Ciltus

Indications

Citric Acid Monohydrate is mostly used together with Potassium Citrate in an oral solution. This combination makes the urine less acidic. It is used to ease burning and discomfort when passing urine in mild cystitis, and doctors use it to help prevent some kidney stones (uric acid and calcium stones). It is also used in some linctus and syrup products, where it gives a soothing, pleasant-tasting base for relief of dry, tickly cough.

How It Works

Citrate is absorbed and changed in the body into bicarbonate, which makes the urine less acidic. More citrate in the urine also stops crystals from sticking together into stones. In cough linctus, the syrup coats and soothes the throat.

Dosage and Administration

• Potassium citrate and citric acid solution, adults: follow the product label; commonly 10 ml well diluted in a glass of water, three times a day after meals.
• For cystitis symptoms, see a doctor if they are not better within 2 days.
• For kidney stone prevention: as prescribed.
• Linctus, adults: commonly 5 ml three or four times a day.
• Children: only as advised by a doctor.

Interactions

• Spironolactone, Amiloride, Enalapril, Ramipril, Losartan and other medicines that keep potassium in the body: the potassium citrate combination can raise potassium to harmful levels.
• Methenamine needs acidic urine and works less well.
• Aluminium-containing antacids: citrate can increase aluminium absorption; take them at different times.

Contraindications

• Kidney failure or high blood potassium (for potassium citrate products).
• Addison's disease or severe dehydration.
• Urinary infection with stones caused by urea-splitting bacteria.
• Allergy to any ingredient.

Side Effects

Mild stomach upset, nausea, loose stools or a laxative effect may occur, especially if not diluted well.

Get urgent medical help for: signs of high potassium such as muscle weakness, numbness, or a slow or irregular heartbeat; severe stomach pain or black stools; fever, back pain or blood in the urine; or signs of an allergic reaction such as swelling of the face or difficulty breathing.

Pregnancy and Lactation

Generally considered acceptable for short-term use, but urine infections in pregnancy need a doctor's check and often an antibiotic. Ask the doctor before use in pregnancy or while breastfeeding.

Precautions and Warnings

• Use with care in kidney disease, heart disease and diabetes (syrups may contain sugar).
• Always dilute the urine alkaliniser solution well with water.
• It relieves symptoms only and does not treat a bladder infection; see a doctor if you have fever or symptoms persist.

Overdose

Too much can upset the stomach and, with potassium citrate, raise blood potassium, which can affect the heart. Seek medical help straight away.

Therapeutic Class

Urinary alkaliniser (systemic alkalinising agent); also used as a base in cough linctus.

Storage

Store below 30°C in a dry place, away from light, with the cap tightly closed, out of the reach of children.