From the FDA Drug Label
Drug Facts Active Ingredient (in each tablet) Sodium bicarbonate 10 gr (650 mg) Directions: Adults - Take 1 tablet, dissolved in a glass of water, as needed. The maximum dose of sodium bicarbonate per tablet is 650 mg as indicated in the drug label 1.
- The maximum daily dose is not explicitly stated in terms of milligrams, but rather in terms of the number of tablets, with a maximum of 24 tablets for adults up to 60 years of age and 12 tablets for adults 60 years of age and older 1. Since each tablet contains 650 mg of sodium bicarbonate, the maximum daily dose would be 24 tablets * 650 mg/tablet = 15,600 mg for adults up to 60 years of age and 12 tablets * 650 mg/tablet = 7,800 mg for adults 60 years of age and older.
From the Research
The maximum dose of sodium bicarbonate is typically 650 mg per dose for adults when used as an antacid for temporary relief of acid indigestion and heartburn. This dose can be taken as needed, but should not exceed 7 doses (4,550 mg) in a 24-hour period. Sodium bicarbonate works by neutralizing excess stomach acid, which helps relieve symptoms of acid reflux and indigestion. It's essential to consider the patient's underlying health conditions, such as hypertension, heart failure, or kidney disease, as sodium bicarbonate contains significant amounts of sodium (about 27% by weight) and may worsen these conditions due to sodium retention 2. Side effects may include belching, flatulence, and increased thirst. Long-term use is not recommended as it can cause metabolic alkalosis, electrolyte imbalances, and milk-alkali syndrome. If symptoms persist for more than two weeks, medical attention should be sought as this may indicate a more serious underlying condition.
Some key points to consider when interpreting arterial blood gases (ABGs) include:
- Understanding the physiological basis for assessing ABGs perioperatively 3
- Using a systematic approach to blood gas analysis, such as the Romanski method 3
- Considering the patient's acid-base balance and identifying any metabolic or respiratory abnormalities 4, 5
- Recognizing the importance of compensation and the degrees of compensation 6
In terms of sodium bicarbonate dosing, it's crucial to prioritize the patient's safety and avoid excessive sodium intake, particularly in those with pre-existing conditions. The most recent and highest quality study on this topic is not directly related to sodium bicarbonate dosing, but rather focuses on arterial blood gas analysis and interpretation 5. However, this study highlights the importance of understanding acid-base balance and its relevance to patient care.
Key considerations for sodium bicarbonate use include:
- Monitoring for signs of metabolic alkalosis, electrolyte imbalances, and milk-alkali syndrome
- Avoiding long-term use and seeking medical attention if symptoms persist
- Being cautious in patients with hypertension, heart failure, or kidney disease due to the risk of sodium retention 2