Citrate (Oral)

Citrate is prescribed to patients with kidney issues to make urine less acidic and more alkaline, which aids in the prevention of particular types of kidney stones.

Overview

Citrates are occasionally combined with other medications to aid in the treatment of kidney stones which happen to take place with gout. In certain circumstances, Citrates are prescribed to increase alkalinity of the blood.

Citrates can only be obtained with a prescription from your physician.

This medication can be obtained in the subsequent forms for dosage:

  • style="font-weight: 400;">Tablet (specifically, Extended Release)
  • Tablet
  • Syrup
  • Solution
  • Powder for Suspension
  • Powder for Solution

US Brand Name:

  •  Urocit-K 5
  • Urocit-K 15
  • Urocit-K 10
  • Polycitra-K Crystals
  • Polycitra-K
  • Liqui-DualCitra
  • Cytra-K Crystals
  • Cytra-K
  • Citra pH

Canadian Brand Name:

  • Pms-Dicitrate

Conditions Treated

  • Kidney issues
  • Metabolic issues (acidosis)

Type of Medicine

  • Urinary alkalinizers

Side Effects

In addition to necessary benefits of certain medications, they can also trigger side effects that are undesirable. While it is not likely that each of the following side effects will take place for individuals taking citrates, there is a possibility that they could require extra medical care.

Do not continue dosage of this medication and seek emergency care right away if side effects take place:

Rare Side Effects (Medical Care Required)

  • Cramping or stomach pain (intense)
  • Vomiting (intense), occasionally accompanied by blood
  • Stools that are tarry (black)

Certain side effects can take place but these typically do not need medical care. These side effects in particular could disappear throughout the course of treatment as the body becomes more adjusted to the medication. Please consult with your medical care professional in order to find out additional methods of reducing or preventing certain side effects. Be sure to consult with your doctor if the following side effects turn out to be prolonged, continue, or are troublesome. Your doctor can also answer any questions that you may have regarding potential side effects of citrates.

Less Common Side Effects (Medical Care Required)

  • Vomiting or nausea
  • Stomach pain (mild) or soreness
  • Abdominal pain (mild) or soreness
  • Diarrhea

Additional side effects that are not included here can occasionally also take place for some individuals. For patients who notice additional side effects, be sure to consult with your doctor right away. Your physician would also be happy to give you medical advice regarding side effects. Side effects can also be reported to the FDA by calling 1-800-FDA-1088.

Dosage

Only follow your physician's instructions regarding how to take citrates. Never take citrates more often than your doctor prescribed.

Never take an amount that is greater than your doctor instructed. Do not take citrates for a longer time than your doctor directed. These instructions are highly important, especially for those who are taking digitalis medication for their heart or a water pill (diuretic) in addition to citrates.

Notes on tablet form citrates:

  • Always swallow the entire tablet ' never suck, chew, or crush the tablet.
  • Be sure to always take this medication with an entire glass of water (8 ounces).
  • If you're having a difficult time swallowing the entire tablet or it feels like it is sticking in the throat,

consult with your physician right away. Citrates can trigger serious irritation if it does not completely dissolve from not being swallowed properly.

Notes on liquid form citrates:

  • Never freeze, but do chill this medication prior to taking it (for optimal taste)
  • Drink one entire glass of water (8 ounces) with this medication, afterward follow with more water (as desired)

Notes on crystal form citrates:

  • Pour all of the medication from one package into 6+ ounces of water
  • Ensure the crystals become entirely dissolved by stirring well
  • To be sure that you are taking the appropriate dose, finish drinking all of the medication. If desired

, more water (or alternatively juice) can be helpful.

Be sure to take every dose right after eating, or soon after having a bedtime snack or meal (less than 30 minutes (half an hour) after eating). Following these instructions can reduce the likelihood that stomach pain will take place.

During the day, be sure to drink one entire glass or more of water (8 ounces) or an alternative drink (other than milk) once an hour, totaling roughly 3 quarts every day. If your doctor directs you otherwise, be sure to always follow their instructions. Doing this will prevent the likelihood of kidney stones from taking place by increasing the flow levels of urine in the system.

Different patients will require different doses of citrates. Ensure to always follow the instructions given by your doctor and on the medication label.

