Last reviewed 2026-04-22 · How we verify

sodium bicarbonate 4.2%

Sodium bicarbonate acts as a buffer to neutralize excess acid and raise pH in body fluids.

Sodium bicarbonate acts as a buffer to neutralize excess acid and raise pH in body fluids. Used for Metabolic acidosis, Urinary alkalinization, Hyperkalemia management.

At a glance

Mechanism of action

Sodium bicarbonate is a weak base that reacts with hydrogen ions to form water and carbon dioxide, thereby increasing bicarbonate concentration and raising pH. It is used to correct metabolic acidosis, alkalinize urine, and manage acute conditions where acid-base balance is disrupted. The 4.2% formulation is typically administered intravenously for rapid systemic effect.

Approved indications

• Metabolic acidosis
• Urinary alkalinization
• Hyperkalemia management
• Tricyclic antidepressant overdose

Common side effects

• Hypokalemia
• Hypernatremia
• Metabolic alkalosis
• Phlebitis at injection site

Key clinical trials

• Reducing Prehospital Medication Errors & Time to Drug Delivery by EMS During Simulated Pediatric CPR (NA)
• Sodium Bicarbonate for the Treatment of Severe Metabolic Acidosis With Moderate or Severe Acute Kidney Injury in ICU (NA)
• Postoperative Analgesia in Laparoscopic Gynecological Surgeries (PHASE4)
• Sodium Bicarbonate to Treat Severe Acidosis in the Critically Ill (PHASE3)
• Clearance Of Mucus In Stents (COMIS) (NA)
• Bicarbonate Epidural Injection in Emergency Caesarian (PHASE3)
• Effect of Buffered Lidocaine With Epinephrine in Local Anesthesia (NA)
• Intravenous Bicarbonate To Verify The Correct Position of IV Catheters in Oncological Patients Oncological Patients Receiving Chemotherapy (PHASE2, PHASE3)

Primary sources

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