Parenteral Manual

Sodium Acetate

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Alkalinizing Agent, Electrolyte Supplement
Original Date: 
June 2017
  • Urine alkalinization for patients receiving high doses of methotrexate
  • Serum and/or urine alkalinization in acid-base disorders and in treatment of some poisoning
  • Treatment ot hyponatremia
Reconstitution and Stability: 
  • Available as a 4 mmol/mL (328 mg/mL) solution for injection; single-use 32.8% 50 mL vial
  • Store at room temperature. Protect from light.
  • Further dilute prior to use. Discard unused portion of vial.

Solutions Compatible: 0.45% and 0.9% NaCl, D5W, Dextrose-saline combinations


(For approved routes of administration by nursing personnel, refer to Policy for the Administration of Intravenous Medications.)

IV Direct NO
IV Intermittent Infusion YES
Must be further diluted
Infusion time: 15 - 20 minutes
IV Continuous Infusion

Central line for concentrations more than 0.9% (preferred)




(For neonatal dosages, refer to Neonatal IV Drug Manual.)

Maintenance of sodium requirements:

  • 3-4 mmol/kg/day; max 100-150 mmol/day

Urinary alkalinization for methotrexate:

  • usually 30-50 mmol/L of IV solution at 100-125 mL/m2/hr
Potential hazards of parenteral administration: 
  • Bicarbonate toxicity: keep serum bicarbonate below 35 mmol/L
  • Hypernatremia, hypocalcemia
  • Fluid retention
  • Avoid extravasation
  • Aluminum toxicity (see below)
  • Substitute 1:1 for sodium bicarbonate in alkalinization solutions with methotrexate
  • Sodium acetate is metabolized to bicarbonate on an equimolar basis outside the liver
  • Caution in patients with edema, congestive heart failure, renal impairment, liver impairment
  • Toxic aluminum concentrations may be seen with high doses, prolonged use, or renal dysfunction. Premature neonates are at higher risk due to immature renal function and aluminum intake from other parenteral sources.

Lexicomp Online® , Pediatric & Neonatal Lexi-Drugs® , Hudson, Ohio: Lexi-Comp, Inc.; June 14th 2017.

Omega. Sodium Acetate Omega Prescribing Information. Production Information Leaflet. COOP1084/V-01. Consulted June 14th 2017

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