Each 1 tsp serving contains: Agropyron repens 27 mg • Barosma betulina 4:1 extract (DHE: 27 mg) 6.75 mg • Hydrangea arborescens 14 mg • Methenamine 23 mg • Potassium Nitrate 11.45 mg • Sodium Bicarbonate 46 mg • Zea Mays L. 14 mg. Other Ingredients: Benzoic Acid, Caramel, Citric Acid, Common Juniper, Coriander, Ethyl Alcohol, Huile de Graine de Carvi, Methyl 4-hydroxybenzoate, Propyl 4-hydroxybenzoate, Propylene Glycol, Purified Water, Vanillin.
Brand name products often contain multiple ingredients. To read detailed information about each ingredient, click on the link for the individual ingredient shown above.
In 2004, Canada began regulating natural medicines as a category of products separate from foods or drugs. These products are officially recognized as "Natural Health Products." These products include vitamins, minerals, herbal preparations, homeopathic products, probiotics, fatty acids, amino acids, and other naturally derived supplements.
In order to be marketed in Canada, natural health products must be licensed. In order to be licensed in Canada, manufacturers must submit applications to Health Canada including information about uses, formulation, dosing, safety, and efficacy.
Products can be licensed based on several criteria. Some products are licensed based on historical or traditional uses. For example, if an herbal product has a history of traditional use, then that product may be acceptable for licensure. In this case, no reliable scientific evidence is required for approval.
For products with non-traditional uses, some level of scientific evidence may be required to support claimed uses. However, a high level of evidence is not necessarily required. Acceptable sources of evidence include at least one well-designed, randomized, controlled trial; well-designed, non-randomized trials; cohort and case control studies; or expert opinion reports.
Finished products licensed by Health Canada must be manufactured according to Good Manufacturing Practices (GMPs) as outlined by Health Canada.
Below is general information about the effectiveness of the known ingredients contained in the product Formule L 10. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
There is insufficient reliable information available about the effectiveness of buchu.
INSUFFICIENT RELIABLE EVIDENCE to RATE
There is insufficient reliable information available about the effectiveness of couch grass.
There is insufficient reliable information available about the effectiveness of hydrangea.
INSUFFICIENT RELIABLE EVIDENCE to RATE
INSUFFICIENT RELIABLE EVIDENCE to RATE
Below is general information about the safety of the known ingredients contained in the product Formule L 10. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
LIKELY SAFE ...when the leaf is used in amounts commonly found in foods. Buchu has Generally Recognized As Safe status (GRAS) for use in foods in the US (4912).
POSSIBLY SAFE ...when the leaf is used orally and appropriately in medicinal amounts (2,12).
POSSIBLY UNSAFE ...when excessive amounts of buchu leaf are taken orally or when the oil is ingested. Buchu contains pulegone, a known hepatotoxin (4). Pulegone is a major component of the oil. It is more abundant in buchu products that come from Agathosma crenulata (93681).
PREGNANCY: LIKELY UNSAFE
when used in medicinal amounts; buchu is reported to be an abortifacient (4).
LACTATION: POSSIBLY SAFE
when used in food amounts.
There is insufficient reliable information available about the safety of using larger amounts; avoid using.
LIKELY SAFE ...when used orally in amounts commonly found in foods. Corn silk, corn silk extract, and corn silk oil has Generally Recognized as Safe (GRAS) status in the US (4912). There is insufficient reliable information available about the safety of corn silk when used orally as medicine.
PREGNANCY: POSSIBLY SAFE
when consumed in food.
PREGNANCY: LIKELY UNSAFE
when used orally in larger amounts because it might have uterine stimulant effects (4); avoid using.
LACTATION: POSSIBLY SAFE
when consumed in food amounts.
Insufficient reliable information available when used as medicine; avoid using.
There is insufficient reliable information available about the safety of couch grass.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
POSSIBLY UNSAFE ...when used orally in excessive amounts. Doses of dried hydrangea rhizome/root greater than 2 grams have been associated with reports of dizziness and a feeling of tightness in the chest (4,12). There is insufficient reliable information available about the safety of hydrangea when used in lower amounts.
PREGNANCY AND LACTATION:
Insufficient reliable information available; avoid using.
LIKELY SAFE ...when used orally in doses up to 100 mEq total potassium daily, not to exceed 200 mEq in a 24-hour period (95010,107989). Oral potassium chloride and potassium citrate are FDA-approved prescription products (95010,107989). Larger doses increase the risk of hyperkalemia (15). ...when administered intravenously (IV) at appropriate infusion rates (95011). Parenteral potassium is an FDA-approved prescription product (15,95011). A tolerable upper intake level (UL) for potassium has not been established; however, potassium levels should be monitored in individuals at increased risk for hyperkalemia, such as those with kidney disease, heart failure, and adrenal insufficiency (100310,107966).
