Indications
Sodium Citrate is a salt of citric acid. In the products listed here it is mainly an ingredient of sterile balanced salt and citrate-buffered irrigating solutions, which are used to rinse and keep moist the eye tissues during eye surgery (such as cataract surgery) and to wash the eye in hospital. Sodium citrate is also used in other medicines: by mouth to make the urine less acidic (urinary alkaliniser) and to neutralise stomach acid before some operations, and in blood bags to stop blood from clotting.
How It Works
In irrigating solutions, sodium citrate works with other salts to keep the fluid close to the natural fluid of the eye in acidity (pH) and salt balance, so it protects delicate eye cells during surgery. When taken by mouth, citrate is changed in the body to bicarbonate, which reduces acid in the urine and stomach. In blood collection it binds calcium, which blood needs to clot.
Dosage and Administration
Eye irrigating solutions are used only by an eye surgeon or trained staff in the operating theatre or clinic, in the amount needed for the procedure. They are not injected and are not eye drops for home use. Oral sodium citrate products should be used as prescribed or as directed on the label.
Interactions
No important interactions are expected with eye irrigating solutions. When taken by mouth, sodium citrate can change the way some medicines are removed in the urine (for example it may lower the effect of Methenamine and change levels of Lithium or Aspirin). Do not take it with aluminium-containing antacids, as citrate can increase aluminium absorption.
Contraindications
Irrigating solutions should not be used if the solution is cloudy, the seal is broken or the person is allergic to any ingredient. Oral sodium citrate should not be used in severe kidney failure, in people on a strict low-sodium diet without medical advice, or with uncontrolled heart failure.
Side Effects
Irrigating solutions are usually well tolerated; temporary clouding or swelling of the cornea (the clear front of the eye) can occur after long surgery. Oral use can cause mild stomach upset, diarrhoea and, with large doses, swelling from salt retention.
Get urgent medical help after eye surgery if you have increasing eye pain, sudden loss of vision, or marked redness and discharge. With oral use, seek help for muscle twitching, cramps, confusion or an irregular heartbeat.
Pregnancy and Lactation
Eye irrigating solutions are not expected to cause harm during pregnancy or breastfeeding. Oral sodium citrate is generally considered safe in normal doses, but use it only on medical advice in pregnancy, especially if you have high blood pressure or swelling.
Precautions and Warnings
Irrigating solutions are for single use and must not be injected or used for intravenous infusion. Discard any unused solution. Oral sodium citrate adds sodium to the body, so people with heart failure, high blood pressure or kidney disease should use it only under medical supervision.
Overdose
Overdose is unlikely with eye irrigation. Too much oral sodium citrate can make the blood too alkaline, causing muscle twitching, cramps, low calcium symptoms and irregular heartbeat. Seek medical help if this is suspected.
Therapeutic Class
Ophthalmic irrigating solution component; electrolyte and alkalinising agent.
Storage
Store as directed on the pack, usually below 25 to 30°C, away from light and out of the reach of children. Do not freeze irrigating solutions.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.