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炭酸水素ナトリウム

Sodium Bicarbonate

Sodium hydrogen carbonate

アルカリ化剤 / 電解質補給剤IVPOSC犬猫鳥馬牛羊ヤギ

別名: Baking soda · Neut · Zegerid · E500 · monosodium carbonate · natrii bicarbonas · natrii hydrogenocarbonas · sal de vichy · sodium acid carbonate · NaHCO3 · sodium hydrogen carbonate

VetSheet 獣医チームが監修更新日 2026年4月5日エビデンスに基づく獣医学リファレンス

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
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用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

動物種別用量

🌎 NA — North America🌍 EU — Europe

犬

適応用量経路頻度期間地域
Severe metabolic acidosismEq 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.IVOnceOver 3-4 hours🌎 NA
Metabolic acidosis secondary to uremia0.3 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.IVOnceOver several hours🌎 NA
Adjunctive therapy of diabetic ketoacidosisDose (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.IVOnceOver 6 hours🌎 NA
Adjunctive treatment of hypercalcemic crisismEq 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/LIVq10-15mUntil effect or max dose🌎 NA
Adjunctive therapy for hyperkalemic crises2-3 mEq/kg IV over 30 minutes (if decreased tissue perfusion/renal failure and no DKA) OR 1-2 mEq/kg IV slowlyIVOnceOver 30 minutes or slowly🌎 NA
To alkalinize the urine10-90 grains (650 mg-5.85 grams) PO per dayPODailyOngoing🌎 NA
Dissolution and/or prevention of urate urolithiasis0.5-1 gram (1/8-1/4 tsp.) per 5 kg of body weight three times daily POPOq8hOngoing🌎 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.

猫

適応用量経路頻度期間地域
Severe metabolic acidosismEq 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.IVOnceOver 3-4 hours🌎 NA
Metabolic acidosis secondary to uremia0.3 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.IVOnceOver several hours🌎 NA
Adjunctive therapy of diabetic ketoacidosisDose (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.IVOnceOver 6 hours🌎 NA
Adjunctive treatment of hypercalcemic crisismEq 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/LIVq10-15mUntil effect or max dose🌎 NA
Adjunctive therapy for hyperkalemic crises2-3 mEq/kg IV over 30 minutes (if decreased tissue perfusion/renal failure and no DKA) OR 1-2 mEq/kg IV slowlyIVOnceOver 30 minutes or slowly🌎 NA
To alkalinize the urine10-90 grains (650 mg-5.85 grams) PO per dayPODailyOngoing🌎 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.

鳥

適応用量経路頻度期間地域
Metabolic acidosis1 mEq/kg initially IV (then SC) for 15-30 minutes to a maximum of 4 mEq/kgIV/SCOnce15-30 minutes🌎 NA

馬

適応用量経路頻度期間地域
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.IVOnceContinuous 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.

牛

適応用量経路頻度期間地域
Acidosis2-5 mEq/kg IV for a 4-8 hour periodIVOnceOver 4-8 hours🌎 NA
Severely dehydrated acidotic calvesIsotonic 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.IVOnceOver 1-2 hours🌎 NA
  • Severely dehydrated acidotic calves: Isotonic solution: 13 grams of sodium bicarbonate in 1 L of sterile water.

羊

適応用量経路頻度期間地域
Acidosis (Ruminants)2-5 mEq/kg IV for a 4-8 hour periodIVOnceOver 4-8 hours🌎 NA

ヤギ

適応用量経路頻度期間地域
Acidosis (Ruminants)2-5 mEq/kg IV for a 4-8 hour periodIVOnceOver 4-8 hours🌎 NA

用量は獣医専門家向けの臨床参考資料です。必ず最新の医薬品情報および個別症例に基づいて確認してください。

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概要

​炭酸水素ナトリウム​は、獣医の救急および集中治療、ならびに特定の疾患の慢性管理に広く使用される全身性および尿アルカリ化剤です。

  • ​救急時の酸塩基管理​：主に、根本的な原因が急速に改善できず、血中pHが危険なレベルに低下した場合の重度な代謝性アシドーシスの補正に使用されます。
  • ​電解質異常の危機​：生命を脅かす​高カリウム血症​（カリウムを細胞内に移動させる）および​高カルシウム血症​の補助治療として機能します。
  • ​尿のアルカリ化​：尿のpHを上昇させることで、特定の尿石（尿酸塩、シスチンなど）の管理または予防のために経口投与されます。

​臨床のポイント​：心肺蘇生（CPR）および糖尿病性ケトアシドーシス（DKA）における炭酸水素ナトリウムのルーチン使用は推奨されなくなりました。DKAでは細胞内低カリウム血症を悪化させ、逆説的な中枢神経系アシドーシスを引き起こす可能性があります。CPRでは、患者の換気が不十分な場合、高炭酸ガス血症を引き起こす可能性があります。

作用機序

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.

