Multibic

Sodium hydrogen carbonate, magnesium chloride hexahydrate, sodium chloride and calcium chloride dihydrate, the active ingredients in Multibic, are an electrolyte solution presented as an intravenous solution for haemodialysis and intravenous use. It provides essential electrolytes and bicarbonate to support patients undergoing renal replacement therapy.

GNH USA supplies Multibic as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals worldwide.

Multibic is an electrolyte solution used in renal replacement therapy and intravenous electrolyte management.

- Haemodialysis: maintains electrolyte balance and acid‑base status during dialysis sessions. - Intravenous electrolyte replacement: corrects deficits of sodium, chloride, calcium, magnesium and bicarbonate in patients with renal failure or peri‑operative fluid loss. - Renal replacement therapy adjunct: supports acid‑base control in patients receiving continuous renal replacement therapies.

Multibic may be associated with a range of adverse reactions, most of which are mild and transient.

Common Side Effects: - Nausea or vomiting - Mild hypotension during infusion - Headache - Transient hypernatremia - Mild hypercalcemia - Mild metabolic alkalosis

Serious or Rare Side Effects: - Severe hypermagnesemia leading to cardiac arrhythmia - Severe hypercalcemia with neuromuscular irritability - Anaphylactic reaction - Significant fluid overload causing pulmonary edema - Severe metabolic alkalosis requiring intervention - Life‑threatening hypotension

When using Multibic, clinicians should observe standard safety measures for intravenous electrolyte solutions.

- Monitor electrolytes: check serum sodium, calcium, magnesium and bicarbonate levels regularly. - Adjust infusion rate: titrate based on patient tolerance and laboratory results. - Cardiac caution: use carefully in patients with pre‑existing cardiac disease or arrhythmias. - Hypernatremia avoidance: avoid in patients with markedly elevated serum sodium. - Pregnancy and lactation: use only if clearly indicated, as safety data are limited. - Store at ambient temperature: keep in original container, protect from moisture and direct sunlight.

Multibic can interact with other agents that affect electrolyte balance or acid‑base status.

Major Interactions (Avoid): - Concurrent calcium‑containing solutions: may cause dangerous hypercalcemia. - Additional bicarbonate preparations: risk of severe metabolic alkalosis. - High‑dose potassium supplements: can precipitate hyperkalemia when combined with sodium load.

Moderate Interactions (Monitor Closely): - Loop diuretics: may enhance electrolyte shifts, requiring closer monitoring. - ACE inhibitors or ARBs: can alter sodium and potassium handling. - NSAIDs: may affect renal perfusion and electrolyte excretion. - Blood transfusions: potential for citrate‑related calcium binding. - Antacids containing magnesium or calcium: may contribute to cumulative electrolyte load.