Citrates

Class: Alkalinizing Agents
VA Class: TN400
CAS Number: 77-92-9
Brands: Bicitra, Cytra-2, Cytra-3, Cytra-K, Oracit

Introduction

Alkalinizing agents.

Uses for Citrates

Preparations containing sodium citrate and citric acid are especially useful when administration of potassium salts is undesirable or contraindicated, while those containing potassium citrate and citric acid are used when administration of sodium salts is undesirable or contraindicated.

Alkalinization of Urine

Citrates are used for alkalinization of urine (as alternatives to sodium bicarbonate) in conditions where long-term maintenance of an alkaline urine is desirable (e.g., management of uric acid and cystine calculi of the urinary tract).

Chronic Metabolic Acidosis

Citrates are used for management of chronic metabolic acidosis associated with conditions such as chronic renal insufficiency or renal tubular acidosis.

Adjuvant in Gout Therapy

Citrates are used as adjuvants to uricosuric agents in gout therapy.

Prevention of Milk Curdling

Sodium citrate has been used to alter cow’s milk so that large hard curds are not formed in the stomach of feeding infants†.

Gastric Acid Neutralization

Some citrate salts (e.g., sodium citrate and citric acid) also used for buffering and neutralizing gastric hydrochloric acid.

Compounding Uses

Sodium citrate and citric acid may be used as a buffer to maintain an approximate pH in various extemporaneous formulations. (See Compatibility under Stability.)

Citrates Dosage and Administration

General

• Selection of a specific preparation may in part be determined by potassium and sodium content.

• Unlike sodium bicarbonate solution, citrate solutions generally are considered highly palatable and pleasant tasting, and may be particularly useful as alkalinizing agents in patients who do not tolerate the taste of sodium bicarbonate oral solution.

Administration

Oral Administration

Dilute oral citrate solutions with adequate amounts of water prior to administration to minimize the risk of GI complications, and follow with additional water after administration; enhance palatability by chilling the solution before administration.

Reconstitute contents of single-dose packets containing potassium citrate and citric acid for oral solution with cool water or juice prior to administration; give additional water or juice after administration.

Administer oral citrate solutions after meals to avoid the saline laxative effect of the drugs as well as upset stomach.

Shake oral solutions well before use, unless otherwise directed.

Reconstitution

Reconstitute contents of single-dose packets containing potassium citrate and citric acid for oral solution with at least 180 mL of cool water or juice prior to administration.

Dosage

Pediatric Patients

General Pediatric Dosage

Potassium Citrate and Citric Acid

Usually, 5–15 mL of solution, diluted with 1/2 glass of water, after meals and at bedtime.

Do not use single-dose packets of potassium citrate and citric acid for oral solution in pediatric patients, since dosage for these patients can be more easily regulated with the commercially available oral solution. Indi.