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Sodium Citrate and Citric Acid
Pronunciation
U.S. Brand Names
Generic Available
Synonyms
Pharmacological Index
Use
Pregnancy Risk Factor
Contraindications
Warnings/Precautions
Adverse Reactions
Overdosage/Toxicology
Drug Interactions
Usual Dosage
Dietary Considerations
Dental Health: Local Anesthetic/Vasoconstrictor Precautions
Dental Health: Effects on Dental Treatment
Patient Information
Nursing Implications
Dosage Forms

Pronunciation
(SOW dee um SIT rate & SI trik AS id)

U.S. Brand Names
Bicitra®; Oracit®

Generic Available

No


Synonyms
Modified Shohl's Solution

Pharmacological Index

Alkalinizing Agent


Use

Treatment of metabolic acidosis; alkalinizing agent in conditions where long-term maintenance of an alkaline urine is desirable


Pregnancy Risk Factor

No rating


Contraindications

Severe renal insufficiency, sodium-restricted diet


Warnings/Precautions

Conversion to bicarbonate may be impaired in patients with hepatic failure, in shock, or who are severely ill


Adverse Reactions

1% to 10%:

Endocrine & metabolic: Metabolic alkalosis, hyperkalemia

Gastrointestinal: Diarrhea, nausea, vomiting


Overdosage/Toxicology

Symptoms of overdose include hypokalemia, hypernatremia, tetany, seizures

Hypernatremia is resolved through the use of diuretics and free water replacement


Drug Interactions

Decreased effect/levels of lithium, chlorpropamide, salicylates due to urinary alkalinization

Increased toxicity/levels of amphetamines, ephedrine, pseudoephedrine, flecainide, quinidine, quinine due to urinary alkalinization


Usual Dosage

Oral:

Adults: 15-30 mL with water after meals and at bedtime


Dietary Considerations

Should be administered after meals to avoid laxative effect


Dental Health: Local Anesthetic/Vasoconstrictor Precautions

No information available to require special precautions


Dental Health: Effects on Dental Treatment

No effects or complications reported


Patient Information

Take as often as directed, preferably on an empty stomach (1 hour before or 2 hours after meals) and at least 2 hours before or after any other medications. Dilute with 4-6 ounces of chilled water. You may experience diarrhea or nausea and vomiting; if severe, contact prescriber. Report changes in CNS status (eg, irritability, tremors, confusion), swelling of feet or ankles, difficulty breathing, palpitations, abdominal pain, or tarry stools.


Nursing Implications

May be ordered as modified Shohl's solution; dilute with 30-90 mL of chilled water to enhance taste


Dosage Forms

Solution, oral:

Oracit®: Sodium citrate 490 mg and citric acid 640 mg per 5 mL

Polycitra®: Sodium citrate 500 mg and citric acid 334 mg with potassium citrate 550 mg per 5 mL


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