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Sodium Bicarbonate

Other Name(s):

Baking Soda, Bicarbonate of Soda, Bread Soda, Cooking Soda, Sodium Hydrogen Carbonate.

Overview

Sodium bicarbonate is a salt that breaks down to form sodium and bicarbonate in water. This breakdown makes a solution alkaline, meaning it is able to neutralize acid. Because of this, sodium bicarbonate is often used to treat conditions caused by high acidity in the body, such as heartburn.

People take sodium bicarbonate by mouth for bowel cleansing, poor kidney function, indigestion, exercise performance, high potassium in the blood, reviving newborns, stomach ulcers, and urinary stones.

People apply sodium bicarbonate to the skin for chemical burns, dental plaque, earwax removal, eczema, insect bites or stings, infertility, inflammation in the mucous membranes lining the digestive tract, poison oak and poison ivy, itchy skin (pruritus), and scaly, itchy skin (psoriasis).

Sodium bicarbonate is injected intravenously (by IV) for heart resuscitation, poor kidney function, cocaine toxicity, to prevent kidney damage caused by dyes used during some X-ray exams, poisoning from certain allergy medications, reviving newborns, pesticide poisoning, prevention of chemotherapy side effects, breakdown of muscles, and fluid build-up in the lungs caused by a certain chemical.

People also use sodium bicarbonate, or baking soda, as an ingredient in baking.

How does it work?

Sodium bicarbonate is a salt that breaks down in fluids, including blood and urine, to form sodium and bicarbonate. This breakdown makes the fluid alkaline, meaning it is able to neutralize acid. This ability to neutralize acid helps treat conditions related to high acidity in bodily fluids, such as indigestion, which is caused by too much acid in the stomach.

Uses & Effectiveness

Possibly Effective for...

  • To prevent kidney damage caused by dyes used during some X-ray exams. Some research suggests that injecting sodium bicarbonate intravenously (by IV) before cardiac angiography, a test that uses dye to show the inside of the arteries, can reduce the risk of kidney damage. However, not all studies are consistent.
  • Exercise performance. Research suggests that taking sodium bicarbonate by mouth 1-2 hours before short-term, high-intensity exercise improves power during exercise in trained men. Other research shows that taking sodium bicarbonate by mouth or intravenously (by IV) up to 3 hours before short-term, high-intensity exercise improves performance. However, taking sodium bicarbonate does not appear to improve performance in females or non-athletes. Also, it does not appear to improve performance during exercises that last longer than 10 minutes.

Insufficient Evidence to Rate Effectiveness for...

  • Chronic kidney disease. Some evidence shows that taking sodium bicarbonate by mouth three times daily for 12 months improves nutrition status and reduces the amount of time spent in the hospital in people with chronic kidney disease. However, other evidence shows that increasing the amount of sodium bicarbonate that is used in standard prescription dialysis does not benefit people with kidney disease.
  • Dental plaque. Brushing teeth with toothpaste containing sodium bicarbonate daily for up to 4 weeks might remove plaque better than using a toothpaste without sodium bicarbonate especially in areas of the mouth that are hard to reach with a toothbrush. However, research is limited. It is not clear that sodium bicarbonate-containing toothpastes are more effective when used for a long time.
  • Earwax. Early research shows that using sodium bicarbonate ear drops twice daily for 5 days before ear cleaning helps clean the ears better than no treatment. However, sodium bicarbonate might make earwax removal more difficult than some other earwax softening products.
  • Reviving newborns. Early research suggests that injecting sodium bicarbonate intravenously (by IV) for 3-5 minutes at 5 minutes of life does not improve survival or reduce the risk of brain damage in newborns that are unable to breath.
  • Bowel cleansing.
  • Chemical burns.
  • Eczema.
  • High potassium levels in the blood.
  • Indigestion.
  • Infertility.
  • Inflammation in the mucous membranes lining the digestive tract.
  • Insect bites or stings.
  • Itchy skin (pruritus).
  • Poison oak and poison ivy.
  • Scaly, itchy skin (psoriasis).
  • Stomach ulcers.
  • Urinary stones.
  • Other conditions.
More evidence is needed to rate sodium bicarbonate for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

Sodium bicarbonate is LIKELY SAFE when taken by mouth appropriately in the short-term and when used intravenously (by IV) and appropriately with proper medical supervision. Over-the-counter antacid products containing sodium bicarbonate are considered safe and effective by the U.S. Food and Drug Administration (FDA). The FDA suggests a maximum daily dosage of 200 mEq sodium and 200 mEq bicarbonate in people up to 60 years old , and maximum daily dosage of 100 mEq sodium and 100 mEq bicarbonate in people over 60 years old for up to 2 weeks.

