potassium bicarbonate

Potassium bicarbonate is a medication used as supplemental potassium to treat and prevent low blood potassium levels (hypokalemia).

Potassium is one of the principal electrolytes in the body and is essential for many physiological processes. Potassium depletion is caused when potassium excretion by the kidneys and gastrointestinal tract is higher than the intake of potassium due to any reason, including diuretic therapy, conditions such as hyperaldosteronism or diabetic ketoacidosis, or inadequate dietary potassium intake.

Potassium is the primary intracellular positively charged ion (cation) in most body tissues. Potassium is essential for many processes such as the conduction of nerve impulses in skeletal and smooth muscles, heart, and brain, and maintaining acid-base balance, normal kidney function, and cellular metabolic processes.

• Do not use potassium bicarbonate in patients with hypersensitivity to any of the components in the formulation
• Do not administer potassium bicarbonate to patients with high blood potassium levels (hyperkalemia).
• Do not use potassium bicarbonate concurrently with potassium-sparing diuretics or other potassium-containing drugs, it can cause severe hyperkalemia.
• Hyperkalemia can complicate any of the following conditions:
• Chronic kidney failure
• Systemic acidosis such as diabetic acidosis or acute dehydration
• Extensive tissue breakdown as in severe burns
• Adrenal insufficiency
• Monitor serum potassium levels closely to avoid hyperkalemia. Severe hyperkalemia can cause muscle weakness and paralysis, cardiac conduction problems and arrest, that can result in death.
• Use potassium carbonate with caution in patients with cardiovascular diseases such as cardiac failure or irregular heart rhythms, and those receiving digitalis treatment; the risk for life-threatening cardiac events is higher.
• Potassium bicarbonate can cause gastrointestinal (GI) effects including nausea, vomiting, diarrhea, abdominal pain, GI ulceration, bleeding, perforation, and/or obstruction.
• Use with caution in patients with acid/base disorders and monitor potassium levels closely.
• Use an alkalinizing potassium salt in hypokalemic patients who also have metabolic acidosis.
• Use with caution in patients with impaired kidney function and monitor the potassium levels closely. Avoid use in patients with severe renal impairment.

Common side effects of potassium bicarbonate include:

• Abdominal discomfort
• Nausea
• Vomiting
• Diarrhea
• Gas (flatulence)
• Hyperkalemia with symptoms that may include:
  • Irregular heart rhythms (arrhythmia)
  • Shortness of breath or difficulty breathing
  • Numbness or tingling in lips, feet and/or hands
  • Unusual fatigue or weakness
  • Heaviness or weakness of legs
  • Mental confusion
  • Unexplained anxiety

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Doses expressed as mEq of potassium

Tablet for Oral Solution

• 10 mEq
• 20 mEq
• 25 mEq

Adult:

Daily Requirements

• 40-100 mEq/day or 1-2 mEq/kg/day

Hypokalemia

• Prevention: 10-80 mEq/day orally once daily or divided 4 times a day
• Treatment: 40–100 mEq/day dissolved in at least 4 ounces (per tablet) of cold water orally divided two or four times a day
• Divide doses so that single doses are not more than 25 mEq to avoid GI adverse effects

Renal Impairment

• Use in patients with chronic renal disease or any condition impairing potassium excretion requires careful monitoring

Hepatic Impairment

• No dosage adjustments listed by the manufacturer

Dose Considerations

• If hypokalemia is the result of diuretic therapy, consider lowering the diuretic dose
• Proper dilution lessens the possibility of gastrointestinal irritation

Pediatric:

• Safety and efficacy not established

Overdose

• Potassium bicarbonate overdose can lead to hyperkalemia with symptoms that include confusion, irregular heart rate, and muscle weakness. Severe hyperkalemia can lead to muscle paralysis, cardiac arrest, and death.
• Overdose treatment is primarily lowering blood potassium levels, which may include:
  • Intravenous (IV) administration of glucose solution with insulin
  • IV administration of sodium bicarbonate in patients with acidosis
  • Discontinuation of potassium-containing drugs and potassium-sparing diuretics in patients receiving these drugs
  • Oral administration of cations exchange resin such as sodium polystyrene sulfonate to eliminate gastrointestinal potassium
  • Hemodialysis

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Potassium bicarbonate has no listed severe interactions with other drugs.
• Serious interactions of potassium bicarbonate include:
  • dextroamphetamine transdermal
  • drospirenone
  • potassium acid phosphate
  • potassium chloride
  • potassium phosphates, IV
  • spironolactone
  • triamterene
• Potassium bicarbonate has mild interactions with at least 103 different drugs.
• Potassium bicarbonate has mild interactions with at least 26 different drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• It is not known if potassium bicarbonate has effects on reproductive capacity or can cause harm if administered to pregnant women. Use during pregnancy only if clearly needed.
• It is not known if potassium bicarbonate is present in breastmilk, but many drugs are excreted in breastmilk. Discontinue the drug or nursing depending on the importance of the drug to the nursing mother, because of the potential for serious adverse reactions in the breastfed infant.

• Take potassium bicarbonate exactly as prescribed.
• Dissolve the tablet completely in the required amount of water before drinking the solution.
• Store safely out of reach of children.
• In case of overdose, seek immediate medical help or contact Poison Control.