citric acid/sodium citrate

  • 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.

What is sodium citrate (alk) citric acid-oral liquid, and how does it work (mechanism of action)?

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.

What brand names are available for sodium citrate (alk) citric acid-oral liquid?

Cytra-2

Is sodium citrate (alk) citric acid-oral liquid available as a generic drug?

GENERIC AVAILABLE: Yes

Do I need a prescription for sodium citrate (alk) citric acid-oral liquid?

Yes

What are the side effects of sodium citrate (alk) citric acid-oral liquid?

Common side effects of sodium citrate/citric acid are nausea, vomiting, diarrhea, stomach pain, and water retention.

It should not be used in patients with kidney failure.

What is the dosage for sodium citrate (alk) citric acid-oral liquid?

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.

Which drugs or supplements interact with sodium citrate (alk) citric acid-oral liquid?

: 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).

Sodium citrate/citric acid reduces stomach acidity, which can lead to increased digoxin (Lanoxin) absorption and possible digoxin side effects like dizziness, headache, nausea, diarrhea, irregular heart rate and rhythm, and visual disturbances.

Is sodium citrate (alk) citric acid-oral liquid safe to take if I'm pregnant or breastfeeding?

It is not known whether sodium citrate/citric acid enters breast milk; therefore, it is best to be cautious before using it in nursing mothers.

What else should I know about sodium citrate (alk) citric acid-oral liquid?

What preparations of sodium citrate (alk) citric acid-oral liquid are available?

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.

How should I keep sodium citrate (alk) citric acid-oral liquid stored?

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.

Summary

Citric acid/sodium citrate (Bicitra, Cytra-2, Oracit, Shohl's) is a medication prescribed to prevent kidney stones. Side effects, drug interactions, storage, dosage, and pregnancy safety information should be reviewed prior to taking this medication.

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References
REFERENCE: FDA Prescribing Information.
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