Also called trometamol or THAM, a buffer for severe acidosis
Tromethamine
A hospital intravenous medicine used to correct severe acidity in the blood (metabolic acidosis).
What is Tromethamine?
Tromethamine, also called trometamol or THAM, is a specialist medicine given into a vein in hospital to correct severe metabolic acidosis, a dangerous build-up of acid in the blood. It works as a buffer, mopping up excess acid so the blood's acidity returns towards normal. It is used only under close supervision, usually in intensive or critical care. Its important risks include slowing or stopping breathing, dangerously low blood sugar, high potassium levels, and tissue damage if the fluid leaks out of the vein, so it is given carefully with monitoring.
Education and reference only. This is a plain-language guide to Tromethamine — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Tromethamine, known in the UK as trometamol and historically as THAM, is an alkalinising buffer, a substance that neutralises acid. It is given as a fluid into a vein to treat severe metabolic acidosis, a state in which there is too much acid in the blood that the body cannot correct on its own. This can happen in serious illness, after major surgery, or in certain poisonings. It is a hospital-only medicine, used by specialists in intensive care or anaesthesia, and is not something taken at home.
How it works
When the blood becomes too acidic, normal body functions and organs can be put at risk. Tromethamine works as a buffer: it chemically binds to excess hydrogen ions (the particles that make blood acidic) and helps remove them, raising the blood towards a healthier acid balance. Unlike some other treatments for acidosis, it does not add extra sodium, which can be useful in certain patients. Because it shifts the body's acid-base and salt balance, and is given directly into the bloodstream, it must be given slowly and with careful monitoring to avoid swinging the balance too far the other way.
Company & origin
Originated / developed by: Specialist manufacturers.
A hospital-only intravenous buffer, also called trometamol or THAM, used in critical care to correct dangerously high acidity in the blood.
Practical use
How to take Tromethamine
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given only in hospital, into a vein, by specialist staff who monitor you closely.
- It is given slowly and at a carefully controlled rate, guided by blood tests.
- Breathing is monitored and may be supported, as it can slow or stop breathing.
- Blood sugar, potassium and acid levels are checked regularly during treatment.
- The drip site is watched carefully, as leakage into the tissues can cause damage.
Weighing it up
Advantages & disadvantages of Tromethamine
Advantages
- Corrects dangerously high blood acidity in seriously ill patients.
- Does not add extra sodium, which can be helpful in certain patients.
- A useful option in critical care when other treatments are unsuitable.
Disadvantages
- Can slow or stop breathing, especially if breathing is already impaired.
- Can cause dangerously low blood sugar and raised potassium levels.
- Can damage tissue if it leaks from the vein, and relies on working kidneys to be cleared.
Practical use
Good to know
The key thing to understand about tromethamine is that it is a critical-care medicine, given and watched closely by specialists, not a routine drug. Several important risks come with it. It can slow or even stop breathing, particularly in people whose breathing is already impaired, so it is often used when breathing is being supported. It can cause blood sugar to drop dangerously low and can push potassium levels up, both of which are monitored. If the fluid leaks out of the vein into surrounding tissue it can cause damage, so the drip site is checked. It needs working kidneys to be cleared from the body, so it is used cautiously when the kidneys are not working well. Doses and rates are calculated carefully by the medical team based on blood tests.
Who should not take it / use with caution
- People with severe kidney failure who cannot clear it should not normally receive it.
- It is used with great caution, or avoided, in those with breathing failure unless breathing is being supported.
- It is avoided in certain types of acidosis (such as long-standing breathing-related acidosis) where it is not appropriate.
- It is used cautiously in newborns and is given only under specialist judgement.
Monitoring
- Frequent blood tests for acid levels, potassium and blood sugar.
- Close monitoring of breathing during and after treatment.
- Checking kidney function and the drip site for leakage.
Side effects
- Slowed or stopped breathing, especially when breathing is already weak.
- Dangerously low blood sugar.
- Raised potassium levels in the blood.
- Tissue damage or irritation if the fluid leaks out of the vein.
Key interactions
- It changes the body's acid balance, which can affect how other medicines behave, so the team takes this into account.
- Care is needed alongside medicines that affect potassium or blood sugar.
- Other treatments for acidosis are balanced against it by the medical team.
Available as: A solution given into a vein in hospital.
Answers
Tromethamine: frequently asked questions
What is tromethamine used for?
It is a hospital medicine given into a vein to correct severe metabolic acidosis, a dangerous build-up of acid in the blood, usually in critical care.
Is it the same as trometamol or THAM?
Yes, tromethamine, trometamol and THAM are different names for the same buffering medicine used to neutralise excess acid in the blood.
Why is it only given in hospital?
It is given into a vein and can affect breathing, blood sugar and potassium, so it needs close monitoring and is used by specialists in critical care.
Can it affect breathing?
Yes, it can slow or stop breathing, especially in people whose breathing is already weak, so breathing is monitored and may be supported.
Why does the drip site need watching?
If the fluid leaks out of the vein into the surrounding tissue it can cause damage, so staff check the drip site carefully during treatment.
Authoritative sources
- BNF
- NICE CKS
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