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Overview: Sodium citrate/citric acid is used to treat high levels of acids in the blood (metabolic acidosis), the stomach, or the urine (pee). It is an alkaline (basic) substance, which increases the pH of the blood, stomach, or urine and reduces acid levels. Take this medicine after meals to help prevent side effects like diarrhea. Sodium citrate/citric acid is an oral liquid that should be mixed with water before each dose.

Uses

What is sodium citrate/citric acid used for?

Sodium citrate/citric acid is commonly used for the following purposes.

  • A condition called metabolic acidosis, where the levels of acids in the body get too high
  • To make the urine (pee) less acidic in people with certain types of kidney problems, such as kidney stones
  • To reduce the amount of acid in the stomach

Sodium citrate/citric acid may also be used for other conditions as determined by your health care provider.

Note: The FDA has not found this medicine to be safe and effective, and the label is not approved by the FDA. Learn more about unapproved drugs here.

How does sodium citrate/citric acid work (mechanism of action)?

Sodium citrate/citric acid is an alkaline (basic) substance, which means that it has a high pH level. It can help to increase the pH of the blood and reduce acid levels in people with high levels of acids (metabolic acidosis). It also reduces the acid levels in the stomach.

In some people, kidney stones form due to high levels of acids in their urine. Sodium citrate/citric acid works by increasing the pH and reducing the amount of acid in the urine (pee), making it harder for kidney stones to form.

How is sodium citrate/citric acid supplied (dosage forms)?

Brands and other names

  • Bicitra
  • Cytra-2
  • Oracit
  • Shohl’s Solution

Example dosage forms and strengths

  • 490 mg/640 mg per 5 milliliters oral solution
  • 500 mg/334 mg per 5 milliliters oral solution

How should I store sodium citrate/citric acid?

Sodium citrate/citric acid should be stored tightly closed at room temperature, between 68 F and 77 F (20 C and 25 C). Some sodium citrate/citric acid products can be exposed to temperatures between 59 F and 86 F (15 C and 30 C) for shorter periods of time, such as when transporting them. Store it in a cool, dry place, and do not freeze it. Ask your pharmacist if you are unsure how to store your sodium citrate/citric acid product.

Side Effects

What are the most common side effects of sodium citrate/citric acid?

Sodium citrate/citric acid is generally well-tolerated. Tell your health care provider if you have any side effects that bother you. 

There may be side effects of sodium citrate/citric acid that are not listed here. Contact your health care provider if you think you are having a side effect of a medicine. In the U.S., you can report side effects to the FDA at www.fda.gov/medwatch or by calling 800-FDA-1088 (800-332-1088). In Canada, you can report side effects to Health Canada at www.health.gc.ca/medeffect or by calling 866-234-2345.

What are the serious side effects of sodium citrate/citric acid?

While less common, the most serious side effects of sodium citrate/citric acid are described below, along with what to do if they happen.

Severe Allergic Reactions. Sodium citrate/citric acid may cause allergic reactions, which can be serious. Stop taking sodium citrate/citric acid and get help right away if you have any of the following symptoms of a serious allergic reaction.

  • Breathing problems or wheezing
  • Racing heart
  • Fever or general ill feeling
  • Swollen lymph nodes
  • Swelling of the face, lips, mouth, tongue, or throat
  • Trouble swallowing or throat tightness
  • Itching, skin rash, or pale red bumps on the skin called hives
  • Nausea or vomiting
  • Dizziness, feeling lightheaded, or fainting
  • Stomach cramps
  • Joint pain

Warnings & Precautions

Who should not use sodium citrate/citric acid?

Allergies to Ingredients. People who are allergic to any of the following should not take sodium citrate/citric acid.

  • Bicitra
  • Citric acid
  • Cytra-2
  • Oracit
  • Shohl’s Solution
  • Sodium citrate
  • Any of the ingredients in the specific product dispensed

Your pharmacist can tell you all of the ingredients in the specific sodium citrate/citric acid products they stock.

