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Discussion Post
Sodium Bicarb Shortage

Can you please share your strategies to manage urine alkalinization before and during high-dose MTX or ifosfamide now that sodium bicarbonate is not readily available? We are not able to get a good supply of sodium acetate either. If you're using the oral tablets, can you please let me know what...


Discussion Thread 1
Sodium Bicarb Shortage

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Discussion Post
Sodium Bicarb orders with HDMTX

Hello, I am evaluating the sodium bicarbonate fluid orders for our high-dose methotrexate chemotherapy protocols, and am gathering information on the following: What do you use for initial prehydration? How many mEq sodium bicarbonate in which fluid base and volume? Do you utilize an...


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Sodium Bicarb orders with HDMTX

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RE: Oral Bicarb Regimen for HD Methotrexate

bicarb +/- acetazolamide regimens. Would


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RE: Oral Bicarb Regimen for HD Methotrexate

We use 1950mg q6h and will increase to 2600mg q6h and add acetazolamide 250mg q12 as long as the patient's serum CO2 is greater than 20 before switching to IV. Good luck! -- Jordan Lundberg PharmD, BCOP Clinical Specialist Pharmacist, Hematology The Arthur G James Cancer Hospital at The Ohio...


Discussion Post
Oral Bicarb Regimen for HD Methotrexate

Does anyone have an oral Sodium Bicarbonate regimen they'd be willing to share for use with high dose methotrexate while inpatient? Assuming we can get methotrexate that is. Trying to concern IV NaBicarb as much as possible and we can't get NaAcetate either. Thanks!! -- Andy Kurtzweil BCOP...


Discussion Thread 3
Oral Bicarb Regimen for HD Methotrexate

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RE: Sodium Bicarb orders with HDMTX

? We do not have conditional bicarb boluses


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RE: Sodium Bicarb orders with HDMTX

prehydration? D5W with bicarb How many mEq sodium