安全性・警告

禁忌

  • 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

有害事象

  • 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)

注意事項

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.

医薬品相互作用

Anticholinergic agents

Concomitant oral sodium bicarbonate may reduce absorption; administer separately

Azole antifungals (ketoconazole, itraconazole)

Concomitant oral sodium bicarbonate may reduce absorption; administer separately

Ciprofloxacin, Enrofloxacin

Solubility is decreased in an alkaline environment; monitor for signs of crystalluria

Corticosteroids

Patients receiving high dosages of sodium bicarbonate and ACTH or glucocorticoids may develop hypernatremia

Diuretics (e.g., thiazides, furosemide)

Concurrent use in patients receiving potassium-wasting diuretics may cause hypochloremic alkalosis

Ephedrine

When urine is alkalinized, excretion may be decreased

Histamine2 blocking agents (e.g., cimetidine, ranitidine)

Concomitant oral sodium bicarbonate may reduce absorption; administer separately

Iron products

Concomitant oral sodium bicarbonate may reduce absorption; administer separately

Oral medications (general)

Can increase or reduce absorption rate/extent; avoid giving other drugs within 12 hours of oral sodium bicarbonate

Quinidine

When urine is alkalinized, excretion may be decreased

Salicylates

When urine is alkalinized, excretion of weakly acidic drugs may be increased

Sucralfate

Oral sodium bicarbonate may reduce efficacy if administered concurrently

Tetracyclines

Concomitant oral sodium bicarbonate may reduce absorption; administer separately

Calcium saltsMajor

Incompatible in solution; do not mix unless checked beforehand (risk of precipitation)

Sympathomimetic drugsModerate

Decreased excretion due to alkalinization of the urine

AspirinModerate

Increased excretion due to alkalinization of the urine

PhenobarbitalModerate

Increased excretion due to alkalinization of the urine

Tetracyclines (especially doxycycline)Moderate

Increased excretion due to alkalinization of the urine

監視

  • 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

薬物動態

吸収

Well absorbed orally.

分布

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.

代謝

Combines with hydrogen ions to form carbonic acid, which dissociates into water and carbon dioxide (exhaled by the lungs).

消失

Filtered and reabsorbed by the kidneys; excess is excreted in the urine, resulting in urinary alkalinization.

過剰投与

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.

製品

製剤

  • 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

動物用医薬品

  • Sodium Bicarbonate Injection: 8.4% (1 mEq/mL) in 50 mL, 100 mL, and 500 mL vials

ヒト用医薬品

  • 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

規制ステータス

European Union✓ 承認済み処方箋医薬品EMA
🐕 Dogs🐈 Cats

POM (Prescription Only Medicine)

United Kingdom✓ 承認済み処方箋医薬品VMD
🐕 Dogs🐈 Cats

POM-V

規制データなし: 🇺🇸 US · 🇭🇰 HK · 🇹🇼 TW · 🇯🇵 JP · 🇰🇷 KR · 🇦🇺 AU

保管・安定性

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.

飼主向け情報

​炭酸水素ナトリウム​（一般に重曹として知られています）は、ペットの血液や尿の酸性度を下げるために医療目的で使用されます。

  • ​投与方法​：経口錠剤や粉末を投与する場合は、獣医師の正確な投与量指示に従ってください。獣医師の特別な指示がない限り、​家庭用の重曹で代用しないでください​。投与量が不正確になり、危険な場合があります。
  • ​他の薬とのタイミング​：胃酸のレベルを変化させ、他の薬の吸収に重大な影響を与える可能性があるため、可能であれば他の経口薬とは​12時間以上間隔をあけて​投与してください。
  • ​モニタリング​：投与量が適切で安全であることを確認するため、獣医師は定期的にペットの血液検査や尿のpHを確認する必要があります。
  • ​注意すべき副作用​：体液貯留の兆候（呼吸が速い、咳、むくみなど）、筋肉のけいれん、または脱力感に注意してください。異常な行動や症状に気づいた場合は、すぐに獣医師に連絡してください。

VetSheet医薬品リファレンスは獣医専門家の臨床意思決定支援を目的としており、専門的判断または製造業者の最新医薬品情報の代替にはなりません。