This information will outline the average dose of citrates. Never adjust your dose if it differs from the information here. Only adjust your dose if your physician has instructed you to change it.

How strong the medication is will also determine the total amount of citrates that a patient will be prescribed. In addition, the medical issue for which you require citrates will also determine how many doses you will take per day and the duration of how long you take the medication.

Potassium citrate tablet (oral dosage form); this medication is intended to reduce the likelihood of kidney stones and to help the urine be less acidic (more alkaline):

  • Adults

o Initially 1.08 '2.16 grams should be taken 3x per day with a meal

o Certain patients are allowed to ingest 1.62 grams 4x per day with a meal, or in the 30-minute period following a snack or meal

o Most patients will not be prescribed over 10.8 grams per day

  • Children: Physician must determine dose.

Potassium citric acid and citrate (oral dosage form ' solution):

  •  For citrates intended to reduce the likelihood of kidney stones and to help the blood or urine become less acidic (more alkaline):

o Adults: initially, take 2' 3 tsps of medication (mixed with juice or water) 4x daily, at bedtime and after mealtimes. Your physician may adjust the dose as your body becomes more accustomed to it.

o Children: Physician must determine dose.

  • For citrates intended to help the urine to have increased alkalinity (less acid):

o Children: initially, have children take 1-3 tsps of medication (mixed with juice or water) 4x daily, at bedtime and after meals.

Oral dose (solution to be mixed with crystals):

  •  For citrates intended to reduce the likelihood of kidney stones and to help the urine be less acidic (more alkaline):

o Adults: initially, take 3.3 grams mixed with juice or water 4x daily, at bedtime and after mealtime.

o Children: Not recommended to use.

Sodium citrate and potassium citrate (oral dosage form ' tablet):

  • For citrates intended to reduce the likelihood of kidney stones and to help the urine be less acidic (more alkaline):

o Adults: take 1-4 tablets at bedtime and after meals.

o Children: Physician must determine dose.

Citric acid and sodium citrate (oral dosage form'solution):

  • For citrates intended to reduce the likelihood of kidney stones and to help the blood and urine become less acidic (more alkaline):

o Adults: initially, take 2-6 tsps of medication 4x daily, at bedtime and after mealtimes. Mix the medication in with 1-3 oz. of water. While your physician may adjust your dose as required, most people won't be prescribed more than 5 oz. per day

  • To increase alkalinity (reduce acid) in the blood:

o Adults: take 1-2 tbsps per dose. It may be mixed with juice or water (1-2 tbsps).

  • To reduce acidity in the stomach prior to surgery:

o Children: initially, take 1-3 tsps 4x daily, at bedtime and after mealtimes. Mix the medication in with 1-3 oz. of fresh water.

Tricitrates (oral dosage form ' solution):

  • For citrates intended to reduce the likelihood of kidney stones and to help the blood and urine become less acidic (more alkaline):

o Adults: initially, take 1-2 tbsps of medication 4x daily, at bedtime and after mealtimes.

  • To reduce acidity in the stomach prior to surgery:

o Adults: take 1 tbsp per dose. It may be mixed with juice or water (1 tbsp).

  • To help the blood and urine become less acidic (more alkaline):

o Children: initially, take 5-10 mL at four different times daily at bedtime and after mealtimes.

Missed Dose

If a dose is missed, the dose should be made up soon after the missed dose is remembered. Alternatively, if nearer in the dosage schedule to the next dose, the skipped dose should remain missed and you should return to the original dosage times. Never take a double dose of citrates.

Interactions

Drug Interactions

While some medicines should never be taken simultaneously in certain circumstances, other situations can warrant the use of two medications prescribed at the same time, even if there is a possibility that an interaction could take place. Under these circumstances, your physician may decide to adjust your dose. They may also take additional precautions to keep you safe. Always inform your physician if currently taking additional medications, even if they are prescription or non-prescription.

Other Interactions

There is a possibility that interactions could take place if particular medications are taken while eating or drinking certain kinds of food. Interactions can also take place if the patient is using tobacco or alcohol. Consult with your physician if you need to ask questions regarding citrates and tobacco, alcohol, or food.

