citric acid, potassium citrate, and sodium citrate

Pronunciation: SIT rik AS id, poe TASS ee um, and SOE dee um SIT rayt

Brand: Cytra-3, Polycitra, Polycitra-LC, Tricitrates

What is the most important information I should know about citric acid, potassium citrate, and sodium citrate?

You should not use this medication if you have severe kidney disease, severe heart damage (such as from a prior heart attack), Addison's disease (an adrenal gland disorder), high levels of potassium or sodium in your blood, or if you are severely dehydrated.

You should not take citric acid, potassium citrate, and sodium citrate tablets if you have problems with your esophagus, stomach, or intestines that make it difficult for you to swallow or digest pills.

Before you take citric acid, potassium citrate, and sodium citrate, tell your doctor about all your medical conditions, especially kidney disease, heart disease, high blood pressure, a history of heart attack, urinary problems, diabetes, swelling (edema), urination problems, stomach ulcer or chronic diarrhea (such as ulcerative colitis, Crohn's disease), or if you are on a low-salt diet.

Also tell your doctor about all other medications you use, including antacids, heart or blood pressure medications, or a diuretic (water pill).

To be sure this medication is helping your condition, your blood and urine may need to be tested often. Your heart rate may also be checked using an electrocardiograph or ECG (sometimes called an EKG) to measure electrical activity of the heart. Follow your doctor's instructions carefully and do not miss any scheduled appointments.

Serious side effects of citric acid, potassium citrate, and sodium citrate include numbness or tingly feeling, swelling or rapid weight gain, muscle twitching or cramps, fast or slow heart rate, confusion, or mood changes, bloody or tarry stools, severe stomach pain, ongoing diarrhea, or seizure (convulsions).

What is citric acid, potassium citrate, and sodium citrate?

Citric acid and sodium citrate are alkalinizing agents that make the urine less acidic.

Potassium is a mineral that is found in many foods and is needed for several functions of your body, especially the beating of your heart.

The combination of citric acid, potassium citrate, and sodium citrate is used to prevent gout or kidney stones, or metabolic acidosis in people with kidney problems.

Citric acid, potassium citrate, and sodium citrate may also be used for other purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking citric acid, potassium citrate, and sodium citrate?

You should not use this medication if you are allergic to it, or if you have:

severe kidney disease;
severe heart damage (such as from a prior heart attack);
Addison's disease (an adrenal gland disorder);
high levels of potassium in your blood (hyperkalemia);
high levels of sodium in your blood (hypernatremia); or
if you are severely dehydrated.

If you have certain conditions, you may need a dose adjustment or special tests to safely take this medication. Before you take citric acid, potassium citrate, and sodium citrate, tell your doctor if you have:

kidney disease;
low levels of calcium in your blood (hypocalcemia);
congestive heart failure, heart rhythm problems, or history of heart attack;
other heart disease or high blood pressure;
diabetes;
a peptic ulcer in your stomach;
swelling of your hands or feet, or in your lungs (pulmonary edema);
toxemia of pregnancy;
urination problems (or if you are unable to urinate);
chronic diarrhea (such as irritable bowel disease, ulcerative colitis, Crohn's disease); or
if you are on a low-salt diet.

It is not known whether this medication is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take citric acid, potassium citrate, and sodium citrate?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Citric acid, potassium citrate, and sodium citrate should be taken after meals to help prevent stomach or intestinal side effects. You may also need to take the medicine at bedtime. Follow your doctor's instructions.

Measure the liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The liquid medicine should be mixed with at lease 4 ounces of water or juice. Drink this mixture slowly and then add a little more water to the same glass, swirl gently and drink right away.

You may chill the mixed medicine to make it taste better, but do not allow it to freeze.

Your treatment may include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat or avoid to help control your condition.

Do not stop taking this medication without first talking to your doctor. If you stop taking potassium suddenly, your condition may become worse.

Store citric acid, potassium citrate, and sodium citrate at room temperature away from moisture, heat, or freezing. Keep the medication in a closed container.

What happens if I miss a dose?

Take the missed dose as soon as you remember. If you are more than 2 hours late in taking your medicine, wait until your next scheduled time to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

What happens if I overdose?

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include muscle cramps or twitching, slow heart rate, and seizure (convulsions).

What should I avoid while taking citric acid, potassium citrate, and sodium citrate?

Avoid using antacids without your doctor's advice, including household baking soda (sodium bicarbonate). Antacids that contain aluminum or sodium can interact with citric acid, potassium citrate, and sodium citrate, causing a serious electrolyte imbalance or aluminum toxicity.

Avoid taking potassium supplements or using other foods or products that contain potassium without first asking your doctor. Salt substitutes or low-salt dietary products often contain potassium. If you take certain products together you may accidentally get too much potassium. Read the label of any other medicine you are using to see if it contains potassium.

Avoid eating foods that are high in salt, or using extra table salt on your meals.

It is very important to follow any diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat or avoid to help control your condition.

What are the possible side effects of citric acid, potassium citrate, and sodium citrate?

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have any of these serious side effects:

swelling, rapid weight gain;
numbness or tingly feeling in your hands or feet, or around your mouth;
muscle twitching or pain, leg pain or cramps;
fast, slow, or uneven heart rate;
unusual weakness, rapid and shallow breathing, dizziness, confusion, or mood changes;
feeling restless, nervous, or irritable;
black, bloody, or tarry stools;
coughing up blood or vomit that looks like coffee grounds;
severe stomach pain, ongoing diarrhea or vomiting; or
seizure (convulsions).

Less serious side effects may include:

nausea, or vomiting, stomach pain;
mild or occasional diarrhea; or
mild stomach pain.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect citric acid, potassium citrate, and sodium citrate?

The following drugs can interact with citric acid, potassium citrate, and sodium citrate. Tell your doctor if you are using any of these:

eplerenone (Inspra);
digoxin (digitalis, Lanoxin);
drospirenone (Angelique, Yasmin, Yaz);
lithium (Eskalith, LithoBid);
quinidine (Quinaglute, Quinidex, Quin-Release);
candesartan (Atacand), losartan (Cozaar, Hyzaar), valsartan (Diovan), or telmisartan (Micardis);
cold or allergy medicine (decongestants), diet pills, ADHD medication;
salicylates such as aspirin, Backache Relief Extra Strength, Novasal, Nuprin Backache Caplet, Doan's Pills Extra Strength, Tricosal, and others;
a vitamin, mineral supplement, or medication that contains potassium;
an ACE inhibitor such as benazepril (Lotensin), captopril (Capoten), fosinopril (Monopril), enalapril (Vasotec), lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), or trandolapril (Mavik);
a diuretic (water pill) such as amiloride (Midamor), spironolactone (Aldactone, Aldactazide), or triamterene (Dyrenium); or
an antacid that contains aluminum or sodium, including Alka-Seltzer, Maalox, Mylanta, Di-Gel, Gelusil, Alamag Plus, Rulox Plus, Tempo, and others.

This list is not complete and there may be other drugs that can interact with citric acid, potassium citrate, and sodium citrate. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

Where can I get more information?

Your pharmacist can provide more information about citric acid, potassium citrate, and sodium citrate.

Remember, keep this and all other medicines out of the reach of children, never share your medicines with others, and use this medication only for the indication prescribed.
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