Sodium bicarbonate solution for infusion 40 mg/ml 200 ml, 28 bottles

Sodium bicarbonate solution for infusion 40 mg/ml 200 ml, 28 bottles

Registration Certificate Holder

DALHIMFARM (Russia)

Dosage form

Medicine - Sodium hydrocarbonate

Description

Solution for infusion

transparent, colorless.

1 ml

sodium bicarbonate 40 ml

Excipients

: water for up to 100 ml.

100 ml - bottles for blood and blood substitutes (1) - cardboard packs. 100 ml - bottles for blood and blood substitutes (35) - cardboard boxes. 200 ml - bottles for blood and blood substitutes (1) - cardboard packs. 200 ml - bottles for blood and blood substitutes (28) - cardboard boxes. 400 ml - bottles for blood and blood substitutes (1) - cardboard packs. 400 ml - bottles for blood and blood substitutes (15) - cardboard boxes.

Indications

Metabolic acidosis (including with diabetes mellitus, infections, intoxication, kidney disease, anesthesia, in the postoperative period); as a symptomatic remedy for relieving heartburn, discomfort in the epigastrium associated with increased acidity of gastric juice; symptomatic treatment of cough with viscous and difficult to separate sputum in various diseases of the respiratory tract; sea ​​and air sickness.

For local use: inflammatory diseases of the oral cavity, eyes, upper respiratory tract, for loosening earwax.

Contraindications for use

Conditions accompanied by the development of metabolic alkalosis.

pharmachologic effect

An antacid that regulates the blood circulation hormone. It has alkaline properties, increases the alkaline reserve of the blood. When taken orally, it quickly neutralizes the hydrochloric acid of gastric juice and has a quick but short-term antacid effect. Irritates the receptors of the gastric mucosa, increases the release of gastrin with secondary activation of secretion, can cause discomfort in the stomach (due to its distension) and belching.

It has an expectorant effect by reducing the viscosity of sputum due to a shift to the alkaline side of the reaction of bronchial mucus.

When absorbed, it leads to the development of alkalosis. Alkalinization of urine prevents the deposition of uric acid in the urinary tract.

Relieves symptoms of sea and air sickness.

Drug interactions

With simultaneous use, the excretion of amphetamine in the urine decreases due to an increase in urine pH under the influence of sodium bicarbonate.

When ingesting sodium bicarbonate while using lithium carbonate in established maintenance doses, a decrease in the concentration of lithium in the blood plasma is possible, which is due to the influence of sodium ions.

When used simultaneously with methotrexate, the excretion of methotrexate in the urine increases and its toxic effect on the kidneys decreases due to an increase in urine pH under the influence of sodium bicarbonate.

With simultaneous oral administration, the absorption of tetracyclines is reduced.

Due to the increase in urine pH under the influence of sodium bicarbonate, there is a delay in the excretion of ephedrine from the body and an increased risk of side effects (tremor, anxiety, sleep disturbances, tachycardia).

With intravenous drip administration of sodium bicarbonate, the antihypertensive effect of reserpine may be enhanced.

Dosage regimen

Apply orally, parenterally, locally externally. The dosage regimen depends on the indications and route of administration.

Side effect

With long-term use

possible development of alkalosis (sometimes uncompensated), accompanied by loss of appetite, nausea, vomiting, pain in the epigastric region, anxiety, headaches, and in some severe cases tetanic convulsions; increased blood pressure, flatulence (when taken orally).

special instructions

It is not recommended to use systematically due to the fact that when hydrochloric acid of the stomach is neutralized with sodium bicarbonate, carbon dioxide is released, which has a stimulating effect on the receptors of the gastric mucosa, increases the release of gastrin and can cause a secondary increase in secretion. In addition, with long-term regular use, urine may become alkaline and increase the risk of phosphate stones.

Intensive removal of CO2 can provoke perforation of the walls of the gastrointestinal tract.

In patients with underlying heart or kidney disease, excess sodium intake causes edema and heart failure.

Use for renal impairment

Restrictions for impaired renal function - With caution.

In patients with underlying kidney disease, excess sodium intake causes edema and heart failure.

