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|Bell/ans

SODIUM BICARBONATE (Systemic)

Some commonly used brand names are:

In the U.S.—

• Arm and Hammer
• Pure Baking Soda
• Bell/ans
• Citrocarbonate
• Soda Mint

In Canada—

• Citrocarbonate

Generic name product may be available in the U.S. and Canada.

Category

• Alkalizer, systemic
• Alkalizer, urinary
• Antacid
• Electrolyte replenisher

Description

Sodium bicarbonate (SOE-dee-um bye-KAR-boe-nate), also known as baking soda, is used to relieve heartburn, sour stomach, or acid indigestion by neutralizing excess stomach acid. When used for this purpose, it is said to belong to the group of medicines called antacids. It may be used to treat the symptoms of stomach or duodenal ulcers. Sodium bicarbonate is also used to make the blood and urine more alkaline in certain conditions.

Antacids should not be given to young children (up to 6 years of age) unless prescribed by their doctor . Since children cannot usually describe their symptoms very well, a doctor should check the child before giving this medicine. The child may have a condition that needs other treatment. If so, antacids will not help and may even cause unwanted effects or make the condition worse.

Sodium bicarbonate for oral use is available without a prescription; however, your doctor may have special instructions on the proper use and dose for your medical problem. Sodium bicarbonate is available in the following dosage forms:

• Oral
• Effervescent powder (U.S. and Canada)
• Oral powder (U.S. and Canada)
• Tablets (U.S. and Canada)

• Parenteral
• Injection (U.S. and Canada)

Before Using This Medicine

If you are taking this medicine without a prescription, carefully read and follow any precautions on the label. For sodium bicarbonate, the following should be considered:

Allergies—Tell your doctor if you have ever had any unusual or allergic reaction to sodium bicarbonate. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy—Sodium bicarbonate is absorbed by the body and although it has not been shown to cause problems, the chance always exists. In addition, medicines containing sodium should usually be avoided if you tend to retain (keep) body water.

Breast-feeding—It is not known whether sodium bicarbonate passes into the breast milk. However, this medicine has not been reported to cause problems in nursing babies.

Children—Antacids should not be given to young children (up to 6 years of age) unless prescribed by a physician. This medicine may not help and may even worsen some conditions, so make sure that your child"s problem should be treated with this medicine before you use it.

Older adults—Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of sodium bicarbonate in the elderly with use in other age groups.

Other medicines—Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. When you are taking sodium bicarbonate, it is especially important that your health care professional know if you are taking any of the following:

• Ketoconazole (e.g., Nizoral) or
• Tetracyclines (medicine for infection) taken by mouth—Use with sodium bicarbonate may result in lower blood levels of these medicines, possibly decreasing their effectiveness

• Mecamylamine (e.g., Inversine)—Use with sodium bicarbonate may increase the effects of mecamylamine

• Methenamine (e.g., Mandelamine)—Use with sodium bicarbonate may reduce the effects of methenamine

Other medical problems—The presence of other medical problems may affect the use of sodium bicarbonate. Make sure you tell your doctor if you have any other medical problems, especially:

• Appendicitis or
• Intestinal or rectal bleeding—Oral forms of sodium bicarbonate may make these conditions worse

• Edema (swelling of feet or lower legs) or
• Heart disease or
• High blood pressure (hypertension) or
• Kidney disease or
• Liver disease or
• Problems with urination or
• Toxemia of pregnancy—Sodium bicarbonate may cause the body to retain (keep) water, which may make these conditions worse

Proper Use of This Medicine

For safe and effective use of sodium bicarbonate:

• Follow your doctor"s instructions if this medicine was prescribed.
• Follow the manufacturer"s package directions if you are treating yourself.

For patients taking this medicine for a stomach ulcer :

• Take it exactly as directed and for the full time of treatment as ordered by your doctor , to obtain maximum relief of your symptoms.
• Take it 1 and 3 hours after meals and at bedtime for best results, unless otherwise directed by your doctor.

Dosing—The dose of sodium bicarbonate will be different for different patients. Follow your doctor"s orders or the directions on the label . The following information includes only the average doses of this medicine. If your dose is different, do not change it unless your doctor tells you to do so.

