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Pharmacology: Sodium bicarbonate acts as urinary alkaliser by excretion of free bicarbonate ions in the urine, thus effectively raising the urinary pH. By maintaining alkaline urine, the actual dissolution of uric acid stones may be accomplished. It also acts as antacid by chemically neutralizing or buffering existing quantities of stomach acid but has no direct effect in its output. This action results in increased pH value of stomach contents, thus providing relief of hyperacidity symptoms.
Pharmacokinetics: Sodium citrate is metabolized to bicarbonates, which increases urinary pH by increasing the excretion of free bicarbonates ions, without producing systemic alkalosis when administered recommended doses. A rise in urinary ph increases the solubility of cysteine in the urine and the ionization of uric acid to more soluble urate iron. It also reacts chemically to neutralize or buffer existing quantities of gastric hydrochloride acid but has no direct effects in its output. Sodium bicarbonate is excreted through renal and also via lung by forming CO2. Sodium citrate, citric acid and absorbed tartaric acid are excreted through urine.