Sodium bicarbonate powder for solution for external use 10g

Name

Sodium bicarbonate pores 10g pack.

Description

White crystalline powder, odorless, slowly decomposes in moist air. Aqueous solutions have an alkaline reaction.

Main active ingredient

Sodium bicarbonate

Release form

Powder

pharmachologic effect

Sodium bicarbonate is a white crystalline powder that dissolves in water to form alkaline solutions. A solution of drinking sodium bicarbonate is used as a weak antiseptic for rinsing, and also as an acid neutralizing agent.

Indications for use

in complex therapy of inflammatory diseases of the oral cavity; as a neutralizer for burns of the skin and mucous membranes with acids.

Directions for use and doses

Sodium bicarbonate is used to prepare aqueous solutions for rinsing and washing. For stomatitis, 0.5%-2% solutions are used for rinsing (1 teaspoon of sodium bicarbonate per 1 liter of water - 1 teaspoon of sodium bicarbonate per 1 glass of water). To wash the skin and mucous membranes when acids, irritants and toxic substances (organophosphorus and organochlorine) come into contact with them - 2% sodium bicarbonate solution (1 teaspoon of sodium bicarbonate per 1 glass of water).

Precautionary measures

It is not recommended to take sodium bicarbonate orally. When used orally, urine may become alkaline and increase the risk of phosphate stones. A shift in the acid-base state to the alkaline side with short-term use is not accompanied by clinical symptoms, however, with chronic renal failure, a significant deterioration of the condition is possible. Vomiting, which often accompanies peptic ulcer disease, can increase the severity of alkalosis. The drug is not recommended for use internally to treat heartburn and stomach pain. This is due to the fact that when hydrochloric acid of the stomach is neutralized with sodium bicarbonate, carbon dioxide is released, which has an exciting effect on the receptors of the gastric mucosa, enhances the release of gastrin and can cause a secondary increase in gastric secretion - “acid rebound”. Intense release of CO2 can provoke perforation of the walls of the gastrointestinal tract. In patients with underlying heart or kidney disease, excessive Na+ intake causes edema and heart failure. Use during pregnancy and lactation. If indicated, the use of the drug is possible only after assessing the balance of benefits and risks for the mother and fetus/child. Impact on the ability to drive vehicles and other potentially dangerous mechanisms. Does not affect.

Interaction with other drugs

When used together, urinary excretion of amphetamine is reduced due to an increase in urine pH under the influence of sodium bicarbonate. When ingesting sodium bicarbonate while using lithium carbonate, a decrease in the concentration of lithium in the blood plasma is possible, which is due to the effect of sodium ions. When used together with methotrexate, the urinary excretion of methotrexate is increased and its toxic effect on the kidneys is reduced due to the increase in urine pH under the influence of sodium bicarbonate. When taken orally with sodium bicarbonate, the absorption of tetracyclines is reduced. Due to the increase in urine pH under the influence of sodium bicarbonate, there is a slowdown in the excretion of ephedrine from the body and the possibility of developing adverse reactions (tremor, sleep disturbances, anxiety, tachycardia) increases.

Contraindications

Hypersensitivity, hypocalcemia, conditions that are accompanied by the development of alkalosis; hypochloremia.

Compound

Sodium bicarbonate - 10 g.

Overdose

An overdose of sodium bicarbonate increases the side effects. Supportive and symptomatic treatment is necessary.

Side effect

With prolonged use - alkalosis and its clinical manifestations: nausea, loss of appetite, abdominal pain, vomiting, headache, anxiety, tetanic convulsions; increased blood pressure; when using suppositories - urge to defecate, laxative effect, flatulence, diarrhea, rumbling. If the above adverse reactions or adverse reactions not listed in these instructions for medical use of the drug occur, you should consult a doctor.

Storage conditions

Keep out of the reach of children. Store in a place protected from moisture at a temperature not exceeding 25°C.

Sodium bicarbonate (baking soda)

Sodium bicarbonate

(English
sodium bicarbonate
; synonyms:
sodium bicarbonate, sodium bicarbonate, baking soda, baking soda
) is an antacid that normalizes acid-base balance.