The number of teaspoonfuls of powder or of tablets you take depends on the strength of the medicine. Also, the number of doses you take each day, the time allowed between doses, and the length of time you take the medicine depends on the medical problem for which you are taking sodium bicarbonate .

• For sodium bicarbonate effervescent powder:
  • To relieve heartburn or sour stomach:
    • Adults and teenagers—3.9 to 10 grams (1 to 21/2 teaspoonfuls) in a glass of cold water after meals. However, the dose is usually not more than 19.5 grams (5 teaspoonfuls) a day.
    • Children up to 6 years of age—Dose must be determined by your doctor.
    • Children 6 to 12 years of age—1 to 1.9 grams (1/4 to 1/2 teaspoonful) in a glass of cold water after meals.
• For sodium bicarbonate powder:
  • To relieve heartburn or sour stomach:
    • Adults and teenagers—One-half teaspoonful in a glass of water every two hours. Your doctor may change the dose if needed.
    • Children—Dose must be determined by your doctor.
  • To make the urine more alkaline (less acidic):
    • Adults and teenagers—One teaspoonful in a glass of water every four hours. Your doctor may change the dose if needed. However, the dose is usually not more than 4 teaspoonfuls a day.
    • Children—Dose must be determined by your doctor.
• For sodium bicarbonate tablets:
  • To relieve heartburn or sour stomach:
    • Adults and teenagers—325 milligrams (mg) to 2 grams one to four times a day.
    • Children up to 6 years of age—Dose must be determined by your doctor.
    • Children 6 to 12 years of age—The dose is 520 mg. The dose may be repeated in thirty minutes.
  • To make the urine more alkaline (less acidic):
    • Adults and teenagers—At first, four grams, then 1 to 2 grams every four hours. However, the dose is usually not more than 16 grams a day.
    • Children—The dose is based on body weight and must be determined by your doctor. The usual dose is 23 to 230 mg per kilogram (kg) (10.5 to 105 mg per pound) of body weight a day. Your doctor may change the dose if needed.

Missed dose—If you must take this medicine regularly and you miss a dose, take it as soon as possible. However, if it is almost time for your next dose, skip the missed dose and go back to your regular dosing schedule. Do not double doses.

Storage—To store this medicine:

• Keep out of the reach of children.
• Store away from heat and direct light.
• Do not store the powder or tablet form of this medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down.
• Do not keep outdated medicine or medicine no longer needed. Be sure that any discarded medicine is out of the reach of children.

Precautions While Using This Medicine

If this medicine has been ordered by your doctor and if you will be taking it regularly for a long time, your doctor should check your progress at regular visits. This is to make sure the medicine does not cause unwanted effects.

Do not take sodium bicarbonate :

• Within 1 to 2 hours of taking other medicine by mouth . To do so may keep the other medicine from working properly.
• For a long period of time . To do so may increase the chance of side effects.

For patients on a sodium-restricted diet :

• This medicine contains a large amount of sodium. If you have any questions about this, check with your health care professional.

For patients taking this medicine as an antacid :

• Do not take this medicine if you have any signs of appendicitis (such as stomach or lower abdominal pain, cramping, bloating, soreness, nausea, or vomiting). Instead, check with your doctor as soon as possible.
• Do not take this medicine with large amounts of milk or milk products . To do so may increase the chance of side effects.
• Do not take sodium bicarbonate for more than 2 weeks or if the problem comes back often. Instead, check with your doctor. Antacids should be used only for occasional relief, unless otherwise directed by your doctor.

Side Effects of This Medicine

Along with its needed effects, a medicine may cause some unwanted effects. Although the following side effects occur very rarely when this medicine is taken as recommended, they may be more likely to occur if it is taken:

• In large doses.
• For a long time.
• By patients with kidney disease.

Check with your doctor as soon as possible if any of the following side effects occur:

Frequent urge to urinate; headache (continuing); loss of appetite (continuing); mood or mental changes; muscle pain or twitching; nausea or vomiting; nervousness or restlessness; slow breathing; swelling of feet or lower legs; unpleasant taste; unusual tiredness or weakness

Other side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. However, check with your doctor if any of the following side effects continue or are bothersome:

Other side effects not listed above may also occur in some patients. If you notice any other effects, check with your doctor.

Revised: 08/10/1994

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