Dehydration. You should not use sodium citrate/citric acid while you are dehydrated. If you are dehydrated, you may get heat cramps. Sweating, nausea, and vomiting can all lead to you not having enough water. 

Low-Sodium Diet. You should not use sodium citrate/citric acid if you are on a low-sodium diet. This medicine contains large amounts of sodium. 

Kidney Problems. Sodium citrate/citric acid should not be used if your kidneys are not working as well as they should be, or if you make little to no urine (pee). If there is a concern about the health of your kidneys, your health care provider may do tests to find out if they are working well enough for you to take this medicine.

High Potassium Levels (Hyperkalemia). People with high potassium levels or a condition called adynamia episodica hereditaria[1] [2]  should not use sodium citrate/citric acid.

Addison's Disease. Sodium citrate/citric acid should not be used if you have Addison's disease that is not being treated or currently controlled.

Heart Damage. Sodium citrate/citric acid should not be used if you have severe heart damage, like what you may have after a heart attack. 

What should I know about sodium citrate/citric acid before using it?

Do not take sodium citrate/citric acid unless it has been prescribed to you by a health care provider. Take it as prescribed.

Do not share sodium citrate/citric acid with other people, even if they have the same condition as you. It may harm them.

Keep sodium citrate/citric acid out of the reach of children.

Sodium citrate/citric acid is an oral liquid that should be mixed with water before use. Each dose should be taken after meals to help reduce the risk of diarrhea. Use an accurate measuring device to measure your dose. A household spoon is not an accurate measuring device and may cause you to take the wrong dose. Ask your pharmacist what measuring device to use.

Your health care provider may monitor your bloodwork while you are taking this medicine. Keep all appointments to have your blood checked.

What should I tell my health care provider before using sodium citrate/citric acid?

Tell your health care provider about all of your health conditions and any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. This will help them know if sodium citrate/citric acid is right for you.

In particular, make sure that you discuss any of the following.

Current and Past Health Conditions. Tell your health care provider if you have any of the following.

Pregnancy. It is not known if or how sodium citrate/citric acid could affect pregnancy or harm an unborn baby. Tell your health care provider if you are pregnant or plan to become pregnant.

Breastfeeding. It is not known if sodium citrate/citric acid passes into breast milk. Tell your health care provider if you are breastfeeding or plan to breastfeed.

Is this in Spanish? Should it be translated to English?

@[email protected] I believe it is correct the way it is. This is how it is presented in the drug label: ORACIT® is contraindicated in patients with severe renal impairment, oliguria or azotemia, untreated Addison's disease, adynamia episodica hereditaria, acute dehydration, heat cramp, anuria, severe myocardial damage, and hyperkalemia.

Interactions

Does sodium citrate/citric acid interact with foods or drinks?

There are no known interactions between sodium citrate/citric acid and foods or drinks. Taking sodium citrate/citric acid after a meal can help to prevent side effects, such as diarrhea.

It is unknown if drinking alcohol will affect sodium citrate/citric acid.

Does sodium citrate/citric acid interact with other medicines (drug interactions)?

Always tell your health care provider about any prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, and other supplements you are using. In particular, make sure that you discuss if you are using an antacid that contains aluminum.

This may not be a complete list of medicines that can interact with sodium citrate/citric acys check with your health care provider.

Does interact with other drugs you are taking?

Enter your medication into the WebMD interaction checker

Overdose/Missed Dose

What should I do if I accidentally use too much sodium citrate/citric acid?

If you or someone else has used too much sodium citrate/citric acid, get medical help right away, call 911, or contact a Poison Control center at 800-222-1222.

What should I do if I miss a dose of sodium citrate/citric acid?

If you miss a dose, take it as soon as you remember. If it is almost time for your next dose, skip the missed dose and only take the next dose. Do not take double or extra doses.