IDENTIFICATION AND USE: Sodium citrate/citric acid is used to make urine less acidic and therefore prevent formation of kidney stones. Sodium citrate/citric acid also is useful as a buffer and neutralizing agent for gastric acid. Sodium citrate is broken down to sodium bicarbonate which decreases the acidity of urine, increasing the excretion of substances that cause kidney stones.

HUMAN EXPOSURE/TOXICITY: should not be used in patients with kidney failure. It is not known whether sodium citrate/citric acid entersbreast milk; therefore, it is best to be cautious before using it in nursing mothers. You should not use this medication if you have kidney failure, severe heart damage (such as from a prior heart attack), Addison’s disease (an adrenal gland disorder), high levels of potassium in your blood (hyperkalemia), or if you are severely dehydrated or have heat cramps. Avoid using antacids without your doctor’s advice, including household baking soda (sodium bicarbonate). Antacids that contain aluminum or sodium can interact with citric acid and sodium citrate, causing a serious electrolyte imbalance or aluminum toxicity.

ADVERSE EFFECTS: common side effects of sodium citrate/citric acid are nausea, vomiting, diarrhea, stomach pain, and water retention. Serious side effects of citric acid and sodium citrate include muscle twitching or cramps, swelling or weight gain, weakness, mood changes, rapid and shallow breathing, fast heart rate, restless feeling, black or bloody stools, severe diarrhea, or seizure (convulsions).