Sodium citrate/citric acid

Sodium citrate/citric acid is a prescription medication used for urine alkalinization and the prevention of nephrolithiasis.

• Sodium citrate/citric acid is available under the following different brand names: Albrights Solution, Bicitra, Cytra 2, Oracit, Shohls Solution

Adult and pediatric dosage

Oral solution

• (500mg/334mg)/5mL
• (500mg/300mg)/5mL
• (490mg/640mg)/5mL

Urine Alkalinization, Prevention of Nephrolithiasis

Adult dosage

• 10-30 mL diluted in up to 6 oz water/juice orally after meals at bedtime when needed
• Follow with additional water if desired

Pediatric dosage

• Children below 2 years: Based on physician's discretion
• Children above 2 years: 5-15 mL diluted in 30-90 mL of water/juice orally after meals at bedtime when needed
• Follow with additional water if desired

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

Common side effects of Sodium citrate/citric acid include:

• diarrhea
• nausea
• muscle spasms
• metabolic alkalosis
• vomiting
• stomach pain, and
• fluid retention.

Serious side effects of Sodium citrate/citric acid include:

• swelling of the hands/ankles/feet,
• tingling/numbness of the hands/feet, 
• weakness,
• rash, 
• itching/swelling (especially of the face/tongue/throat),
• fast/slow/irregular heartbeat, 
• mental/mood changes (such as confusion, restlessness),
• muscle spasms,
• seizures,
• severe dizziness, and
• trouble breathing.

Rare side effects of Sodium citrate/citric acid include:

• none 

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Sodium citrate/citric acid has severe interactions with no other drugs.
• Sodium citrate/citric acid has serious interactions with the following drugs:
  • atazanavir
  • dapsone
  • dasatinib
  • demeclocycline
  • digoxin
  • doxycycline
  • eltrombopag
  • fleroxacin
  • gemifloxacin
  • indinavir
  • itraconazole
  • ketoconazole
  • levofloxacin
  • levoketoconazole
  • minocycline
  • moxifloxacin
  • nimodipine
  • nisoldipine
  • nitrendipine
  • ofloxacin
  • oxytetracycline
  • tetracycline
• Sodium citrate/citric acid has moderate interactions with at least 85 other drugs.
• Sodium citrate/citric acid has minor interactions with the following drugs:
  • aspirin
  • aspirin rectal
  • aspirin/citric acid/sodium bicarbonate
  • balsalazide
  • blessed thistle
  • choline magnesium trisalicylate
  • chromium
  • devil's claw
  • diflunisal
  • mesalamine
  • salicylates (non-ASA)
  • salsalate
  • strontium ranelate
  • sulfasalazine
  • willow bark

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all the products you use. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your health care professional or doctor for additional medical advice, or if you have health questions, concerns.

Contraindications

• Hypersensitivity to drug or component of the formulation
• Severe renal impairment, oliguria, anuria, azotemia, acute dehydration, untreated Addison disease, adynamia episodica hereditaria, heat cramp, hyperkalemia, severe myocardial damage, a sodium-restricted diet

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Sodium citrate/citric acid?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Sodium citrate/citric acid?”

Cautions

• Use with caution in toxemia of pregnancy
• Contains sodium; use caution in patients with peripheral or pulmonary edema, severe renal impairment, hypertension, or heart failure
• Conversion to bicarbonate may be impaired; use caution in shock, severely ill, or hepatic failure
• Do not dilute in tomato juice

Pregnancy and Lactation

• Use with caution if benefits outweigh risks during pregnancy

Lactation

• Consult physician