology during haemodialysis or intravenous therapy.

Adverse reactions may occur with any intravenous solution. Monitoring during and after infusion is recommended.

Common Side Effects

• Mild hypernatremia: transient elevation of serum sodium.
• Mild hyperchloremia: slight increase in chloride levels.
• Transient hypotension: temporary drop in blood pressure during infusion.
• Infusion site irritation: redness or discomfort at the catheter site.
• Nausea: occasional mild gastrointestinal upset.
• Headache: brief episodes during or after administration.

Serious or Rare Side Effects

• Severe hypermagnesemia: risk of muscle weakness, respiratory depression.
• Severe hypercalcemia: may cause cardiac arrhythmias and renal impairment.
• Anaphylactic reaction: rare but potentially life‑threatening hypersensitivity.
• Cardiac arrhythmia: due to electrolyte shifts.
• Metabolic alkalosis: excessive bicarbonate leading to high pH.
• Pulmonary edema: fluid overload in susceptible patients.

Use Multibic only under medical supervision with appropriate laboratory monitoring.

• Renal function: assess serum electrolytes before and during therapy.
• Cardiac disease: monitor ECG for arrhythmias caused by electrolyte changes.
• Pregnancy: prescribe only if the potential benefit justifies the potential risk to the fetus.
• Concomitant electrolyte supplements: avoid concurrent high‑dose oral or IV electrolytes to prevent overload.
• Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Potential drug interactions should be evaluated before initiating therapy.

Major Interactions (Avoid)

• Calcium‑containing antacids: may cause hypercalcemia.
• Magnesium sulfate infusion: additive risk of hypermagnesemia.
• Sodium bicarbonate infusion: can lead to excessive alkalosis.

Moderate Interactions (Monitor Closely)

• ACE inhibitors: may alter potassium balance.
• Loop diuretics: increase risk of electrolyte depletion.
• Beta‑adrenergic agonists: affect serum potassium levels.