Potassium Bicarbonate

May cause GI upset (eg, nausea, vomiting, diarrhea, abdominal pain, discomfort) and lead to GI ulceration, bleeding, perforation and/or obstruction.

Close monitoring of serum potassium concentrations is needed to avoid hyperkalemia; severe hyperkalemia may lead to muscle weakness/paralysis and cardiac conduction abnormalities (eg, heart block, ventricular arrhythmias, asystole). Disease-related concerns:

Use with caution in patients with acid/base alterations; changes in serum potassium concentrations can occur during acid/base correction, monitor closely.

Use with caution in patients with cardiovascular disease (eg, heart failure, cardiac arrhythmias); patients may be more susceptible to life-threatening cardiac effects associated with hyper/hypokalemia.

Patients with hypokalemia accompanied by metabolic acidosis should be treated with an alkalinizing potassium salt.

Use with caution in patients with disorders or conditions likely to contribute to altered serum potassium and hyperkalemia (eg, untreated Addison's disease, heat cramps, severe tissue breakdown from trauma or burns).

Use with caution in patients with renal impairment; monitor serum potassium concentrations closely. Avoid with severe impairment. Concurrent drug therapy issues:

Use with caution in digitalized patients; may be more susceptible to potentially life-threatening cardiac effects with rapid changes in serum potassium concentrations.

Use with caution in patients receiving concomitant medications or therapies that increase potassium (eg, ACE inhibitors, potassium-sparing diuretics, potassium-containing salt substitutes).