Multibic

Sodium hydrogen carbonate, magnesium chloride hexahydrate, sodium chloride, calcium chloride dihydrate, the active ingredients in Multibic, are an electrolyte solution presented as a solution for injection for haemodialysis and intravenous use. It helps restore acid‑base and electrolyte balance in patients undergoing dialysis.

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

Multibic is used to manage electrolyte and acid‑base disturbances in renal replacement and intravenous therapy settings. - Hemodialysis: supports electrolyte and acid‑base homeostasis during renal replacement therapy. - Electrolyte replacement therapy: supplies essential sodium, magnesium, calcium and chloride ions to correct deficits. - Intravenous fluid therapy: provides a balanced electrolyte solution for peri‑operative and critical‑care fluid management.

Common Side Effects: - Infusion site pain or erythema: mild discomfort at the injection site. - Transient increase in blood pressure: short‑term elevation during rapid infusion. - Mild electrolyte shifts: temporary hypernatremia, hypercalcemia or hypermagnesemia. - Metabolic alkalosis: mild rise in blood pH due to bicarbonate load. - Fluid overload: excess volume if administered too quickly.

Serious or Rare Side Effects: - Severe hypermagnesemia: can cause muscle weakness, respiratory depression. - Severe metabolic alkalosis: may lead to seizures or cardiac arrhythmias. - Anaphylactic reaction: rare but potentially life‑threatening hypersensitivity. - Cardiac arrhythmia: due to abrupt electrolyte disturbances. - Pulmonary edema: from rapid volume administration in susceptible patients.

Before using Multibic, consider the following precautions: - Baseline electrolyte assessment: verify serum Na+, Mg2+, Ca2+ and bicarbonate levels. - Acid‑base monitoring: check arterial blood gases during therapy. - Renal impairment: adjust volume and rate in patients with reduced clearance. - Infusion rate: avoid rapid administration to prevent volume overload and sudden electrolyte shifts. - Aseptic technique: ensure sterility to prevent infection. - Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Multibic may interact with other medications and solutions as follows: Major Interactions (Avoid): - Co‑administration with other bicarbonate‑containing products: risk of severe metabolic alkalosis. - Simultaneous use of calcium‑rich infusions: may cause hypercalcemia. - Concurrent magnesium supplements: can lead to hypermagnesemia.

Moderate Interactions (Monitor Closely): - Loop diuretics: increase renal calcium loss, requiring electrolyte monitoring. - ACE inhibitors or ARBs: may affect potassium balance when combined with other electrolytes. - Blood transfusions: can alter calcium and magnesium levels, necessitating close observation.