Taking sodium bicarbonate by mouth in high doses is POSSIBLY UNSAFE. Complications including stomach rupture and serious alterations in electrolyte levels have been reported following long-term or excessive use of sodium bicarbonate.

There is not enough information available to know if sodium bicarbonate is safe when applied to the skin.

QUESTION

Next to red peppers, you can get the most vitamin C from ________________. See Answer

Special Precautions & Warnings

Pregnancy and breast-feeding: Sodium bicarbonate is POSSIBLY UNSAFE when taken by mouth or used intravenously (by IV) during pregnancy. There is some concern that it might increase the risk of water retention or pH imbalances in the tissues. There is not enough reliable information about the safety of taking sodium bicarbonate if you are breast feeding. Stay on the safe side and avoid use.

Children: Sodium bicarbonate is POSSIBLY SAFE when used by IV under appropriate medical supervision in infants and children. Sodium bicarbonate (baking soda) is POSSIBLY UNSAFE when applied to the skin, as there have been reports of high sodium blood levels in children following use. There is not enough reliable information about the safety of taking sodium bicarbonate by mouth in children. Stay on the safe side and avoid use.

Diabetic ketoacidosis: Sodium bicarbonate increases blood acids called ketones, which are associated with a diabetes complication in which blood acid levels are too high. People with this condition should avoid sodium bicarbonate.

Swelling (edema): Because sodium bicarbonate contains sodium, it can increase the risk of swelling caused by excess fluids in the body. People with heart failure, liver disease, or other conditions associated with fluid build-up should use sodium bicarbonate with caution.

High calcium levels in the blood: People with high calcium levels in the blood can have trouble excreting bicarbonate. Therefore, using sodium bicarbonate might increase the risk of complications such as milk-alkali syndrome.

High sodium levels in the blood: Sodium bicarbonate might increase sodium levels in the blood. People who already have high levels of sodium in the blood should avoid sodium bicarbonate.

High blood pressure: Sodium bicarbonate might increase blood pressure. People who already have high blood pressure should avoid sodium bicarbonate.

Low potassium levels in the blood: Sodium bicarbonate might lower potassium blood levels. People who already have low levels of potassium should avoid sodium bicarbonate.

Iron deficiency: Sodium bicarbonate decreases how much iron the body absorbs. People with iron deficiency should take sodium bicarbonate and iron supplements separately.

Interactions


AminoglycosidesInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Aminoglycosides can also decrease potassium in the body. In theory, taking sodium bicarbonate along with aminoglycosides might decrease potassium in the body too much. Potassium supplements might be necessary.
Some aminoglycosides include amikacin (Amikin), gentamicin (Garamycin), kanamycin (Kantrex), streptomycin, and tobramycin (Nebcin).


Amphotericin-B (Abelcet, Amphotec, AmBisome, Amphocin, Fungizone)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Amphotericin-B can also decrease potassium in the body. In theory, taking sodium bicarbonate along with amphotericin-B might decrease potassium in the body too much. Potassium supplements might be necessary.


AspirinInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate intravenously might increase how quickly the body breaks down and excretes aspirin. This might lower the effects of aspirin. Aspirin and sodium bicarbonate should be taken separately.


Beta-2 AgonistsInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Beta-2 agonists can also decrease potassium in the body. In theory, taking sodium bicarbonate along with beta-2 agonists might decrease potassium in the body too much. Potassium supplements might be necessary.
Some aminoglycosides include albuterol (salbutamol, Proventil, Ventolin), bitolterol (Tornalate), isoetharine, levalbuterol (Xopenex), metaproterenol (Alupent), pirbuterol (Maxair), salmeterol (Serevent), and terbutaline (Brethine).


