What is Tromethamine

Tromethamine is a parenteral, highly alkaline, sodium-free solution used for short-term treatment of metabolic acidosis.

It is used for the prevention and correction of systemic metabolic acidosis associated with cardiac bypass surgery, acidity from acid citrate dextrose, and cardiac arrest. Sodium bicarbonate is usually preferred in the treatment of metabolic acidosis.

Tromethamine is hypertonic and can usually only be used for a short period of time without risking solute and fluid overload. In neonates and infants with respiratory failure, tromethamine has been used as an alternative to bicarbonate to treat severe cases of metabolic acidosis with concurrent respiratory acidosis because it does not raise PCO2.

Tromethamine has also been used in neonates and infants with hypernatremia and metabolic acidosis to avoid the additional sodium associated with sodium bicarbonate administration.

Tromethamine (Tham) was approved by the FDA in 1971.

Brand Name



  • metabolic acidosis

Side Effects

  1. fever
  2. hepatic necrosis
  3. hypoglycemia
  4. infection
  5. phlebitis
  6. pulmonary edema
  7. respiratory depression
  8. thrombosis

Monitoring Parameters

  • serum bicarbonate
  • serum electrolytes
  • serum osmolality
  • total CO2


  • anuria
  • breast-feeding
  • electrolyte imbalance
  • extravasation
  • geriatric
  • heart failure
  • hypoglycemia
  • infants
  • neonates
  • pregnancy
  • premature neonates
  • pulmonary edema
  • renal disease
  • renal failure
  • renal impairment
  • respiratory acidosis
  • respiratory depression
  • uremia


  • Acetaminophen; Aspirin, ASA; Caffeine
  • Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
  • Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Dextromethorphan; Pseudoephedrine
  • Acetaminophen; Pseudoephedrine
  • Acrivastine; Pseudoephedrine
  • Amphetamines
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  • Aspirin, ASA; Butalbital; Caffeine
  • Aspirin, ASA; Butalbital; Caffeine; Codeine
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  • Aspirin, ASA; Caffeine; Orphenadrine
  • Aspirin, ASA; Carisoprodol
  • Aspirin, ASA; Carisoprodol; Codeine
  • Aspirin, ASA; Citric Acid; Sodium Bicarbonate
  • Aspirin, ASA; Dipyridamole
  • Aspirin, ASA; Omeprazole
  • Aspirin, ASA; Oxycodone
  • Aspirin, ASA; Pravastatin
  • Atropine; Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Benzoic Acid; Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate
  • Bismuth Subsalicylate
  • Bismuth Subsalicylate; Metronidazole; Tetracycline
  • Brompheniramine; Hydrocodone; Pseudoephedrine
  • Brompheniramine; Pseudoephedrine
  • Carbetapentane; Pseudoephedrine
  • Carbinoxamine; Dextromethorphan; Pseudoephedrine
  • Carbinoxamine; Hydrocodone; Pseudoephedrine
  • Carbinoxamine; Pseudoephedrine
  • Cetirizine; Pseudoephedrine
  • Chlophedianol; Dexchlorpheniramine; Pseudoephedrine
  • Chlorpheniramine; Dihydrocodeine; Pseudoephedrine
  • Chlorpheniramine; Guaifenesin; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Hydrocodone; Pseudoephedrine
  • Chlorpheniramine; Pseudoephedrine
  • Chlorpropamide
  • Choline Salicylate; Magnesium Salicylate
  • Colchicine
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  • Desloratadine; Pseudoephedrine
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  • Dextromethorphan; Guaifenesin; Pseudoephedrine
  • Dextromethorphan; Quinidine
  • Dihydrocodeine; Guaifenesin; Pseudoephedrine
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  • Fexofenadine; Pseudoephedrine
  • Flecainide
  • Guaifenesin; Hydrocodone; Pseudoephedrine
  • Guaifenesin; Pseudoephedrine
  • Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
  • Hydrocodone; Pseudoephedrine
  • Hyoscyamine; Methenamine; Methylene Blue; Phenyl Salicylate; Sodium Biphosphate
  • Ibuprofen; Pseudoephedrine
  • Lithium
  • Loratadine; Pseudoephedrine
  • Magnesium Salicylate
  • Memantine
  • Methenamine
  • Methenamine; Sodium Acid Phosphate
  • Methenamine; Sodium Acid Phosphate; Methylene Blue; Hyoscyamine
  • Naproxen; Pseudoephedrine
  • Pseudoephedrine
  • Quinidine
  • Salsalate

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