Lactic Acidosis Medication

Updated: Sep 11, 2020
  • Author: Kyle J Gunnerson, MD; Chief Editor: Michael R Pinsky, MD, CM, Dr(HC), FCCP, FAPS, MCCM  more...
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Medication Summary

Definitive treatment for lactic acidosis is correction of the underlying cause for type A lactic acidosis and the removal of the offending drug or toxin in type B lactic acidosis.  As previously stated, controversy surrounds the use of alkali in treating lactic acidosis. 


Alkalinizing Agents

Class Summary

NaHCO3 may be used as a temporizing measure in very severe acidosis and in patients who become hemodynamically unstable because of the acidosis. Tromethamine is a buffering agent that does not generate carbon dioxide.

Sodium bicarbonate

Sodium bicarbonate is commonly used for severe metabolic acidosis with associated hemodynamic instability, although this practice remains controversial.

Tromethamine (Tham)

Tromethamine confers a theoretical benefit over sodium bicarbonate as it does not generate carbon dioxide. The effects on patient outcomes are not known.



Class Summary

Vitamins are essential for normal metabolism.


Vitamin B-1 is used for thiamine deficiency, including Wernicke encephalopathy syndrome. It is also used in patients with lactic acidosis of no established cause. Thiamine deficiency may rarely cause lactic acidosis.