potassium bicarbonate

Potassium is a principal electrolyte in the body and is essential for many physiological processes. Potassium depletion occurs when its excretion by the kidneys and gastrointestinal tract exceeds intake due to reasons like diuretic therapy, hyperaldosteronism, diabetic ketoacidosis, or inadequate dietary potassium intake.

Potassium is the primary intracellular cation in most body tissues. It is necessary for nerve impulse conduction in muscles, heart, and brain, as well as acid-base balance, kidney function, and cellular metabolism.

Warnings

• Do not use potassium bicarbonate in patients with hypersensitivity to any component in the formulation.
• Avoid administering potassium bicarbonate to patients with high blood potassium levels (hyperkalemia).
• Avoid concurrent use of potassium bicarbonate with potassium-sparing diuretics or other potassium-containing drugs to prevent severe hyperkalemia.
• Hyperkalemia can complicate conditions such as chronic kidney failure, systemic acidosis, extensive tissue breakdown, and adrenal insufficiency.
• Closely monitor serum potassium levels to prevent hyperkalemia, which can lead to muscle weakness, paralysis, cardiac conduction problems, and death.
• Exercise caution when using potassium carbonate in patients with cardiovascular diseases or those receiving digitalis treatment due to increased risk of life-threatening cardiac events.
• Potassium bicarbonate may cause gastrointestinal effects such as nausea, vomiting, diarrhea, abdominal pain, ulceration, bleeding, perforation, and obstruction.
• Use with caution in patients with acid/base disorders and closely monitor potassium levels.
• Use alkalinizing potassium salts in hypokalemic patients with metabolic acidosis.
• Exercise caution in patients with impaired kidney function and avoid use in those with severe renal impairment.

Side Effects of Potassium Bicarbonate

Common side effects of potassium bicarbonate include:

• Abdominal discomfort
• Nausea
• Vomiting
• Diarrhea
• Gas (flatulence)
• Hyperkalemia with symptoms like irregular heart rhythms, shortness of breath, numbness or tingling in lips, feet, and hands, unusual fatigue or weakness, heaviness or weakness of legs, mental confusion, and unexplained anxiety.

Seek immediate medical attention if you experience any of the following symptoms or serious side effects:

• Serious heart symptoms such as 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 including blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not an exhaustive list of side effects or adverse reactions. Contact your doctor for medical advice regarding serious side effects or adverse reactions. Report side effects or health problems to the FDA at 1-800-FDA-1088.

Dosages of Potassium Bicarbonate

Doses are expressed as mEq of potassium.

Tablet for Oral Solution

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
• Use with caution and monitor potassium levels closely in patients with chronic renal disease or conditions impairing potassium excretion
• No dosage adjustments listed by the manufacturer

Considerations for Dosing

• If hypokalemia is a result of diuretic therapy, consider reducing the diuretic dose
• Dilute properly to minimize gastrointestinal irritation

Pediatric:

• Safety and efficacy not established

Overdose

• Potassium bicarbonate overdose may cause hyperkalemia with symptoms like confusion, irregular heart rate, and muscle weakness. Severe hyperkalemia can result in muscle paralysis, cardiac arrest, and death.
• Overdose treatment primarily involves lowering blood potassium levels through intravenous administration of glucose solution with insulin, intravenous administration of sodium bicarbonate in patients with acidosis, discontinuation of potassium-containing drugs and potassium-sparing diuretics, oral administration of cation exchange resin like sodium polystyrene sulfonate to eliminate gastrointestinal potassium, and hemodialysis.

Drug Interactions with Potassium Bicarbonate

Inform your doctor about all medications you are currently taking to check for possible drug interactions. Do not start, stop, or change the dosage of any medication without your doctor’s recommendation.

• Potassium bicarbonate has no severe interactions listed with other drugs.
• Serious interactions include dextroamphetamine transdermal, drospirenone, potassium acid phosphate, potassium chloride, potassium phosphates (intravenous), spironolactone, and triamterene.

The above drug interactions are not exhaustive. For more information, use the RxList Drug Interaction Checker.

Always inform your doctor, pharmacist, or healthcare provider about all prescription and over-the-counter medications you are using, along with their dosages. Keep a list of this information. Consult your doctor or healthcare provider if you have any questions about the medication.

Pregnancy and Breastfeeding

• Effect on reproductive capacity or potential harm to pregnant women with potassium bicarbonate use is unknown. Use during pregnancy only if necessary.
• Presence of potassium bicarbonate in breastmilk is unknown, but many drugs are excreted in breastmilk. Discontinue the drug or nursing depending on the importance of the drug to the nursing mother, due to the potential for serious adverse reactions in the breastfed infant.

Additional Information on Potassium Bicarbonate

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

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Summary

Potassium bicarbonate is a medication used to treat and prevent low blood potassium levels (hypokalemia). Common side effects include abdominal discomfort, nausea, vomiting, diarrhea, gas, and hyperkalemia. Consult your doctor if pregnant or breastfeeding.