Sodium bicarbonate is a chemical substance

Sodium bicarbonate is an acidic sodium salt of carbonic acid. Chemical formula of sodium bicarbonate: NaHCO3. Sodium bicarbonate is a white, odorless, crystalline powder with a salty-alkaline taste. Sodium bicarbonate is stable in dry air, but decomposes slowly in humid air. Easily soluble in water to form alkaline solutions. The acidity of a five percent sodium bicarbonate solution = 8.1 pH. Sodium bicarbonate is practically insoluble in ethanol. Molecular weight 84.01. Sodium bicarbonate reacts with acids to form a salt and carbonic acid, which immediately breaks down into carbon dioxide and water.

Sodium bicarbonate - medicine

Sodium bicarbonate (this is its name in pharmaceuticals) is the international nonproprietary name (INN) of the drug. According to the pharmacological index, sodium bicarbonate belongs to the groups “Regulators of water-electrolyte balance and acid-base balance” and “Antacids”, according to ATC - to the group: “B05 Plasma-substituting and perfusion solutions” and has codes B05CB04 and B05XA02. In addition, in the group “A02 Drugs for the treatment of diseases associated with acidity disorders” there is a five-digit code “A02AH Antacids in combination with sodium bicarbonate”.

Sodium bicarbonate therapy for pregnant and nursing mothers

Due to the unwanted side effects of sodium (edema and weight gain), some experts advocate the use of alternative antacids that do not contain sodium bicarbonate in pregnant women. FDA Fetal Risk Category for sodium bicarbonate therapy is "C" (animal studies have shown adverse effects on the fetus and there have been no adequate studies in pregnant women, but the potential benefit associated with the drug in pregnant women may justify its use , despite the existing risk). Due to the lack of data on the excretion of sodium bicarbonate into breast milk, there are no restrictions for the treatment of breastfeeding mothers.

Baking soda is a traditional but dangerous remedy for relieving heartburn.

Sodium bicarbonate is a traditional remedy for relieving heartburn, an absorbable antacid. Absorbed antacids are those that either themselves or the products of their reaction with gastric acid dissolve in the blood.

A positive quality of absorbed antacids is the rapid decrease in acidity after taking the medicine. Negative - short duration of action, acid rebound (increased secretion of hydrochloric acid after the end of the drug's effect), the formation of carbon dioxide during their reaction with hydrochloric acid, stretching the stomach and stimulating gastroesophageal reflux (see the figure on the right from the article by D.S. Bordin)

. Absorption of bicarbonates into the blood can lead to the development of systemic alkalosis, and their long-term use in combination with a dairy diet can lead to the development of Burnett's syndrome (milk-alkali syndrome).

After taking 3 g of sodium bicarbonate, the pH of the gastric contents remains above 3 pH units for only 75 minutes. The carbon dioxide formed during neutralization causes belching and bloating. As a rare complication after taking sodium bicarbonate, gastric rupture due to the sudden release of a large amount of gas has been described (A.V. Okhlobystin).

In the 19th century, “soda” was one of the most popular remedies for heartburn; for example, P.I. constantly took it. Chaikovsky.

Sodium bicarbonate in acid-suppressing drugs

Despite the negative attitude towards sodium bicarbonate as a means of relieving heartburn, it is sometimes included in medications intended to reduce acidity in the upper gastrointestinal tract, in sufficient quantities to be considered as another active ingredient (although the instructions for this sodium bicarbonate may be listed among the excipients rather than the active substances).
Proton pump inhibitors

.
There are two versions of the proton pump inhibitor Zegerid
.
Zegerid itself is prescription and over-the-counter Zegerid OTC
.
Zegerid is not registered in Russia, but Omez Insta
. Both medicines contain omeprazole and sodium bicarbonate. In the US, Zegerid is marketed as the only "immediate response" proton pump inhibitor that does not have the "overnight acid breakthrough" phenomenon. It is intended for relief of symptoms of gastroesophageal reflux disease, short-term (4-8 weeks) therapy of erosive esophagitis, confirmed by endoscopy, gastric and duodenal ulcers. The content of omeprazole and sodium bicarbonate in various dosage forms of these drugs is given in the table:

Note.
*) The sachet contains powder for the preparation of a suspension for oral administration. Alginates.

