citric acid/sodium citrate (Bicitra, Cytra-2, Oracit, Shohl's)

  • Pharmacy Author:
    Omudhome Ogbru, PharmD

    Dr. Ogbru received his Doctorate in Pharmacy from the University of the Pacific School of Pharmacy in 1995. He completed a Pharmacy Practice Residency at the University of Arizona/University Medical Center in 1996. He was a Professor of Pharmacy Practice and a Regional Clerkship Coordinator for the University of the Pacific School of Pharmacy from 1996-99.

  • Medical and Pharmacy Editor: Jerry R. Balentine, DO, FACEP
    Jerry R. Balentine, DO, FACEP

    Jerry R. Balentine, DO, FACEP

    Dr. Balentine received his undergraduate degree from McDaniel College in Westminster, Maryland. He attended medical school at the Philadelphia College of Osteopathic Medicine graduating in1983. He completed his internship at St. Joseph's Hospital in Philadelphia and his Emergency Medicine residency at Lincoln Medical and Mental Health Center in the Bronx, where he served as chief resident.

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GENERIC NAME: Sodium citrate dihydrate and citric acid monohydrate

BRAND NAME: Cytra-2

DRUG CLASS AND MECHANISM: Sodium citrate/citric acid is used to make urine less acidic and therefore prevent formation of kidney stones. Sodium citrate/citric acid also is useful as a buffer and neutralizing agent for gastric acid. Sodium citrate is broken down to sodium bicarbonate which decreases the acidity of urine, increasing the excretion of substances that cause kidney stones.

PRESCRIPTION: Yes

GENERIC AVAILABLE: Yes

PREPARATIONS: Sodium citrate/citric acid oral solution contains 500 mg of sodium citrate dihydrate and 334 mg of citric acid monohydrate per 5 ml, available in 16 fluid ounce bottles. Sodium citrate/citric acid is grape flavored and sugar free liquid.

STORAGE: Store sodium citrate/citric acid solution at room temperature between 20 C and 25 C (68 F and 77 F). Keep container tightly closed. Keep from excessive heat or freezing.

PRESCRIBED FOR: Sodium citrate/citric acid is used for reducing the acidity of urine in patients with poor kidney function, prevention of kidney stones, and to neutralize gastric acid in stomach.

DOSING:

Systemic alkalization:

  • Adult: Take 2 to 6 teaspoons (10 to 30 ml) of liquid diluted in 1 to 3 ounces (30 to 90 ml) of water after meals and at bedtime, or as directed by doctor.
  • Pediatric: Take 1 to 3 teaspoons (5 to 15 ml) of liquid diluted in 1 to 3 ounces (30 to 90 ml) of water after meals and at bedtime, or as directed by doctor.

Neutralizing buffer: Take 3 teaspoons (15 ml), diluted in 15 ml of water, taken as single dose or as directed by doctor.

Safe and effective use of sodium citrate/citric acid is not established for children under two years of age.

DRUG INTERACTIONS: Sodium citrate/citric reduces stomach acidity, which reduces the absorption and may decrease the effectiveness atazanavir (Reyataz), ritonavir (Norvir), and indinavir (Crixivan), antibiotics like ciprofloxacin (Cipro), moxifloxacin (Avelox), doxycycline (Vibramycin), tetracycline (Tetracon), and antifungals like ketoconazole (Nizoral) and itraconazole (Sporanox).

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