Cefpodoxime ProxetilInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate with the antibiotic cefpodoxime proxetil reduces the concentrations of cefodoxime proxetil in the body. This might reduce how well the antibiotic works.


Chlorpropamide (Diabinese)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate with the antidiabetes drug chlorpropamide (Diabinese) increases how quickly the body gets rid of chlorpropamide (Diabinese). This might reduce how well the antidiabetes drug works.


Cisplatin (Platino-AQ)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Cisplatin can also decrease potassium in the body. In theory, taking sodium bicarbonate along with cisplatin might decrease potassium in the body too much. Potassium supplements might be necessary.


Fluconazole (Diflucan)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Fluconazole can also decrease potassium in the body. In theory, taking sodium bicarbonate along with fluconazole might decrease potassium in the body too much. Potassium supplements might be necessary.


GlucocorticoidsInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Glucocorticoids can also decrease potassium in the body. It is most common with hydrocortisone (Cortef, Hydrocortone, Solu-Cortef), cortisone (Cortone), and fludrocortisone (Florinef), followed by prednisone (Deltasone) and prednisolone (Delta-Cortef). Glucocorticoids that might not decrease potassium as much are (Celestone), dexamethasone (Decadron), methylprednisolone (Medrol, Depo-Medrol, Solu-Medrol), and triamcinolone (Aristocort, Kenalog) (4425). In theory, taking sodium bicarbonate along with some glucocorticoids might decrease potassium in the body too much. Potassium supplements might be necessary.


MethylxanthinesInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Methylxanthines can also decrease potassium in the body. In theory, taking sodium bicarbonate along with methylxanthines might decrease potassium in the body too much. Potassium supplements might be necessary.


PenicillinInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Penicillins can also decrease potassium in the body. In theory, taking sodium bicarbonate along with some penicillins might decrease potassium in the body too much. Potassium supplements might be necessary.

Penicillins that might decrease potassium include penicillin G sodium (Pfizerpen), mezlocillin (Mezlin), carbenicillin (Geocillin), ticarcillin (Ticar), and piperacillin (Pipracil).


Pseudoephedrine (Sudafed)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate intravenously (by IV) might reduce how quickly the body breaks down pseudoephedrine. This might increase pseudoephedrine levels in the body and increase the risk of developing pseudoephedrine toxicity.


Stimulant LaxativesInteraction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. Stimulant laxatives (e.g., in bowel-cleansing regimens), can also decrease potassium in the body. In theory, taking sodium bicarbonate along with stimulant laxatives might decrease potassium in the body too much. Potassium supplements might be necessary.

Some stimulant laxatives include cascara (CitraMax Plus), senna (Senokot), bisacodyl (Dulcolax), and others.


Water pills (Loop diuretics)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. "Water pills" can also decrease potassium in the body. Taking sodium bicarbonate along with "water pills" might decrease potassium in the body too much.

Some "water pills" that can deplete potassium include bumentanide (Bumex), ethacrynic acid (Edecrin), furosemide (Lasix), torsemide (Demadex), and others.


Water pills (Thiazide diuretics)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Taking sodium bicarbonate can decrease potassium levels in the body. "Water pills" can also decrease potassium in the body. Taking sodium bicarbonate along with "water pills" might decrease potassium in the body too much.

Some "water pills" that can deplete potassium include chlorothiazide (Diuril), hydrochlorothiazide (HydroDIURIL, Esidrix, Microzide), indapamide (Lozol), methyclothiazide (Aquatensen), metolazone (Mykrox), and others.

Dosing

The following doses have been studied in scientific research:

ADULT

By mouth:
  • For exercise performance: 100-400 mg/kg body weight taken 1-3 hours before exercise has been used.
By IV or shot:
  • To prevent kidney damage caused by dyes used during some X-ray exams: a sodium bicarbonate solution has been given by IV at a rate of 1 mL/kg/hr for up to 12 hours before or 3 mL/kg/hr for 1 hour before cardiac angiography, followed by 1 mL/kg/hr for 6-12 hours after cardiac angiography has been used. In some cases, 2400 mg of N-acetylcysteine injected along with sodium bicarbonate has also been used.
  • For exercise performance: 100-400 mg/kg body weight taken 3 hours before exercise has been used.