Bicarbonato de sodio
Sodium Bicarbonate
Sodium hydrogen carbonate
También conocido como: Baking soda · Neut · Zegerid · E500 · monosodium carbonate · natrii bicarbonas · natrii hydrogenocarbonas · sal de vichy · sodium acid carbonate · NaHCO3 · sodium hydrogen carbonate
Revisado por el equipo veterinario de VetSheetActualizado 5 abr 2026Referencia veterinaria basada en la evidencia
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Dosis por especie
🌎 NA — North America🌍 EU — Europe
Perros
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Severe metabolic acidosis | mEq of bicarbonate required = 0.5 x body weight in kg x (desired total CO2 mEq/L minus measured total CO2 mEq/L). Give 1/2 of the calculated dose slowly over 3-4 hours IV. | IV | Once | Over 3-4 hours | 🌎 NA |
| Metabolic acidosis secondary to uremia | 0.3 x body weight (kilograms) x the base deficit. Administration of one third of this dose slowly IV and the rest placed in the intravenous fluids. OR 1-2 mEq/kg of bicarbonate can be given as a slow IV bolus if blood gas is not possible. | IV | Once | Over several hours | 🌎 NA |
| Adjunctive therapy of diabetic ketoacidosis | Dose (in mEq) = body weight in kgs. x 0.4 x (12 - patient's bicarbonate) x 0.5. Give above dose over 6 hours in IV fluids. | IV | Once | Over 6 hours | 🌎 NA |
| Adjunctive treatment of hypercalcemic crisis | mEq of bicarbonate required = 0.3 x body weight in kg x (desired plasma bicarbonate mEq/L - measured plasma bicarbonate mEq/L); or 1 mEq/kg IV every 10-15 minutes; maximum total dose: 4 mEq/L | IV | q10-15m | Until effect or max dose | 🌎 NA |
| Adjunctive therapy for hyperkalemic crises | 2-3 mEq/kg IV over 30 minutes (if decreased tissue perfusion/renal failure and no DKA) OR 1-2 mEq/kg IV slowly | IV | Once | Over 30 minutes or slowly | 🌎 NA |
| To alkalinize the urine | 10-90 grains (650 mg-5.85 grams) PO per day | PO | Daily | Ongoing | 🌎 NA |
| Dissolution and/or prevention of urate urolithiasis | 0.5-1 gram (1/8-1/4 tsp.) per 5 kg of body weight three times daily PO | PO | q8h | Ongoing | 🌎 NA |
- Severe metabolic acidosis: Recheck blood gases and assess clinical status. Avoid over-alkalinization.
- Metabolic acidosis secondary to uremia: Avoid rapid IV boluses. Recheck blood gas after 2-4 hours.
- Adjunctive therapy of diabetic ketoacidosis: Only if plasma bicarbonate is <=11 mEq/L. Recheck and repeat if still <=11 mEq/L. Use is controversial.
- Adjunctive therapy for hyperkalemic crises: Must be used judiciously.
- To alkalinize the urine: Goal is urine pH of about 7; avoid pH >7.5.
- Dissolution and/or prevention of urate urolithiasis: Goal is urine pH of 7-7.5.
Gatos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Severe metabolic acidosis | mEq of bicarbonate required = 0.5 x body weight in kg x (desired total CO2 mEq/L minus measured total CO2 mEq/L). Give 1/2 of the calculated dose slowly over 3-4 hours IV. | IV | Once | Over 3-4 hours | 🌎 NA |
| Metabolic acidosis secondary to uremia | 0.3 x body weight (kilograms) x the base deficit. Administration of one third of this dose slowly IV and the rest placed in the intravenous fluids. OR 1-2 mEq/kg of bicarbonate can be given as a slow IV bolus if blood gas is not possible. | IV | Once | Over several hours | 🌎 NA |
| Adjunctive therapy of diabetic ketoacidosis | Dose (in mEq) = body weight in kgs. x 0.4 x (12 - patient's bicarbonate) x 0.5. Give above dose over 6 hours in IV fluids. | IV | Once | Over 6 hours | 🌎 NA |
| Adjunctive treatment of hypercalcemic crisis | mEq of bicarbonate required = 0.3 x body weight in kg x (desired plasma bicarbonate mEq/L - measured plasma bicarbonate mEq/L); or 1 mEq/kg IV every 10-15 minutes; maximum total dose: 4 mEq/L | IV | q10-15m | Until effect or max dose | 🌎 NA |
| Adjunctive therapy for hyperkalemic crises | 2-3 mEq/kg IV over 30 minutes (if decreased tissue perfusion/renal failure and no DKA) OR 1-2 mEq/kg IV slowly | IV | Once | Over 30 minutes or slowly | 🌎 NA |
| To alkalinize the urine | 10-90 grains (650 mg-5.85 grams) PO per day | PO | Daily | Ongoing | 🌎 NA |
- Severe metabolic acidosis: Recheck blood gases and assess clinical status. Avoid over-alkalinization.
