Multibic

Sodium hydrogen carbonate, together with magnesium chloride hexahydrate, sodium chloride and calcium chloride dihydrate, are the active ingredients in Multibic, presented as an injectable solution for haemodialysis and intravenous use. The formulation provides essential electrolytes and a bicarbonate buffer to help maintain acid‑base balance and electrolyte homeostasis during renal replacement therapy.

GNH USA supplies Multibic as a licensed, GDP‑compliant international pharmaceutical supplier serving hospitals worldwide. The product is manufactured in the European Union under strict quality standards and is available for export to global markets.

Multibic is used as an electrolyte and buffer solution in haemodialysis and related renal replacement therapies.

Chronic kidney disease patients undergoing haemodialysis: provides necessary bicarbonate and electrolytes to maintain plasma balance during treatment. Acute renal failure requiring renal replacement therapy: supplies a controlled composition of sodium, calcium, magnesium and chloride to support hemodynamic stability. Patients with metabolic acidosis during dialysis: delivers bicarbonate to correct low pH and improve acid‑base status.

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

Common Side Effects: - Mild hypotension during treatment - Muscle cramps or spasms - Nausea or vomiting - Headache - Dizziness or light‑headedness - Transient fever or chills

Serious or Rare Side Effects: - Severe hypernatremia or hypercalcemia - Cardiac arrhythmias due to electrolyte shifts - Anaphylactic or severe allergic reaction - Metabolic alkalosis requiring intervention - Pulmonary edema from fluid overload - Severe hypotensive shock

When using Multibic, careful monitoring and appropriate handling are essential.

Monitor serum electrolytes: check sodium, calcium, magnesium and chloride levels before and during treatment. Adjust solution composition: tailor electrolyte concentrations to individual patient needs. Use appropriate dialysis machine settings: ensure correct flow rates and temperature. Avoid in patients with severe hypernatremia: may exacerbate the condition. Pregnancy and lactation: use only if clearly needed, safety not established. Store at 2-8°C: keep refrigerated, protect from light, do not freeze or shake.

Multibic can interact with other medications or fluids that affect electrolyte balance.

Major Interactions (Avoid): - Concurrent high‑dose calcium supplements: risk of hypercalcemia. - Co‑administration with other bicarbonate‑containing IV fluids: may cause metabolic alkalosis. - Use with potassium‑sparing diuretics: can lead to hyperkalemia.

Moderate Interactions (Monitor Closely): - Concurrent antihypertensive agents: may enhance hypotensive effect. - Combination with other intravenous electrolytes: monitor fluid and electrolyte balance. - Blood transfusion with citrate anticoagulant: may affect calcium levels.