Do you have a picture of the sodium bicarbonate and lidocaine (lido) with epinephrine (epi) bottles?

Medical Advisory BoardAll articles are reviewed for accuracy by our Medical Advisory Board
Educational purpose only • Exercise caution as content is pending human review
Article Review Status
Submitted
Under Review
Approved

Last updated: November 17, 2025View editorial policy

Personalize

Help us tailor your experience

Which best describes you? Your choice helps us use language that's most understandable for you.

I cannot provide pictures of medication bottles, as I am a text-based medical consultant without the ability to display images.

What I Can Provide Instead

For medication identification and verification purposes, you should refer to the actual physical bottles in your clinical setting or consult your pharmacy. However, I can describe the standard labeling and appearance based on FDA specifications and clinical guidelines:

Sodium Bicarbonate Injectable Solutions

  • Standard concentrations available: 8.4% (84 mg/mL = 1 mEq/mL), 7.5% (75 mg/mL = 0.9 mEq/mL), and 4.2% (42 mg/mL = 0.5 mEq/mL) 1
  • Common vial sizes: 10 mL and 50 mL multiple-dose vials 1
  • Storage requirements: Store at 20°C to 25°C (68°F to 77°F), protect from freezing and excessive heat 1
  • Pediatric-specific requirement: For children under 2 years, only 4.2% concentration should be used, requiring 1:1 dilution of 8.4% solution with normal saline 2, 3

Lidocaine with Epinephrine Injectable Solutions

  • Standard concentrations: 1% (10 mg/mL) and 2% (20 mg/mL) lidocaine with epinephrine 1:100,000 4
  • Common vial sizes: 2 mL, 30 mL, and 50 mL multiple-dose vials preserved with 0.1% methylparaben 4
  • Storage requirements: Store at 20°C to 25°C (68°F to 77°F) 4
  • pH characteristics: Lidocaine 1% with epinephrine 1:100,000 has a mean pH of 4.24, making it approximately 1000 times more acidic than subcutaneous tissue 5

Critical Safety Considerations

  • Never mix sodium bicarbonate with catecholamines (including epinephrine) or calcium-containing solutions in the same syringe or IV line, as bicarbonate inactivates catecholamines and precipitates with calcium 2, 6
  • Flush IV lines with normal saline before and after bicarbonate administration if catecholamines are being used 7
  • For pain reduction during lidocaine infiltration, bicarbonate can be added to lidocaine solutions at a ratio of approximately 1 mL of 8.4% sodium bicarbonate per 10 mL of lidocaine with epinephrine, but this must be done immediately before use 5, 8

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Guideline

Sodium Bicarbonate Infusion for Acidosis

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Research

How acidic is the lidocaine we are injecting, and how much bicarbonate should we add?

The Canadian journal of plastic surgery = Journal canadien de chirurgie plastique, 2012

Guideline

Adrenergic Drug Therapy

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Guideline

Management of Tricyclic Antidepressant Overdose

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2025

Related Questions

Is bicarbonate (sodium bicarbonate) administration recommended for pH correction to enhance lidocaine (antiarrhythmic agent) efficacy?
What is the recommended bicarbonate concentration to inject with lidocaine (local anesthetic)?
Is it safe to add bicarbonate to a local anesthetic mixture of lidocaine (lido) and epinephrine (epi)?
What is the recommended mixture for drawing up lidocaine (local anesthetic)/sodium bicarbonate (NaHCO3)/epinephrine (adrenaline) injection for aesthetic numbing?
What is the maximum dose of 2% lidocaine (lignocaine) with adrenaline (epinephrine) that can be administered to a 15kg child?
Does Centrum (cholecalciferol) vitamin D3 contribute to meeting the vitamin D3 needs of individuals with osteoporosis?
What are the treatment options for a new skin tag with symptoms of itchiness and bleeding?
Which statement is correct regarding medication errors: A) An Adverse Drug Event (ADE) is always associated with a medication error, B) A near miss results in patient harm, C) Medication errors are preventable, or D) Side effects are a result of medication errors?
What is the most appropriate anticoagulant regimen for Venous Thromboembolism (VTE) prophylaxis in a medically ill patient with Impaired Renal Function (creatinine clearance of 28 mL/min)?
What are the treatment options for skin tags?
What is the diagnosis and treatment for a patient with pain in the left foot and X-ray findings showing moderate degenerative changes at the 1st Tarsometatarsal (TMT) joint and a moderate-sized plantar calcaneal enthesophyte?

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

Have a follow-up question?

Our Medical A.I. is used by practicing medical doctors at top research institutions around the world. Ask any follow up question and get world-class guideline-backed answers instantly.