- Metabolic acidosis secondary to uremia: Avoid rapid IV boluses. Recheck blood gas after 2-4 hours.
- Adjunctive therapy of diabetic ketoacidosis: Only if plasma bicarbonate is <=11 mEq/L. Recheck and repeat if still <=11 mEq/L. Use is controversial.
- Adjunctive therapy for hyperkalemic crises: Must be used judiciously.
- To alkalinize the urine: Goal is urine pH of about 7; avoid pH >7.5.
Aves
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Metabolic acidosis | 1 mEq/kg initially IV (then SC) for 15-30 minutes to a maximum of 4 mEq/kg | IV/SC | Once | 15-30 minutes | 🌎 NA |
Caballos
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Metabolic acidosis (associated with colic) | bicarbonate deficit (HCO3 mEq) = base deficit (mEq/L) x 0.4 x body weight (kg). May administer as a 5% sodium bicarbonate solution. Should not be administered any faster than 1-2 L/hr. | IV | Once | Continuous infusion | 🌎 NA |
- Metabolic acidosis (associated with colic): If pH is <7.3 and base deficit is >10 mEq/L. May be preferable to give as isotonic sodium bicarbonate (150 mEq/L) if dehydrated.
Ganado
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Acidosis | 2-5 mEq/kg IV for a 4-8 hour period | IV | Once | Over 4-8 hours | 🌎 NA |
| Severely dehydrated acidotic calves | Isotonic sodium bicarbonate (156 mEq/L). Most calves require about 2 liters of this solution given over 1-2 hours, then change to isotonic saline and sodium bicarbonate or a balanced electrolyte solution. | IV | Once | Over 1-2 hours | 🌎 NA |
- Severely dehydrated acidotic calves: Isotonic solution: 13 grams of sodium bicarbonate in 1 L of sterile water.
Ovejas
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Acidosis (Ruminants) | 2-5 mEq/kg IV for a 4-8 hour period | IV | Once | Over 4-8 hours | 🌎 NA |
Cabras
| Indicación | Dosis | Vía | Frecuencia | Duración | Región |
|---|---|---|---|---|---|
| Acidosis (Ruminants) | 2-5 mEq/kg IV for a 4-8 hour period | IV | Once | Over 4-8 hours | 🌎 NA |
Las dosis son una referencia clínica para profesionales veterinarios autorizados. Confirme siempre con el prospecto actual y cada paciente individual.
Resumen
El bicarbonato de sodio es un agente alcalinizante sistémico y urinario ampliamente utilizado en medicina veterinaria de urgencias y cuidados críticos, así como para el manejo crónico de condiciones específicas.
- Manejo de urgencias ácido-base: Utilizado principalmente para corregir la acidosis metabólica grave, particularmente cuando la causa subyacente no puede revertirse rápidamente y el pH sanguíneo cae a niveles críticamente bajos.
- Crisis electrolíticas: Sirve como tratamiento adyuvante para la hiperpotasemia potencialmente mortal (al desplazar el potasio al interior de las células) y la hipercalcemia.
- Alcalinización urinaria: Administrado por vía oral para manejar o prevenir urolitos específicos (p. ej., uratos, cistina) al aumentar el pH urinario.
Perla clínica: El uso rutinario de bicarbonato de sodio en la reanimación cardiopulmonar (RCP) y en la cetoacidosis diabética (CAD) ha dejado de recomendarse. En la CAD, puede empeorar la hipopotasemia intracelular y causar acidosis paradójica del SNC. En la RCP, puede conducir a hipercapnia si el paciente no está adecuadamente ventilado.
