Indications
Trisodium Citrate (sodium citrate) is a salt of citric acid. Depending on the product, it is used:
- To make the urine less acidic (urinary alkaliser), which can ease the burning of mild cystitis and help prevent some kinds of kidney stones, such as uric acid stones.
- As one of the ingredients of oral rehydration salts, where it helps correct the acid build-up caused by diarrhoea.
- To correct too much acid in the blood (metabolic acidosis), for example in some kidney conditions, under medical supervision.
- In blood collection and transfusion bags to stop blood from clotting (hospital use).
How It Works
The body changes citrate into bicarbonate, a natural alkali. This reduces acid in the blood and urine. Less acidic urine is less irritating to the bladder and keeps some stone-forming substances dissolved. Citrate also binds calcium, which is why it stops stored blood from clotting.
Dosage and Administration
- Urinary alkaliser or mixtures: as directed on the pack or by a doctor. Dissolve granules or dilute the liquid in a full glass of water and take after meals.
- For cystitis, it is usually taken for no more than 2 days without seeing a doctor.
- For kidney stones or acidosis: as prescribed, with blood and urine tests to guide the dose.
- As part of oral rehydration salts: follow the oral rehydration salts instructions.
- Children: only as prescribed.
Interactions
It can change how some medicines are removed by the kidneys. It may reduce the effect of Lithium and some antibiotics such as Nitrofurantoin and Methenamine, and increase levels of medicines such as Quinidine and some stimulants. Do not take it with aluminium-containing antacids, as citrate increases aluminium absorption. Extra sodium may reduce the effect of blood pressure medicines.
Contraindications
- Severe kidney disease or kidney failure.
- Conditions that need a low-salt diet, such as heart failure or severe high blood pressure, unless a doctor advises.
- Already alkaline blood (metabolic alkalosis) or low calcium in the blood.
- Urinary infection with stones caused by certain bacteria (infection stones).
Side Effects
Common: mild stomach upset, nausea, loose stools and a salty taste. Taking it after food with plenty of water helps.
Get urgent medical help for muscle twitching or cramps, tingling around the mouth or in the fingers, confusion, swelling of the legs or breathlessness, a very slow or irregular heartbeat, or signs of a serious allergy. See a doctor if urinary symptoms include fever, back pain or blood in the urine, or do not improve in 2 days.
Pregnancy and Lactation
Urinary symptoms in pregnancy should always be checked by a doctor, as urine infections in pregnancy need proper treatment. Use only if a doctor advises it. It is not expected to harm a breastfed baby at normal doses.
Precautions and Warnings
- Each dose contains sodium; take care in high blood pressure, heart failure, swelling of the legs and kidney disease.
- Not for men, children or anyone with fever or back pain for cystitis without seeing a doctor first.
- Long-term use for stones needs regular blood and urine tests.
- Do not use for longer than advised.
Overdose
Too much can make the blood too alkaline and upset salt balance. This may cause muscle twitching, cramps, tingling, confusion, fits and irregular heartbeat. Get urgent medical help.
Therapeutic Class
Systemic and urinary alkaliser; electrolyte. Also used as an anticoagulant for stored blood.
Storage
Store below 30°C in a dry place, away from light. Keep containers tightly closed. Keep out of reach of children.
Prepared by the Oshud Alo team from standard drug references. For information only; always follow your doctor's advice.