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sodium citrate/citric acid (Bicitra)
Tradename: Bicitra (also available as citric acid alkaline syrup)
Indications:
1) treatment of metabolic acidosis, especially caused by renal tubular acidosis
2) long-term maintenance of alkaline urine
- gouty nephropathy
Dosage:
1) dilute in water
2) adults 15-30 mL with water after meals & QHS
3) children: 2-3 meq/kg//day divided TID-QID or 5-15 mL after meals & QHS
Solution: (oral)
- sodium citrate 500 mg & citric acid 334 mg/5 mL (473 mL)
Adverse effects:
- not common (1-10%)
- metabolic alkalosis, tetany, cardiac arrhythmias due to hypocalcemia, hyperkalemia, hypernatremia, diarrhea, nausea/vomiting
- other
- calcium citrate urolithiasis
- exacerbation of CHF
- edema
- calcium citrate may increase gastrointestinal Al+3 absorption
Monitor: urinary pH
Drug interactions:
1) increased excretion of chlorpropamide, lithium, methotrexate, salicylates, tetracyclines
2) decreased excretion of anorexiants, quinidine, sympathomimetics
Mechanism of action:
- systemic & urinary alkalinizer
General
pharmacologic combination
salt
metabolic agent (metabolic modifier)
Database Correlations
PUBCHEM cid=107687
References
- Drug Information & Medication Formulary, Veterans Affairs,
Central California Health Care System, 1st ed., Ravnan et al
eds, 1998
Department of Veterans Affairs, VA National Formulary
- Medical Knowledge Self Assessment Program (MKSAP) 11, American
College of Physicians, Philadelphia 1998
- Kaiser Permanente Northern California Regional Drug
Formulary, 1998
Components
citrate (citric acid)