Mecanismo de acción
Sodium bicarbonate acts as an exogenous source of bicarbonate anion ($HCO_3^-$), which is the primary extracellular buffer in the body.
- Buffering Acidosis: $HCO_3^-$ combines with free hydrogen ions ($H^+$) to form carbonic acid ($H_2CO_3$), which then dissociates into water ($H_2O$) and carbon dioxide ($CO_2$).
- Pathway: $HCO_3^-$ + $H^+$ → $H_2CO_3$ → $H_2O$ + $CO_2$ (The $CO_2$ must be exhaled via the lungs, highlighting the need for adequate ventilation).
- Hyperkalemia Management: By increasing blood pH, it stimulates the $Na^+/H^+$ exchanger and subsequently the $Na^+/K^+$-ATPase pump, driving potassium into cells and rapidly lowering serum potassium levels.
- Urinary Alkalinization: Bicarbonate is excreted in the urine, raising the pH. This increases the solubility of weak acids (like uric acid and cystine) and decreases the solubility of weak bases.
Seguridad y advertencias
Contraindicaciones
- Metabolic or respiratory alkalosis
- Excessive chloride loss secondary to vomiting or GI suction
- Patients at risk for development of diuretic-induced hypochloremic alkalosis
- Hypocalcemia (alkalosis may induce tetany)
- Hypoventilating patients
- Hypercapnoeic patients
- Animals unable to effectively expel carbon dioxide
Efectos adversos
- Metabolic alkalosis
- Hypokalemia
- Hypocalcemia
- 'Overshoot' alkalosis
- Hypernatremia
- Volume overload
- Shifts in the oxygen dissociation curve (decreased tissue oxygenation)
- Paradoxical CNS acidosis leading to respiratory arrest
- Hypercapnia (if not well ventilated during CPR)
- Predisposition to ventricular fibrillation
- Hypernatraemia
- Congestive heart failure (due to sodium load)
- Decreased tissue oxygenation (shift in oxygen dissociation curve)
Precauciones
Extreme Caution: Use with extreme caution and give very slowly in patients with hypocalcemia to avoid inducing tetany. Caution: Because of the potential sodium load, use with caution in patients with congestive heart failure (CHF), nephrotic syndrome, hypertension, oliguria, acute renal failure, or volume overload. Ventilation: When used during CPR, ensure the patient is well ventilated to prevent hypercapnia and paradoxical CNS acidosis.
Interacciones farmacológicas
Concomitant oral sodium bicarbonate may reduce absorption; administer separately
Concomitant oral sodium bicarbonate may reduce absorption; administer separately
Solubility is decreased in an alkaline environment; monitor for signs of crystalluria
Patients receiving high dosages of sodium bicarbonate and ACTH or glucocorticoids may develop hypernatremia
Concurrent use in patients receiving potassium-wasting diuretics may cause hypochloremic alkalosis
When urine is alkalinized, excretion may be decreased
Concomitant oral sodium bicarbonate may reduce absorption; administer separately
Concomitant oral sodium bicarbonate may reduce absorption; administer separately
Can increase or reduce absorption rate/extent; avoid giving other drugs within 12 hours of oral sodium bicarbonate
When urine is alkalinized, excretion may be decreased
When urine is alkalinized, excretion of weakly acidic drugs may be increased
Oral sodium bicarbonate may reduce efficacy if administered concurrently
Concomitant oral sodium bicarbonate may reduce absorption; administer separately
Incompatible in solution; do not mix unless checked beforehand (risk of precipitation)
Decreased excretion due to alkalinization of the urine
Increased excretion due to alkalinization of the urine
Increased excretion due to alkalinization of the urine
Increased excretion due to alkalinization of the urine
Monitorización
- Acid/base status (venous or arterial blood gases)
- Serum electrolytes (especially potassium, calcium, and sodium)
- Urine pH (if being used to alkalinize urine)
- Blood gas analysis (pH, pCO2, HCO3-)
- Serum electrolytes (Na+, K+, Ca2+)
- Respiratory rate and effort
- Clinical signs of fluid overload or congestive heart failure
Farmacocinética
Absorción
Well absorbed orally.