CHILDREN: LIKELY SAFE
when used orally and appropriately in dietary amounts.
A tolerable upper intake level (UL) has not been established for healthy individuals (6243,100310).
PREGNANCY AND LACTATION: LIKELY SAFE
when used orally in dietary amounts of 40-80 mEq daily (15).
A tolerable upper intake level (UL) has not been established for healthy individuals (100310).
POSSIBLY UNSAFE ...when used orally in excessive amounts. Over 20 cases of stomach rupture have been reported for patients who used sodium bicarbonate to relieve stomach discomfort after eating large meals (29414,29415,29416,29962,90913). In some of these cases, it is believed that the patients consumed dry sodium bicarbonate or a sodium bicarbonate suspension rather than a completely dissolved sodium bicarbonate solution. Ingestion of undissolved or partially undissolved sodium bicarbonate is believed to produce excess carbon dioxide and corresponding gastric dilation, leading to stomach rupture (90913). There is also concern that excessive or prolonged use of oral sodium bicarbonate may cause metabolic alkalosis characterized by hypokalemia, hypochloremia, and hypernatremia (25733,29962,90913). There is insufficient reliable information available about the safety of sodium bicarbonate when used topically.
CHILDREN: POSSIBLY SAFE
when used intravenously and appropriately with proper medical supervision.
Intravenous sodium bicarbonate solutions are approved by the US Food and Drug Administration (FDA) to be used in infants and children (13309).
CHILDREN: POSSIBLY UNSAFE
when used topically.
At least two cases of hypernatremia resulting from topical application of sodium bicarbonate (baking soda) have been reported (29962,90914).
There is insufficient reliable information available about the safety of sodium bicarbonate when used orally; avoid using unless advised by a physician.
PREGNANCY AND LACTATION: POSSIBLY UNSAFE
when used orally or intravenously during pregnancy.
There is concern that sodium bicarbonate may increase the risk of metabolic alkalosis or fluid retention when used orally during pregnancy (90915).
There is insufficient reliable information available about the safety of oral or intravenous sodium bicarbonate when used in medicinal amounts during lactation.
Below is general information about the interactions of the known ingredients contained in the product Formule L 10. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
Buchu may have antiplatelet effects (6002). Theoretically, buchu may enhance the effects of anticoagulant or antiplatelet drugs and increase the risk of bleeding in some patients. Some anticoagulant or antiplatelet drugs include aspirin, clopidogrel (Plavix), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, ticlopidine (Ticlid), warfarin (Coumadin), and others.
|
Buchu contains pulegone, a known hepatotoxin (4,93681). There is some concern that buchu may adversely affect the liver, especially when the leaf is used in large doses or the oil is ingested (93681). Theoretically, concomitant use with hepatotoxic drugs might increase the risk of liver damage. Some of these drugs include acarbose (Precose, Prandase), amiodarone (Cordarone), atorvastatin (Lipitor), azathioprine (Imuran), carbamazepine (Tegretol), cerivastatin (Baycol), diclofenac (Voltaren), felbamate (Felbatol), fenofibrate (Tricor), fluvastatin (Lescol), gemfibrozil (Lopid), isoniazid, itraconazole, (Sporanox), ketoconazole (Nizoral), leflunomide (Arava), lovastatin (Mevacor), methotrexate (Rheumatrex), nevirapine (Viramune), niacin, nitrofurantoin (Macrodantin), pioglitazone (Actos), pravastatin (Pravachol), pyrazinamide, rifampin (Rifadin), ritonavir (Norvir), rosiglitazone (Avandia), simvastatin (Zocor), tacrine (Cognex), tamoxifen, terbinafine (Lamisil), valproic acid, and zileuton (Zyflo)
|
Buchu is thought to have diuretic properties (93681). Theoretically, buchu might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
|
In an animal diabetic model, corn silk extract reduced levels of fasting blood glucose (103365). Theoretically, corn silk might have an additive effect with antidiabetes drugs and cause hypoglycemia.
