citric acid, potassium citrate, and sodium citrate

What is the most important information I should know about this medicine?

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

What is citric acid, potassium citrate, and sodium citrate?

Citric acid, potassium citrate, and sodium citrate is a combination medicine that helps make your urine less acidic. Sometimes called a urinary alkalizer, this medicine is used to treat acidosis or to prevent gout or kidney stones.

Citric acid, potassium citrate, and sodium citrate may also be used for purposes not listed in this medication guide.

What should I discuss with my healthcare provider before taking this medicine?

• severe kidney disease;
• decreased urination;
• severe heart damage (such as from a prior heart attack);
• untreated Addison's disease (an adrenal gland disorder); or
• if you are on a low-salt diet or a low-potassium diet.

Tell your doctor if you have ever had:

• kidney problems;
• heart problems, high blood pressure;
• toxemia of pregnancy;
• swelling in your hands or feet, or in your lungs (pulmonary edema); or
• an electrolyte imbalance (such as low levels of potassium or calcium in your blood).

Tell your doctor if you are pregnant or breastfeeding.

How should I take this medicine?

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

This medicine is usually taken after meals and at bedtime. Follow your doctor's dosing instructions very carefully.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon). Mix the medicine with at least 4 ounces of water or juice. Stir and drink this mixture right away. Add a little more water to the glass, swirl gently and drink right away.

Drink plenty of liquids while you are taking this medicine.

You will need frequent blood and urine tests.

What happens if I miss a dose?

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

What happens if I overdose?

Overdose symptoms may include diarrhea, vomiting, unusual thoughts, or a seizure.

What should I avoid while taking this medicine?

Ask your doctor before using an antacid, and use only the type your doctor recommends. Antacids that contain aluminum can interact with this medicine and cause serious side effects.

Avoid using potassium supplements or salt substitutes without your doctor's advice.

What are the possible side effects of this medicine?

• swelling or severe pain in your stomach;
• vomiting;
• black or tarry stools, coughing up blood or vomit that looks like coffee grounds; or
• high potassium level --nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common side effects may include:

• nausea, vomiting; or
• diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

What other drugs will affect this medicine?

Tell your doctor about all your other medicines, especially:

• digoxin, digitalis;
• a diuretic or "water pill" --amiloride, eplerenone, spironolactone, triamterene; or
• heart or blood pressure medication --benazepril, captopril, enalapril, lisinopril, quinapril, ramipril, and others.

This list is not complete. Other drugs may affect citric acid, potassium citrate, and sodium citrate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.

Where can I get more information?

Your pharmacist can provide more information about citric acid, potassium citrate, and sodium citrate.