Maximum Oral Dose of Sodium Bicarbonate
The maximum oral dose of sodium bicarbonate is 24 tablets (approximately 12-13 grams) per day for adults up to 60 years of age, and 12 tablets (approximately 6-6.5 grams) per day for adults 60 years and older, with this maximum dosage not to be used for more than 2 weeks except under physician supervision. 1
FDA-Approved Dosing Limits
The FDA drug label provides explicit maximum dosing parameters for oral sodium bicarbonate:
- Adults under 60 years: Maximum of 24 tablets per 24-hour period 1
- Adults 60 years and older: Maximum of 12 tablets per 24-hour period 1
- Duration limit: Do not use maximum dosage for more than 2 weeks without physician supervision 1
Critical Safety Warnings
The FDA mandates several important precautions that must be followed:
- Complete dissolution required: Do NOT take until tablet is completely dissolved in water to avoid serious injury 1
- Timing restriction: It is very important NOT to take this product when overly full from food or drink 1
- Sodium restriction: Do not use if on a sodium-restricted diet unless directed by a doctor 1
Chronic Kidney Disease Context
For patients with chronic kidney disease requiring long-term oral sodium bicarbonate therapy, the dosing differs substantially from over-the-counter use:
- Therapeutic dose: 2-4 grams per day (25-50 mEq/day) for chronic kidney disease patients 2
- Target: Maintain serum bicarbonate ≥22 mmol/L 2
- This chronic dosing is lower than the maximum OTC dose and requires medical supervision 2
Sports Performance Context (Not Medical Use)
Research on sodium bicarbonate for exercise performance uses different dosing:
- Ergogenic dose: 0.2-0.3 g/kg body weight (approximately 14-21 grams for a 70 kg person) 3
- Timing: 60-180 minutes before exercise 3
- Side effects: Higher doses (0.4-0.5 g/kg) increase gastrointestinal symptoms without additional benefit 3
Important caveat: These sports performance doses exceed FDA-approved OTC limits and should not be used for medical purposes without physician supervision 1, 3
Common Pitfalls to Avoid
- Exceeding daily limits: Taking more than the specified maximum can cause severe electrolyte abnormalities, fluid overload, and metabolic alkalosis 4
- Inadequate dissolution: Swallowing undissolved tablets can cause serious gastrointestinal injury 1
- Prolonged use: Using maximum doses beyond 2 weeks without medical supervision risks sodium overload and metabolic complications 1
- Ignoring age-based limits: Older adults (≥60 years) have half the maximum dose of younger adults due to increased risk of adverse effects 1