Details
Some antidiabetes drugs include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, metformin (Glucophage), pioglitazone (Actos), rosiglitazone (Avandia), and others.
|
In clinical research, corn silk extract reduced systolic and diastolic blood pressure in both hypertensive and non-hypertensive individuals (93869). Taking corn silk extract with antihypertensive drugs might increase the risk for hypotension (4).
|
In clinical research, corn silk extract increases the urinary excretion of potassium (93869). Theoretically, taking corn silk might have additive effects with drugs that deplete potassium, including corticosteroids (4).
|
Overuse of corn silk might compound diuretic-induced potassium loss (4). In human research, corn silk extract increases the volume of urine and increases the excretion of sodium and potassium (93869). There is some concern that people taking corn silk along with potassium depleting diuretics might have an increased risk for hypokalemia. Initiation of potassium supplementation or an increase in potassium supplement dose may be necessary for some patients. Some diuretics that can deplete potassium include chlorothiazide (Diuril), chlorthalidone (Thalitone), furosemide (Lasix), hydrochlorothiazide (HCTZ, Hydrodiuril, Microzide), and others.
|
Corn silk contains vitamin K. Individuals taking warfarin should consume a consistent daily amount of corn silk to maintain consistent anticoagulation (19).
|
Hydrangea is thought to have diuretic properties. Theoretically, due to these potential diuretic effects, hydrangea might reduce excretion and increase levels of lithium. The dose of lithium might need to be decreased.
|
Using ACEIs with high doses of potassium increases the risk of hyperkalemia.
Details
ACEIs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion (95628). Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia (15,23207). However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels (95628).
|
Using ARBs with high doses of potassium increases the risk of hyperkalemia.
Details
ARBs block the actions of the renin-angiotensin-aldosterone system and reduce potassium excretion (95628). Concomitant use of these drugs with potassium supplements increases the risk of hyperkalemia (15,23207). However, concomitant use of these drugs with moderate dietary potassium intake (about 3775-5200 mg daily) does not increase serum potassium levels (95628).
|
Concomitant use increases the risk of hyperkalemia.
Details
Using potassium-sparing diuretics with potassium supplements increases the risk of hyperkalemia (15).
|
Theoretically, sodium bicarbonate may increase the risk for hypokalemia in patients receiving aminoglycosides.
Details
Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, when administered intravenously, the most common complication of sodium bicarbonate is hypokalemia (25709). Nephrotoxicity caused by aminoglycosides may lead to increased urinary losses of various electrolytes, including potassium (9519).
|
Theoretically, sodium bicarbonate may increase the risk for hypokalemia in patients receiving amphotericin B.
Details
Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, when administered intravenously, the most common complication of sodium bicarbonate is hypokalemia (25709). Amphotericin B increases urinary potassium losses due to toxic effects on renal tubular epithelium. Hypokalemia can occur in up to 50% of patients (9519).
|
Theoretically, sodium bicarbonate may reduce the levels and clinical effects of aspirin.
Details
In humans, oral or intravenous administration of sodium bicarbonate increases salicylate elimination. Although the exact mechanism of this effect is not clear, some researchers hypothesize that sodium bicarbonate increases urinary pH, which increases salicylate ionization and subsequent excretion by the kidneys. In patients with urine pH of about 5.5, renal clearance of salicylate is approximately 55 mL/min. When urine pH is increased with oral sodium bicarbonate to about 7.5, renal clearance of salicylate increases to approximately 100 mL/min. Similarly, urine alkalinization with sodium bicarbonate increases the mean total body clearance of salicylate by approximately 60% compared with urine acidification (29410,29411).
|
Theoretically, sodium bicarbonate may increase the risk for hypokalemia in patients taking beta-adrenergic agonists.
Details
Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, the most common adverse effect of intravenous sodium bicarbonate is hypokalemia (25709). Oral, parenteral, or inhaled beta-adrenergic agonists can reduce serum potassium levels, especially during acute use of high doses (6217,7001,8880,8881,8882,8883,8884,8885,8886,8889)(8890,9534,9599).
|
Theoretically, sodium bicarbonate might reduce the levels and clinical effects of cefpodoxime.
Details
Cefpodoxime proxetil is an oral prodrug that is de-esterified in the intestine to the active drug cefpodoxime. Drugs or supplements that increase gastric pH can inhibit the activation of cefpodoxime proxetil and reduce the peak plasma concentrations of cefpodoxime. In humans, taking sodium bicarbonate 12.6 grams orally along with cefpodoxime proxetil 200 mg reduces peak plasma concentrations and area under the plasma concentration-time curve (AUC) of cefpodoxime by 35% to 50% (25740).
|
Theoretically, sodium bicarbonate might reduce the levels and clinical effects of chlorpropamide.
Details
The elimination of chlorpropamide by the kidneys depends strongly on urine pH. At a pH of 5, the renal clearance of chlorpropamide ranges from 0.5 to 3 mL/hr. At a pH of 8, renal clearance of chlorpropamide ranges from 500 to 1000 mL/hr. When taken in combination with oral sodium bicarbonate, the elimination half-life of chlorpropamide is shortened from 49.7 to 12.8 hours and urinary excretion of chlorpropamide is increased four-fold (25741).
|
Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients receiving cisplatin.
