Sodium Bicarbonate as an Antacid
Baking soda (sodium bicarbonate) is the antacid made from sodium bicarbonate, typically available in 650 mg (10 grain) tablets for oral use as an antacid. 1
Composition and Formulation
- Sodium bicarbonate is available as an over-the-counter antacid in tablet form
- The active ingredient in each tablet is 650 mg (10 grain) of sodium bicarbonate 1
- It is commonly known as "baking soda" when in powder form for household use
Mechanism of Action
Sodium bicarbonate works as an antacid by:
- Neutralizing stomach acid through its alkaline properties
- Increasing the pH of the stomach contents
- Providing rapid relief from acid indigestion, heartburn, and sour stomach
Clinical Uses
Sodium bicarbonate is primarily used as:
- An antacid for temporary relief of acid indigestion 1
- A treatment for specific medical conditions:
- First-line therapy for sodium channel blocker toxicity (e.g., tricyclic antidepressant overdose) 2
- Management of certain types of metabolic acidosis
- Treatment of hyperkalemia in emergency situations
Cautions and Adverse Effects
When used as an antacid, sodium bicarbonate carries several risks:
- Metabolic alkalosis from excessive use 3, 4
- Electrolyte imbalances including hypokalemia and hypernatremia 3
- Potential for significant toxicity when ingested in excessive amounts 4
- Risk of acid rebound effect
Patterns of Misuse
Research has documented concerning patterns of sodium bicarbonate misuse:
- Chronic use as a home remedy for indigestion 4
- Attempts to "beat" urine drug tests (11.5% of misuse cases) 4
- Self-treatment of urinary tract infections (4.7% of misuse cases) 4
- Use as a toothpaste additive, which can lead to inadvertent ingestion and metabolic alkalosis 5
Clinical Implications
- Over 55% of cases involving baking soda misuse required medical evaluation 4
- 12% of patients in one study required hospital admission for electrolyte imbalances, metabolic alkalosis, or respiratory depression 4
- High-risk populations include those who chronically use it as an antacid, pregnant women, and young children 4
Alternative Antacids
Other antacid options that may have fewer risks include:
- Calcium carbonate-based antacids
- Aluminum hydroxide/magnesium hydroxide combinations
- H2 receptor antagonists
- Proton pump inhibitors for more severe or persistent symptoms
Sodium bicarbonate remains an effective antacid option for short-term, occasional use, but patients should be educated about proper dosing and potential risks of overuse or misuse.