Neut ® 4% SODIUM BICARBONATE ADDITIVE SOLUTION

To adjust acidic parenteral solutions to a more nearly neutral pH.

Fliptop Vial

Rx Only

(0.2 g in 5 mL)

Neut (4% sodium bicarbonate additive solution) is a sterile, nonpyrogenic solution of sodium bicarbonate in water for injection. It is administered by the intravenous route only after addition as a neutralizing agent to an acidic large volume parenteral solution. Each 5 mL contains sodium bicarbonate 0.2 g (2.4 mEq each of Na⁺ and HCO₃ ^– ); edetate disodium, anhydrous 10 mg added as a stabilizer. Total sodium (Na⁺) content of each 5 mL is 56.1 mg (11.2 mg/mL).

The solutions contain no bacteriostat, antimicrobial agent or added buffer; pH 8.0 (7.0 to 8.5).

Sodium Bicarbonate, USP is chemically designated as NaHCO₃, a white crystalline powder soluble in water.

The acid pH of most intravenous solutions has been implicated as a factor in the production of postinfusion (chemical) phlebitis not caused by obvious infection. Vein irritation, with local redness and tenderness near the site of venipuncture or along the course of a vein, appears to be related to the nature of the substances in the infusion and the speed (insufficient dilution by the bloodstream) as well as the duration (prolonged exposure of the intima) of infusion. Other contributing factors include the size of the vein used for venipuncture, shape or method of insertion of the venipuncture needle, the use or type of indwelling catheter, infection at the infusion site and the age of the patient (children and females seem to be more susceptible).

The pH of commonly used dextrose infusion solutions ranges from 3.5 to 6.5. Other commonly used solutions also may have an acid pH. Since non-neutral parenteral solutions with a low (acid) pH are known to cause chemical irritation of tissues, it is not surprising that chemical phlebitis may occur as a complication with their infusion. Vein irritation is most likely when the duration of infusion is long or when hemodilution is minimized by a large needle in a small vein.

The amount of sodium bicarbonate recommended as an additive to neutralize acid parenteral solutions is too small to exert a clinically significant increase in electrolyte content.

Neut (4% sodium bicarbonate additive solution) is indicated for use as an additive to raise the pH of acid solutions administered intravenously to reduce the incidence of chemical phlebitis and patient discomfort due to vein irritation at or near the site of infusion.

Not for use as a systemic alkalizer.

None known.

Do not administer unless solution is clear and seal is intact. Discard unused portion.

Solutions prepared with Neut (4% sodium bicarbonate additive solution) should be administered promptly. When introducing additives, use aseptic technique, mix thoroughly and do not store.

When Neut is added to Hospira solutions, the compatibility of these solutions with other drugs may be altered. (See section on COMPATIBILITY, etc., for listing of additives tested with Neut added D5-W.)

Raising the pH of I.V. fluids with Neut will only reduce the incidence of chemical irritation caused by the infusate; it will not diminish any foreign body effects caused by the needle or catheter.

None known.

None known.

None known.

One vial (5 mL) of Neut added to a liter (1000 mL) of any of the following Hospira parenteral solutions will increase the pH to a more physiologic range. Specific pH may vary slightly from lot to lot.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution and container permit. See PRECAUTIONS.

Addition of one vial of Neut to one-half liter (500 mL) is recommended to achieve a more physiologic pH of the following Hospira parenteral solutions:

Note: Some products, e.g., Aminosyn^® solutions and those Ionosol^® and Normosol^® formulas containing dextrose will NOT be brought to near physiologic pH by the addition of Neut. This is due to the relatively high buffer capacity of these fluids.

Neut (4% sodium bicarbonate additive solution) is supplied in partial-fill single-dose containers 5 mL fliptop vial. Unit of Sale is a Tray containing 25 vials (NDC: 0409-6609-02).

Distributed by Hospira, Inc., Lake Forest, IL 60045 USA

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LAB-1233-2.0

Revised: 06/2018

RL-0672

Label NDC 0409-6609-02

5 mL

Neut^®
Sodium Bicarbonate 4% (2.4 mEq)
Additive Solution

Single-dose

25 Units/NDC 0409-6609-02

Rx only

Hospira, Inc., Lake Forest, IL 60045 USA

Hospira