The only medicine for the treatment of acid-related diseases from this group approved in Russia, as well as in the USA, is
Gaviscon
and its variants Gaviscon Forte and Gaviscon Double Action. In addition to the “main” active ingredient - sodium alginate, Gaviscon contains sodium bicarbonate and calcium carbonate. When sodium alginate enters the stomach, it quickly reacts with its acidic contents, resulting in the formation of an alginate gel that has an almost neutral acidity value (gel pH is about 7). The gel forms a protective barrier on the surface of the stomach contents, preventing the occurrence of gastroesophageal reflux. In case of regurgitation or reflux, the gel enters the esophagus, where it has a neutralizing effect on hydrochloric acid and pepsin that enter during reflux and additionally protects the mucous membrane of the esophagus. The content of sodium alginate and sodium bicarbonate in various dosage forms of Gaviscon is given in the table:

Sodium bicarbonate in other medicines

In addition to the medications described above for the treatment of acid-dependent diseases, sodium bicarbonate is included as an active ingredient, in particular, in the following medications:

• osmotic laxative Endofalk
  , one sachet of which includes: macrogol 3350 52.5 g, sodium chloride 1.4 g, sodium bicarbonate 715 mg, potassium chloride 185 mg
• osmotic laxative Lavacol
  , one sachet of which includes: macrogol 4000 12.0 g, sodium sulfate anhydrous 1.0 g, sodium bicarbonate 0.6 g, sodium chloride 0.2 g, potassium chloride 0.2 g
• antitussive drug Codelac
  , one tablet of which contains: codeine 8 mg, sodium bicarbonate 200 mg, licorice root powder 200 mg, thermopsis lanceolate herb powder 20 mg
• a drug for the treatment of cough that has a mucolytic and expectorant effect, Codelac Broncho
  , one tablet of which contains: ambroxol hydrochloride 20 mg, sodium glycyrrhizinate 30 mg, thermopsis dry extract 10 mg, sodium bicarbonate 200 mg
• solution for infusion with detoxification effect Gemodez-N
  , 100 ml of which contains: medical povidone with a molecular weight of 8000 6 g, sodium chloride 550 mg, potassium chloride 42 mg, calcium chloride 50 mg, magnesium chloride anhydrous 500 mcg, sodium bicarbonate 23 mg

The use of sodium bicarbonate in the study of the stomach (Noller test)

The Knoller test (alkaline test) is performed to obtain information about the amount of hydrochloric acid in the patient’s stomach, the intensity of acid formation, and also, indirectly, the amount of gastric juice. The test is carried out simultaneously with the intragastric pH-metry
, 20 minutes after stabilization of acidity under basal conditions or 45 minutes after the administration of stimulants. At a pH equal to or higher than 4.0, the alkaline test is not performed.

The patient drinks 0.5 g of sodium bicarbonate dissolved in 30 ml of distilled water. Typically, the pH in the body of the stomach is recorded below 2.5. As a result of the introduction of alkali into the stomach, the pH values ​​​​change to alkaline and remain at the same level for a certain time, and then, after some time, called “alkaline time,” they return to the original ones. The alkaline time determines the state of acid production in the patient’s stomach (S.I. Rapoport et al.):

The figure shows an example of a pH gram in

three sections of the stomach
(in the antrum - lower graph, in the body of the stomach - middle and in the cardiac section of the stomach closest to the esophagus - lower graph) of a patient with chronic superficial gastritis and high acidity in the antrum. Basal acidity is shown (the first 30 minutes, basal - that is, before any stimulation) and acidity after the alkaline test (AL) and histamine stimulation (HT).

Bicarbonates as a natural means of protecting the gastrointestinal tract from acid

In the stomach and duodenum, bicarbonate ions HCO3– are secreted by surface epithelial cells. Bicarbonates play a vital role in the digestive process, neutralizing hydrochloric acid and protecting the tissues of the digestive organs from its effects.

