Tromethamine
Tromethamine is a biological buffering agent used to correct metabolic acidosis by neutralizing excess acid in the bloodstream and raising pH levels. It is primarily employed in critical care and surgical settings, particularly cardiac surgery, to manage acid-base imbalances.
A pH-buffering agent that treats metabolic acidosis by accepting hydrogen ions and restoring normal blood pH.
This medication carries a boxed (black box) warning — the strongest type of FDA warning. Review the full prescribing information before use.
Key facts at a glance
- ATC
- B05BB03
- RxNorm
- 10865
- Generic
- Tromethamine
- Class
- atc-b05
- Brands
- —
- Availability
- rx
- Lactation
- unknown
- Routes
- —
- Forms
- injection
- Regions
- US, EU, CN, JP
- Monitoring
- —
This page is for informational purposes only.
Do not use this information to diagnose yourself or to replace a physician's advice. Always consult a qualified healthcare provider before starting, stopping, or changing any medication. If you believe you are experiencing a medical emergency, call your local emergency number immediately.
Dosage and administration
- Usual dose
- 500mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 250mg twice daily
- Maximum
- consult physician
- Frequency
- every 12 hours
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
- Usual dose
- 400mg daily
- Maximum
- consult physician
- Frequency
- once daily
- Instructions
- Follow physician instructions
- Duration limits
- as prescribed
- Monitoring
- standard
Overdose information
Special Populations
10 groupspregnancy
first trimesteruse only if clearly needed
avoid unless benefits outweigh potential risks to fetus
regular fetal monitoring recommended
Use with caution and monitor for adverse effects.
pregnancy
second trimesteruse only if clearly needed
use when indicated for maternal metabolic acidosis
fetal well-being monitoring
Use with caution and monitor for adverse effects.
pregnancy
third trimesteruse only if clearly needed
use when indicated for maternal metabolic acidosis
fetal and maternal monitoring
Use with caution and monitor for adverse effects.
lactation
breastfeedingno specific adjustment
use with caution, monitor infant
observe infant for adverse effects
pediatric_age
neonatesweight-based dosing required
use under close medical supervision, monitor acid-base status
frequent monitoring of electrolytes and acid-base balance
Use with caution and monitor for adverse effects.
pediatric_age
childrenweight-based dosing required
use under close medical supervision
monitor acid-base status and electrolytes
Use with caution and monitor for adverse effects.
geriatric
elderlyadjust based on renal function
use with caution, assess renal function first
monitor renal function and electrolytes
Use with caution and monitor for adverse effects.
renal_impairment
mild renal impairmentadjust dose based on severity
use with caution, may accumulate
monitor renal function and electrolytes closely
Use with caution and monitor for adverse effects.
renal_impairment
severe renal impairmentsignificant dose adjustment required
use only when benefits outweigh risks, consider dialysis
frequent monitoring of renal function and electrolytes
Use with caution and monitor for adverse effects.
hepatic_impairment
mild hepatic impairmentno specific adjustment
use with caution
monitor liver function
Use with caution and monitor for adverse effects.
Statistics and clinical data
Commonly prescribed since
General prescribing information for Tromethamine as a pharmaceutical buffer
Drug class
Classification as pharmaceutical excipient and active agent
Common uses
Primary therapeutic applications
Common dosage forms
Available pharmaceutical formulations
Treatment of metabolic acidosis in critical care, cardiac surgery (especially pediatric), and trauma settings; urinary alkalinization; and management of acidemia associated with renal tubular acidosis or drug toxicity.
Acts as an organic base (weak amine buffer) that accepts hydrogen ions, buffering excess acid in the blood and tissues to raise pH toward normal physiological levels.
Administered intravenously under close medical supervision with careful pH and electrolyte monitoring; use caution in patients with renal impairment, hypokalemia, or fluid overload; may cause hyperkalemia or respiratory depression in certain populations.
Contraindications
Conditions and patient states where this medication should be avoided or used with caution.
Do not use (1)
Known allergy to this medication or its components
Use caution (1)
Consult healthcare provider for benefits vs risks assessment
Official drug label
WellAlly may earn a referral fee from linked resources at no extra cost to you. Editorial content is never influenced by commercial relationships.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.
This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.
If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.
Medically reviewed by WellAlly Editorial Team Last reviewed August 24, 2026. · Read our editorial policy