Distribución
Bicarbonate increases initially in the intravascular space, but is then buffered by intracellular buffers. Diffusion and buffering by intracellular buffers takes approximately 2-4 hours.
Metabolismo
Combines with hydrogen ions to form carbonic acid, which dissociates into water and carbon dioxide (exhaled by the lungs).
Eliminación
Filtered and reabsorbed by the kidneys; excess is excreted in the urine, resulting in urinary alkalinization.
Sobredosis
Overdose or overly rapid administration can cause severe alkalosis, leading to irritability, muscle twitching, or tetany (due to a sudden drop in ionized calcium).
- Mild Overdose: May only require discontinuing the bicarbonate therapy or using a rebreathing mask.
- Severe Alkalosis: May require intravenous calcium therapy to treat tetany.
- Electrolyte Correction: Sodium chloride or potassium chloride may be necessary if hypokalemia or hypochloremia is present.
Always thoroughly check dosages and frequently monitor electrolyte and acid/base status during administration.
Productos disponibles
Formulaciones
- Injection: 4%, 4.2%, 5%, 7.5%, 8.4%
- Oral tablets: 325 mg, 650 mg
- Oral powder
- Oral suspension/capsules (combination with omeprazole)
- 1.26% solution for IV infusion
- 4.2% solution for IV infusion
- 8.4% solution for IV infusion (1 mmol/ml)
- 300 mg oral tablet
- 500 mg oral tablet
- 600 mg oral tablet
Veterinario
- Sodium Bicarbonate Injection: 8.4% (1 mEq/mL) in 50 mL, 100 mL, and 500 mL vials
Etiquetado para humanos
- Sodium Bicarbonate Neutralizing Additive Solution: 4% (0.48 mEq/mL), 4.2% (0.5 mEq/mL)
- Sodium Bicarbonate Injection: 4.2%, 5%, 7.5%, 8.4%
- Sodium Bicarbonate Tablets: 325 mg & 650 mg (OTC)
- Sodium Bicarbonate Powder: 120 grams, 300 grams & 1 lb (OTC)
- Omeprazole/Sodium Bicarbonate Capsules (Zegerid): 20 mg/1,100 mg & 40 mg/1,100 mg
- Omeprazole/Sodium Bicarbonate Powder for Oral Suspension (Zegerid): 20 mg/1,680 mg & 40 mg/1,680 mg
- 1.26% IV infusion
- 4.2% IV infusion
- 8.4% IV infusion
- 300 mg tablets
- 500 mg tablets
- 600 mg tablets
Estado regulador
POM (Prescription Only Medicine)
POM-V
Sin datos reguladores para: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU
Almacenamiento y estabilidad
Tablets should be stored in tight containers at room temperature (15-30°C). Injection should be stored at temperatures less than 40°C (preferably room temperature); avoid freezing. Powder is stable in dry air but will slowly decompose upon exposure to moist air.
Información para el cliente
El bicarbonato de sodio (conocido comúnmente como bicarbonato de uso alimentario) se utiliza médicamente para reducir la acidez de la sangre o la orina de su mascota.
- Administración: Si administra tabletas o polvo por vía oral, siga exactamente la dosis indicada por su veterinario. No sustituya por bicarbonato de uso doméstico a menos que su veterinario se lo indique específicamente, ya que la dosificación puede ser imprecisa y potencialmente peligrosa.
- Horario con otros medicamentos: Si es posible, administre este medicamento con al menos 12 horas de diferencia de otros medicamentos orales, ya que altera los niveles de ácido estomacal y puede afectar gravemente la absorción de otros fármacos.
- Monitoreo: Es probable que su veterinario necesite revisar regularmente los análisis de sangre o el pH de la orina de su mascota para asegurar que la dosis sea correcta y segura.
- Efectos secundarios a vigilar: Esté atento a signos de retención de líquidos (como respiración rápida, tos o hinchazón), espasmos musculares o debilidad. Contacte a su veterinario inmediatamente si nota cualquier comportamiento o síntoma inusual.
La referencia de medicamentos de VetSheet está destinada a profesionales veterinarios autorizados como ayuda para la toma de decisiones clínicas, no como sustituto del criterio profesional ni del prospecto actual del fabricante.