In an acidic environment, bicarbonate ions react irreversibly with hydrogen ions to form water and carbon dioxide:
H+ + HCO3– = H2CO3 = H2O + CO2

Bicarbonates, together with mucus, constitute the so-called pre-epithelial level of protection of the gastric mucosa. Mucus cannot protect the epithelium from H+ ions without bicarbonates constantly entering it, also secreted by the surface epithelium. With the help of bicarbonates, a pH gradient is maintained in the mucus: on the surface facing the lumen of the stomach, the environment is acidic, and on the epithelial cells it is neutral or slightly alkaline. Immediate mixing of bicarbonates with the acidic secretion in the lumen and neutralization does not occur: the mucus layer forms a barrier, due to which the pH gradient exists (T.L. Lapina).

Bicarbonates are also secreted by the ductal cells of the pancreas and, together with pancreatic juice, enter the duodenum, where they participate in the neutralization of hydrochloric acid (O.A. Sablin et al.).

Bicarbonate in mineral waters

Hydrocarbonate ions HCO3– are present in almost all natural mineral waters.
To determine them in water, GOST 23268.3-78 “Healing mineral drinking waters, medicinal table waters and natural table waters” is used. Methods for determining bicarbonate ions". According to GOST R 54316-2011. “Natural drinking mineral waters. General technical conditions" the content of bicarbonates is indicated on consumer packaging (on the labels of bottles of mineral water). Content of hydrocarbonates in some natural mineral waters (g/l):

• healing mineral waters:
• Nagutskaya-17 — 5.0–7.2
• Essentuki No. 17 — 4.9–6.5

• Nagutskaya-56 — 4.2–5.6
• Essentuki No. 4 - 3.4–4.8
• Narzan - 1.0–1.5
• Kashinskaya - less than 0.05

• Gelendzhikskaya 117 — 0.35–0.7
• Essentuki Novaya-55 - 0.2–0.35

Bicarbonate anions give mineral water an alkaline character and most often combine with sodium cations to form sodium bicarbonate. Sodium bicarbonate waters increase the alkaline reserve of the blood, have an antacid effect (by reducing the concentration of H+ ions), reduce pyloric spasm and accelerate the evacuation of gastric contents, which helps reduce pain and dyspeptic symptoms. Alkaline waters thin and help remove excess mucus, which is formed during inflammation in the gastrointestinal tract, urinary and respiratory tracts. In addition, they improve nucleic acid metabolism, reduce the formation of uric acid and promote the removal of excess from the body, alkalize bile and increase the secretion of bilirubin, cholesterol and mucus. In diabetes mellitus, these waters reduce hyperglycemia and increase tolerance to carbohydrates. And finally, in combination with bicarbonate, macro- and microelements, in particular iron, are better absorbed from the intestine (Baranovsky A.Yu. et al.).

Professional medical articles addressing the role of bicarbonates and sodium bicarbonate in gastroenterology

• Mikheev A.G., Nevsky D.I., Rakitin A.B., Rakitin B.V. Study of pH dynamics in alkaline dough // Izvestiya VUZov. North Caucasus region. Natural Sciences. – 2006. Special issue. – pp. 44–46.
• Sablin O.A., Grinevich V.B., Uspensky Yu.P., Ratnikov V.A. Stomach. Methods for studying alkaline secretion. Functional diagnostics in gastroenterology. St. Petersburg 2002
• Lapina T.L. Possibilities of medicinal effects on the cytoprotective properties of the gastroduodenal mucosa // Russian Journal of Gastroenterology, Hepatology, Coloproctology. – 2006. – No. 5. – volume XVI. – c. 2–7.
• Ushkalova E.A. Clinical pharmacology of modern antacids // Farmateka. – 2006. – No. 11. – p.1–6.
• Gelfand B.R. , Filimonov M.I., Mamontova O.A. and others. Prevention and treatment of stress damage to the gastrointestinal tract in patients in critical conditions // Methodological recommendations. - Moscow. - 2010. - 34 p.