Other Medical Issues

Patients who have additional medical concerns can experience issues in the effectiveness of taking citrates. Be sure to always inform your physician if additional medical issues are taking place, specifically:

  • Diarrhea (chronic) - citrates treatment may not prove to be effective, and could require an adjustment in the total amount of citrates prescribed
  • Esophageal or intestinal blockage; intestines or stomach can experience irritation due to potassium citrate tablets
  • Heart disease ; take caution; the body can become more inclined to retain water due to sodium level in citrates. Potassium within citrates can aggravate heart diseases and make them worse
  • High blood pressure (hypertension)
  • Kidney disease' take caution, citrates that contain potassium can cause heart issues to become aggravated for patients who are diagnosed with kidney diseases
  • Stomach problems or stomach ulcer' products that contain potassium can aggravate these conditions
  • Swelling of the lower legs or feet (edema)
  • Toxemia of pregnancy ' take caution, the body can become more inclined to retain water due to the sodium in citrates
  • Type 2 diabetes mellitus
  • Underactive adrenal glands (Addison's disease)
  • Urinary tract infection ' condition can be made worse with citrates

Warnings

Inform your physician if you currently have, or have previously ever had any allergic reaction that is/was unusual. Also inform your physician if you know that you are susceptible to other kinds of allergies, including allergies to preservatives, foods, dyes, or animals. Be sure to carefully read and be cautious of the ingredients listed on the label of any non-prescription medication that you may be taking.

It is highly imperative that a physician carefully checks on your adaption to the medication at regularly scheduled appointments. These appointments will give you and your doctor a chance to see if the medication is working as it should within your body, and it will give your doctor a chance to monitor unwanted side effects.

Do not use additional table salt or eat foods that are highly salted while taking citrates. Doing so will decrease the likelihood that kidney stones may take place and can lower the chance of unwanted side effects.

Consult with your physician prior to beginning any type of intense physical exercise regimen, specifically if previously out of shape and if currently also taking another medication. Intense exercise and particular medicines can increase the concentration of potassium levels within the blood.

Warnings for medications containing potassium citrate:

  • Do not incorporate salt substitutes or milk that has lower salt levels unless your physician instructs you to do so, as there is a chance that they can contain potassium.
  • Consult with your physician right away if you're prescribed citrates tablets and you notice signs of intestinal or stomach bleeding such as tarry or black stools.
  • Do not worry if you see what looks like it could be an entire tablet within the stool. The tablet shell is the only part of the medication that is expelled, as your body has used the tablet to gain the appropriate amount of medication already. Consult with your physician with questions regarding an expelled medication shell.
  • For those on a diet that is either rich or restricted in potassium, consult with your medical care professional. Medications that contain citrates also typically contain high levels of potassium.

Warnings for medications containing sodium citrate:

  • For those on a diet that is restricted in sodium, consult with your medical care professional. Medications that contain citrates also usually contain high levels of sodium.

Specific Demographic Use

Pediatric

While there is not currently enough data that has compared the impacts of citrates on children, there are not any expected side effects for children that could occur.

Geriatric

Numerous medications have not yet been researched in older individuals. For this reason, it cannot be known exactly if they work in a similar manner as they do for adults who are younger. There is a chance that they could trigger side effects that are varied, or older adults could experience other issues due to taking citrates. There is not enough information collected to properly compare citrates and elderly patients.

Pregnancy

There have been no demonstrated harmful effects for animals or humans when taking citrates while pregnant. Mothers who are pregnant, or who plan to become pregnant, should consult their physician for further information on citrates.

Breastfeeding

While it is not completely known if citrates can pass into expelled breast milk, this medication has not been known to trigger problems for babies who are nursing. Nursing mothers should consult their physician for further information on citrates and breastfeeding.

Storage

Never store this medication in an area where children can reach it. Always keep this medication in a container that is sealed far from heat, direct light, and moisture. Store this medication at room temperature. Never allow citrates to become frozen. Always discard medication that is expired or no longer required.

Summary

Citrates aid patients with kidney issues in making the urine less acidic and more alkaline. This helps in the prevention of kidney stones. Citrates are occasionally used with other medications to help treat kidney stones and gout. Citrates are also sometimes utilized to increase the alkalinity of the blood.