Sodium Citrate: Uses, Dosage, Benefits, and Side Effects

Summary of Key Points

Sodium citrate is a medication commonly used to treat conditions such as metabolic acidosis, urinary tract infections (UTIs), kidney stones, and gout. It works by reducing the acidity of urine, which helps prevent certain types of kidney stones and lowers uric acid levels. Always consult your healthcare provider before starting or adjusting your dose. Our telemedicine providers are available to assist with any questions or concerns you may have.

Names of Medication

US Brand Name: Bicitra

Generic Name: Sodium citrate

The generic name is the standard name of the medication, while the brand name is assigned by the manufacturer. The generic name is listed in parentheses.

Pharmacologic Category

Category: Alkalinizing Agent

Sodium Citrate Dosage

Sodium citrate is prescribed for various conditions, and the dosage and frequency depend on the specific condition being treated. Always follow your healthcare provider’s instructions and consult them before making any changes to your dose. You can also reach out to one of our telemedicine providers for personalized guidance.

Sodium Citrate for Metabolic Acidosis

Dosage: 10-30 mL orally, 4 times a day.

Duration: Until metabolic balance is restored, as directed by your doctor.

Sodium Citrate for Urinary Tract Infections (UTIs)

Dosage: 10-30 mL orally, 4 times a day.

Duration: Typically 3-7 days, depending on the severity of the infection.

Sodium Citrate for Kidney Stones

Dosage: 10-30 mL orally, 4 times a day.

Duration: As directed by your healthcare provider, usually until the stones pass or dissolve.

Sodium Citrate for Gout

Dosage: 10-30 mL orally, 4 times a day.

Duration: During gout flare-ups or as prescribed by your doctor to prevent future attacks.

Sodium Citrate for Hyperuricemia

Dosage: 10-30 mL orally, 4 times a day.

Duration: As directed by your healthcare provider, often long-term to manage uric acid levels.

Sodium Citrate for Cystinuria

Dosage: 10-30 mL orally, 4 times a day.

Duration: As prescribed by your doctor, typically long-term to prevent cystine stones.

Sodium Citrate for Renal Tubular Acidosis

Dosage: 10-30 mL orally, 4 times a day.

Duration: Until acid-base balance is restored, as directed by your healthcare provider.

Sodium Citrate for Osteoporosis

Dosage: 10-30 mL orally, 4 times a day.

Duration: As prescribed by your doctor, often long-term as part of a treatment plan to manage bone health.

Sodium Citrate for Chronic Kidney Disease (CKD)

Dosage: 10-30 mL orally, 4 times a day.

Duration: As directed by your healthcare provider to manage acid levels in the body.

Sodium Citrate for Urinary Alkalinization

Dosage: 10-30 mL orally, 4 times a day.

Duration: As prescribed by your doctor, often to prevent kidney stones or manage certain types of infections.

Dosage Forms and Strengths

Oral solution: 500 mg/5 mL

Oral tablet: 1 g

Administration Instructions for Sodium Citrate

Sodium citrate should be taken by mouth, typically 4 times a day or as directed by your healthcare provider. It is best to take it after meals to minimize the risk of stomach upset. Be sure to measure your dose carefully using a special measuring device or spoon. Avoid using a household spoon, as it may not provide an accurate dose. Always follow your doctor’s instructions closely.

Sodium Citrate Side Effects and Adverse Reactions

Like all medications, sodium citrate can cause side effects. While most are mild, some may be more serious. If you experience any of the following, contact your healthcare provider immediately.

1. Nausea or Vomiting (Common): You may feel nauseous or vomit after taking sodium citrate.
2. Diarrhea (Common): Loose stools or diarrhea can occur, especially if taken in higher doses.
3. Stomach Pain (Common): Some patients may experience mild to moderate stomach discomfort.
4. Increased Thirst (Less Common): You may feel thirstier than usual.
5. Swelling of Hands or Feet (Rare): This could indicate fluid retention and should be reported to your doctor.
6. Confusion or Dizziness (Rare): These symptoms may suggest an electrolyte imbalance and require medical attention.
7. Severe Allergic Reaction (Very Rare): Symptoms such as rash, itching, swelling, or difficulty breathing require immediate medical attention.

Contraindications for Sodium Citrate

A contraindication is a specific condition or situation where a medication should not be used because it may cause harm. If you have any of the following conditions, sodium citrate may not be safe for you. Always consult with your healthcare provider before starting any new medication.

1. Severe renal impairment: Sodium citrate is processed by the kidneys. If your kidneys are not functioning properly, this medication could lead to an electrolyte imbalance or worsen kidney function.
2. Severe sodium-restricted diet: Sodium citrate contains sodium, which can increase sodium levels in the body. If you are on a strict low-sodium diet due to conditions like heart failure or hypertension, this medication could exacerbate your condition.
3. Metabolic alkalosis: Sodium citrate can increase blood alkalinity. If you already have metabolic alkalosis (a condition where your blood is too alkaline), taking this medication could worsen the condition.
4. Hypocalcemia (low calcium levels): Sodium citrate can bind to calcium in the blood, potentially lowering calcium levels further. This can be dangerous if you already have low calcium levels.
5. Dehydration: Sodium citrate can affect your electrolyte balance, and if you are dehydrated, this could lead to serious complications such as worsening kidney function or electrolyte imbalances.

