Natrijev Hidrogenkarbonat Braun (Sodium Hydrogen Carbonate)

• Natrijev Hidrogenkarbonat Braun is used to correct disturbances in the acid‑base balance and related electrolyte disorders.
• Metabolic acidosis: restores normal plasma pH by providing bicarbonate ions.
• Acid‑base disorders: corrects systemic acidosis in various clinical settings.
• Hyperkalemia (as adjunct therapy): facilitates intracellular shift of potassium, aiding potassium reduction.
• Urinary alkalinization: raises urinary pH to enhance excretion of certain substances.

• Sodium hydrogen carbonate dissociates after intravenous administration, releasing bicarbonate ions that combine with excess hydrogen ions to form carbonic acid, which is then converted to water and carbon dioxide. This buffering action raises plasma bicarbonate concentration, shifts the acid‑base equilibrium toward neutrality, and helps correct metabolic acidosis.

Adverse reactions may occur following intravenous administration of sodium hydrogen carbonate.

Common Side Effects

• Injection site pain or irritation.
• Hypernatremia due to sodium load.
• Metabolic alkalosis if over‑corrected.
• Fluid overload in susceptible patients.
• Transient hypertension.
• Hypokalemia secondary to intracellular potassium shift.

Serious or Rare Side Effects

• Severe metabolic alkalosis leading to respiratory depression.
• Pulmonary edema from fluid overload.
• Cardiac arrhythmias due to electrolyte disturbances.
• Hyperosmolarity causing neurologic symptoms.
• Anaphylactic or severe hypersensitivity reactions.
• Life‑threatening electrolyte imbalances.

• Careful monitoring and patient assessment are required when using this injectable.
• Monitor serum electrolytes: check sodium, potassium, and bicarbonate levels regularly.
• Assess acid‑base status: obtain arterial blood gases before and during therapy.
• Adjust dose in renal impairment: reduced excretion may increase risk of alkalosis.
• Avoid in patients with severe volume overload: risk of pulmonary edema.
• Store at ambient temperature: keep in original container, protect from light and moisture.

Sodium hydrogen carbonate can interact with other agents that affect acid‑base balance or electrolyte status.

Major Interactions (Avoid)

• Concomitant alkalinizing agents: risk of severe metabolic alkalosis.
• Sodium‑containing IV solutions: may cause hypernatremia.
• Loop diuretics causing hypokalemia: exacerbate electrolyte imbalance.
• Calcium carbonate oral preparations: can precipitate in solution.

Moderate Interactions (Monitor Closely)

• ACE inhibitors or ARBs: influence potassium shifts.
• NSAIDs: may affect renal function and bicarbonate handling.
• Antacids containing bicarbonate: additive alkalinizing effect.
• Insulin therapy: may potentiate intracellular potassium movement.