Details
Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, the most common complication of intravenous sodium bicarbonate is hypokalemia (25709). Cisplatin can cause renal tubular damage, with increased losses of electrolytes including potassium (15509,15510,15511).
|
Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking corticosteroids.
Details
Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, the most common intravenous complication of sodium bicarbonate is hypokalemia (25709). Some glucocorticoids (corticosteroids) can also cause hypokalemia by causing sodium retention, resulting in compensatory renal potassium excretion. It is most common with hydrocortisone, cortisone, and fludrocortisone, followed by prednisone and prednisolone (4425).
|
Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking loop diuretics.
Details
Loop diuretics increase urinary potassium excretion (4412,4425,4449). Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, the most common complication of intravenous sodium bicarbonate is hypokalemia (25709).
|
Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking methylxanthines.
Details
Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, the most common complication of intravenous sodium bicarbonate is hypokalemia (25709). Theophylline and related drugs can reduce serum potassium levels, possibly by increasing intracellular uptake of potassium. Hypokalemia is most likely to occur after acute overdose of these drugs (17). However, reduced potassium levels can occur with therapeutic doses, and the incidence and degree of hypokalemia increases with increasing serum theophylline levels (9534,9537,9538,9539).
|
Theoretically, sodium bicarbonate may increase levels and adverse effects of pseudoephedrine.
Details
In humans, intravenous or oral administration of sodium bicarbonate can increase urinary pH. Clinical evidence shows that urine alkalinization increases the serum elimination half-life of pseudoephedrine by approximately 10-fold (29412). In one patient with persistently alkaline urine, treatment with pseudoephedrine resulted in hallucinations and personality changes (29412).
|
Concomitant use of sodium-containing drugs with additional sodium from dietary or supplemental sources may increase the risk of hypernatremia and long-term sodium-related adverse effects.
Details
The Chronic Disease Risk Reduction (CDRR) intake level of 2.3 grams of sodium daily indicates the intake at which it is believed that chronic disease risk increases for the apparently healthy population (100310). Some medications contain high quantities of sodium. When used in conjunction with sodium bicarbonate, the CDRR may be exceeded. Additionally, concomitant use may increase the risk for hypernatremia; this risk is highest in the elderly and people with other risk factors for electrolyte disturbances.
|
Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking stimulant laxatives.
Details
Long-term use of stimulant laxatives, or acute use of high doses (e.g., in bowel-cleansing regimens), can result in potassium loss and hypokalemia (4411,4412,4425). Orally, use of excessive sodium bicarbonate (such as intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, the most common complication of intravenous sodium bicarbonate is hypokalemia (25709).
|
Theoretically, sodium bicarbonate may increase the risk of hypokalemia in patients taking thiazide diuretics.
Details
Thiazide diuretics increase urinary potassium excretion (4412,4425,4449). Orally, use of excessive sodium bicarbonate (such as the intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with cases of hypokalemia (25733). Furthermore, the most common complication of intravenous sodium bicarbonate is hypokalemia (25709).
|
Below is general information about the adverse effects of the known ingredients contained in the product Formule L 10. Some ingredients may not be listed. This information does NOT represent a recommendation for or a test of this specific product as a whole.
General ...Orally, buchu leaf can cause GI and kidney irritation (4,6) and increase menstrual flow (6). Buchu is also a reported abortifacient (4).
Gastrointestinal ...Orally, buchu may cause gastrointestinal irritation (4,6).
Genitourinary ...Orally, buchu may increase menstrual flow (6). Buchu is also a reported abortifacient (4).
General ...Orally, corn silk seems to be well tolerated. However, a thorough evaluation of safety outcomes associated with medicinal use has not been conducted (103362). Corn silk has been reported to cause hypokalemia with prolonged use (4). Topically, corn silk can cause contact dermatitis and urticaria (4).
Dermatologic ...Topically, corn silk can cause dermatitis and urticaria (4).
Endocrine ...Orally, corn silk has been reported to cause hypokalemia with prolonged use (4).
Renal ...Orally, corn silk extract can increase urinary volume and increase the excretion of sodium and potassium (93869).
General ...No adverse effects have been reported; however, a thorough evaluation of safety outcomes has not been conducted.
General ...Orally, hydrangea may cause gastroenteritis, dizziness, and a feeling of tightness in the chest (4).
Cardiovascular ...Orally, hydrangea may cause a feeling of tightness in the chest (4).
