Multibic

Sodium hydrogen carbonate, the active ingredient in Multibic, is an electrolyte solution presented as a multi‑electrolyte infusion for haemodialysis and intravenous use. It contains magnesium chloride, potassium chloride, sodium chloride and calcium, providing a balanced composition that supports acid‑base regulation and electrolyte homeostasis in patients with renal failure undergoing dialysis.

GNH USA supplies Multibic as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals, transplant centres and dialysis clinics worldwide. The company adheres to European Union manufacturing standards and provides regulatory documentation to support safe clinical use.

Multibic is used in renal replacement therapy to manage electrolyte and acid‑base disturbances during dialysis.

- Renal failure requiring haemodialysis: maintains plasma sodium, potassium, calcium and magnesium levels to prevent electrolyte imbalance. - Haemodialysis procedures: provides buffering capacity to control metabolic acidosis during treatment. - Acute kidney injury with electrolyte disturbances: supplies essential ions intravenously to support homeostasis.

Multibic may be associated with several adverse reactions, which are categorised by frequency.

Common Side Effects: - Mild hypotension - Nausea or vomiting - Transient muscle cramps - Slight increase in serum calcium - Low‑grade fever

Serious or Rare Side Effects: - Severe hyperkalemia - Severe hypocalcemia - Anaphylactic or severe allergic reaction - Metabolic alkalosis - Cardiac arrhythmia - Pulmonary edema

When using Multibic, clinicians should observe specific precautions to ensure patient safety.

- Assess electrolyte levels: monitor serum sodium, potassium, calcium and magnesium before and during infusion. - Check acid‑base status: evaluate blood pH and bicarbonate to guide dosing. - Use with compatible dialysis fluids: verify compatibility with the dialysis machine’s settings and other solutions. - Avoid rapid infusion: administer at the prescribed rate to prevent fluid overload and cardiovascular stress. - Pregnancy and lactation: consider use only if potential benefits outweigh risks and after specialist consultation. - Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Multibic can interact with other medicines that affect electrolyte balance or cardiovascular function.

Major Interactions (Avoid): - Calcium channel blockers: may increase risk of hypercalcemia. - Potassium‑sparing diuretics: can lead to dangerous hyperkalemia. - ACE inhibitors or ARBs: additive potassium elevation may occur.

Moderate Interactions (Monitor Closely): - Loop diuretics: may cause rapid shifts in sodium and potassium. - Beta‑blockers: may mask hypotensive effects of the solution. - Blood transfusions: can alter calcium levels and affect coagulation.