Drug to Drug Interactions with Sodium Citrate

Sodium citrate can interact with certain medications, potentially reducing its effectiveness or increasing the risk of side effects. It is essential to inform your healthcare provider about all medications you are taking, including over-the-counter drugs and supplements. Below are some medications that may interact with sodium citrate:

1. Aluminum-based antacids (e.g., Amphojel): Sodium citrate can increase the absorption of aluminum, which may be harmful, particularly for individuals with kidney problems.
2. Potassium-sparing diuretics (e.g., Spironolactone, Aldactone): These medications can raise potassium levels, and when combined with sodium citrate, may lead to dangerously high potassium levels (hyperkalemia).
3. ACE inhibitors (e.g., Lisinopril, Prinivil): These drugs also increase potassium levels, and taking them with sodium citrate may further elevate the risk of hyperkalemia.
4. Calcium supplements or calcium-based antacids (e.g., Tums): Sodium citrate can bind to calcium, reducing its absorption and potentially leading to low calcium levels.
5. Digoxin (e.g., Lanoxin): Sodium citrate may affect how your body absorbs digoxin, potentially diminishing its effectiveness.

Sodium Citrate in Pregnancy

Is it safe to take sodium citrate during pregnancy?

Sodium citrate is generally considered safe during pregnancy when used as directed by a healthcare provider. However, it is important to consult your doctor before taking this medication, as each pregnancy is unique. Your healthcare provider will carefully weigh the benefits and potential risks to both you and your baby. If you are pregnant and considering sodium citrate, our telemedicine providers can help you determine if it is the right choice for you.

Sodium Citrate While Breastfeeding

Is it safe to take sodium citrate while breastfeeding?

Sodium citrate is usually considered safe while breastfeeding, but it is always best to consult your healthcare provider before starting any new medication. Small amounts of sodium citrate may pass into breast milk, but it is not expected to harm a nursing infant. If you have concerns, our telemedicine providers are available to discuss your options and ensure the safety of both you and your baby.

Estimated Cost of Sodium Citrate Medication

The cost of a 30-day supply of sodium citrate without insurance can vary depending on the pharmacy. Using a GoodRx coupon, the estimated cost is around $10 to $20 for a 30-day supply. Prices may fluctuate, so it is a good idea to check with your local pharmacy or use a discount service like GoodRx to find the best price.

Possible Alternatives to Sodium Citrate

If sodium citrate is not suitable for you, there are alternative treatments and lifestyle changes that may help manage your condition. Always discuss any changes with your healthcare provider before adjusting your treatment plan. If you’re unsure, our telemedicine providers are available to guide you through these options.

1. Metabolic acidosis: Alternatives include sodium bicarbonate or potassium citrate. Lifestyle changes, such as improving hydration and managing underlying conditions like diabetes, may also help.
2. Urinary tract infections (UTIs): Antibiotics are the primary treatment for UTIs. Drinking plenty of water and urinating frequently can help flush bacteria from the urinary tract.
3. Kidney stones: Potassium citrate may be used as an alternative. Staying hydrated and reducing intake of oxalate-rich foods (such as spinach and nuts) can help prevent kidney stones.
4. Gout: Medications like allopurinol (Zyloprim) or febuxostat (Uloric) are commonly prescribed. Reducing intake of purine-rich foods (such as red meat and seafood) can also help manage gout.
5. Hyperuricemia: Allopurinol or febuxostat may be recommended. Lifestyle changes, such as reducing alcohol consumption and maintaining a healthy weight, can also help lower uric acid levels.
6. Cystinuria: Potassium citrate or tiopronin (Thiola) may be used. Drinking plenty of water and reducing salt intake can also help manage this condition.
7. Renal tubular acidosis: Sodium bicarbonate or potassium citrate are alternatives. Managing the underlying cause of the condition is also important.
8. Osteoporosis: Calcium and vitamin D supplements, along with medications like bisphosphonates (e.g., alendronate), are common treatments. Weight-bearing exercises and a diet rich in calcium and vitamin D can also help strengthen bones.
9. Chronic kidney disease (CKD): Managing blood pressure and blood sugar levels is crucial. Medications like ACE inhibitors or angiotensin II receptor blockers (ARBs) may be prescribed. Reducing salt intake and staying hydrated are important lifestyle changes.
10. Urinary alkalinization: Potassium citrate is often used as an alternative. Drinking plenty of water and avoiding acidic foods can help maintain a healthy urinary pH.

Recent Updates on Sodium Citrate Research

Recent studies have explored the use of sodium citrate in various medical conditions, including its potential benefits in managing chronic kidney disease and preventing kidney stones. Ongoing research is also investigating its role in improving exercise performance by buffering lactic acid buildup in athletes. While these studies are promising, more research is needed to confirm these benefits. As always, consult with your healthcare provider before making any changes to your treatment plan. If you have questions about the latest research or how sodium citrate might fit into your care, our telemedicine providers are available to help.

James Kingsley

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