Gastrointestinal ...Orally, hydrangea may cause gastroenteritis (4).
Neurologic/CNS ...Orally, hydrangea may cause dizziness (4).
General
...Orally or intravenously, potassium is generally well-tolerated.
Most Common Adverse Effects:
Orally: Abdominal pain, belching, diarrhea, flatulence, nausea, and vomiting.
Serious Adverse Effects (Rare):
All ROAs: High potassium levels can cause arrhythmia, heart block, hypotension, and mental confusion.
Cardiovascular ...Orally or intravenously, high potassium levels can cause hypotension, cardiac arrhythmias, heart block, or cardiac arrest (15,16,3385,95011,95626,95630).
Gastrointestinal ...Orally or intravenously, high doses of potassium can cause, nausea, vomiting, abdominal pain, diarrhea, and flatulence (95010,95011). Bleeding duodenal ulcers have also been associated with ingestion of slow-release potassium tablets (69625,69672).
Neurologic/CNS ...Orally or intravenously, high potassium levels can cause paresthesia, generalized weakness, flaccid paralysis, listlessness, vertigo, or mental confusion (15,16,3385,95011).
General
...Orally, sodium bicarbonate is generally well tolerated when used in over-the-counter antacid products.
However, it is possibly unsafe when used in excessive amounts. Intravenously, sodium bicarbonate is generally well tolerated when used appropriately with proper medical supervision. Topically, a thorough evaluation of safety outcomes has not been conducted.
Most Common Adverse Effects:
Orally: Abdominal pain, bloating, diarrhea, flatulence, nausea, and vomiting.
Serious Adverse Effects (Rare):
Orally: Metabolic alkalosis and stomach rupture.
Intravenously: Alkalotic tetany, hypernatremia, hypocalcemia, hypokalemia, and metabolic alkalosis.
Cardiovascular ...Orally, sodium bicarbonate has been reported to cause increased blood pressure (109689).
Gastrointestinal
...Orally, sodium bicarbonate may cause mild adverse effects including gastrointestinal disturbance such as bloating, nausea, vomiting, and abdominal pain (25706,106250).
The severity of these effects appears to increase with dose (104850). When taken in large amounts (300 mg/kg as a single dose, 4 ounces over a 24-hour time period, or 10-12 ounces over 5 days), sodium bicarbonate can cause diarrhea, nausea, vomiting, bloating, flatulence, and abdominal pain (29962,104853,104850). Gastrointestinal side effects during exercise can be reduced when single doses of 200-300 mg/kg are taken 3 hours before with a high-carbohydrate meal (106250). Taking enteric-coated or delayed-release formulations may also reduce the incidence and severity of mild gastrointestinal symptoms (104853,106250), but enteric-coated formulations may also reduce overall absorption of bicarbonate (104853).
Sodium bicarbonate antacids may cause serious gastrointestinal effects, including stomach rupture, if taken orally as a partially dissolved slurry rather than a solution, especially if taken when overly full from food or drink (25735,25736,29414,29415,29416,90913).
Hematologic
...In patients with normal kidney function, appropriate use of oral sodium bicarbonate may not cause significant alkalosis, although it may increase loss of sodium, chloride, potassium, and volume due to diuresis (25733).
However, excessive use or chronic oral intake of sodium bicarbonate may induce metabolic alkalosis characterized by levels of sodium bicarbonate ≥40 mEq/L, hypokalemia, hypochloremia, and hypernatremia (25733,29962,106255). When administered intravenously, the most common complication of sodium bicarbonate is hypokalemia (25709). Hypocalcemia or hypernatremia may also occur, although these effects are less common and typically associated with overaggressive therapy (25709,106255).
At least two cases of hypernatremia resulting from topical application of sodium bicarbonate (baking soda) have been reported (29962,90914).
Musculoskeletal ...Metabolic alkalosis induced by sodium bicarbonate has reportedly been associated with tetany that results from hypocalcemia; however, this condition is rare (25709).
Neurologic/CNS ...Orally, concomitant use of excessive sodium bicarbonate (intake of "tablespoons" of sodium bicarbonate daily or up to one box of baking soda weekly) has been associated with at least two cases of hypercalcemia-induced metabolic alkalosis, characterized by dizziness, headache, and loss of consciousness with shivering (25733). Rare symptoms include drowsiness, lethargy, seizures, and coma (106255). Sodium bicarbonate may also cause metabolic alkalosis and the associated symptoms when administered intravenously (13309). However, these effects are typically associated with therapy that is overaggressive.
Ocular/Otic ...At least three cases of otitis externa have been reported following the use of eardrops containing sodium bicarbonate (25696).