On the website in the literature catalog there is a section “Antacids”, containing articles devoted to the treatment of diseases of the gastrointestinal tract with antacids. Back to section

Baking soda (sodium bicarbonate)

When professional cyclists were given 0.3g/kg bicarbonate (divided into 5 doses over 60 minutes) during a 4-minute cycling test, while the other group had already been taking bicarbonate for 3 days (0.4g/kg 3 times a day), then all participants in the experiment increased endurance and performance (by 2.2-3.1%) and increased the maximum initial speed of VO2 max (by 1.2-2%). Similar results were obtained in another cycling test (with weights; taking 300 mg/kg sodium bicarbonate increased the time to exhaustion rate from 61.5+/-2 to 75.3+/-8; 22.4%) , and in another study (500mg/kg x 5 days; 60s cycling) - 14.2%,[174] however, in contrast to these three experiments, there are many failed experiments in which bicarbonate had no effect on performance and endurance cyclists during a 2-3 minute ride at 110% VO2 max,43) a 3-minute sprint for amateur cyclists, a 90-second obstacle course, a series of short rides (60s) for women and BMX cyclists. As for long (and/or medium-duration) races, bicarbonate does not lose its effectiveness here (in healthy men; 14-second sprint followed by 16 seconds of rest; a total of 60 races within 30 minutes), increasing the endurance of athletes by 11 .5+/-5% (on average), with 4 second rides (100s pedaling and 20s rest) for a total duration of 36 minutes, bicarbonate also effectively increases the endurance of cyclists (400mg/kg in professional cyclists), the same can be said for 5 rides of 6 seconds each with 30 second breaks (5%) and doubling the duration of each ride (2%), about 5 separate 60 second rides, of which only the last used a placebo control (the distance the cyclist covers in 1 minute, increased by 42%), as well as about 10 separate 10-second runs with 50-second breaks (with isolated cases of an increase in peak power by 0.9-2%). The impressive results of the study were not confirmed in another experiment involving men with poor physical fitness who participated in 5-minute cycling races (at 70, 80 and 90% VO2 max), followed by another sprint at 100% VO2 max (endurance). ), while pre-administered sodium bicarbonate (300 mg/kg) did not have a significant effect on any of the indicators.44) During the differentiated cycling test (every 4 minutes, the cyclists made the task more difficult so that in the end they were completely exhausted, or pedaled until until the RPM drops to 60) in women who were given 200mg/kg sodium bicarbonate daily while training for 8 weeks, scientists noticed that the participants became significantly more resilient (by 164%), whereas in women who took a placebo under the guise of bicarbonate all this time, endurance increased by 123%. 45) If we talk about short-term races, then, in most cases, there is no benefit from bicarbonate. And yet, with repeated sprints (short races that are repeated many times) it helps more often than not. In a 3km ride with professional cyclists pre-given 300mg/kg sodium bicarbonate, the drug was found to shorten ride time by 1.2% (similar to 3mg/kg caffeine), while increasing cyclists' performance and endurance , on average, by 2.6%, while during the 60m race, the average performance and endurance of the participants increased by 13.7%, while the maximum value of this indicator remained virtually unchanged. Nutritionists recommend taking sodium bicarbonate during prolonged aerobic exercise (about 60 minutes) because it stimulates energy production in the later stages of exercise, thereby improving energy quality. Results from experiments involving rowers who took 300mg/kg sodium bicarbonate (or, in one test, 500mg/kg) either as a single dose 60 to 90 days before exercise or for three days prior suggest that bicarbonate, rowers' endurance increases (slightly) and, as a result, they begin to row faster (that is, if previously they spent 6 minutes 16 seconds on a 2000-meter sprint, then after taking bicarbonate - 6m 1s, that is, 1.3% faster ), which was confirmed in other experiments (time per sprint decreased by an average of 1.8%). And yet, in most cases, these experiments do not produce the expected results.46) All of them were 2000-meter sprints, except for one 2-meter endurance test. Including sodium bicarbonate in a fluid-rich diet (resulting in a person losing 4% of body weight to get into pre-workout shape) also does not produce any significant positive changes, as does longer-term (4 weeks) daily supplementation of 300 mg/day. kg bicarbonate (the effect is no different from placebo). Experiments involving professional rowers who were given sodium bicarbonate before starting a 2000m sprint were mostly ineffective, that is, bicarbonate most often does not improve endurance and performance, only in some (in their own words, that is, purely subjective).