Bicitra

Common side effects of sodium citrate/citric acid are nausea, vomiting, diarrhea, stomach pain, and water retention.

It should not be used in patients with kidney failure.

Bicitra is part of the drug class:

• Acid preparations

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.

Before you take citric acid and sodium citrate, tell your doctor about all your medical conditions, especially kidney disease, heart disease, high blood pressure, a history of heart attack, urinary problems, swelling (edema), or chronic diarrhea (such as ulcerative colitis, Crohn's disease).

Also tell your doctor about all other medications you use, including over-the-counter medications and household remedies.

Citric acid and sodium citrate should be taken after meals to help prevent stomach or intestinal side effects.

The liquid medicine should be mixed with water or juice. Drink plenty of liquids while you are taking citric acid and sodium citrate.

Your treatment may include a special diet. You should become very familiar with the list of foods you should eat or avoid to help control your condition.

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.

Avoid eating foods that are high in salt, or using extra table salt on your meals.

To be sure citric acid and sodium citrate is helping your condition, your blood and urine may need to be tested often. Follow your doctor's instructions carefully and do not miss any scheduled appointments.

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).

Seek emergency medical attention if you think you have used too much of this medicine.

Overdose symptoms may include muscle spasms or seizure (convulsions).

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.

Avoid eating foods that are high in salt, or using extra table salt on your meals.

It is very important to follow any diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat or avoid to help control your condition.

Get emergency medical help if you have any of these signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Stop using this medication and call your doctor at once if you have any of these serious side effects:

• swelling, tingling, or numbness in your hands or feet;

• muscle twitching or pain, leg pain or cramps;

• unusual weakness, rapid and shallow breathing, fast or slow heart rate, dizziness, confusion, or mood changes;

• feeling restless, nervous, or irritable;

• black, bloody, or tarry stools;

• severe or ongoing diarrhea; or

• seizure (convulsions).

Less serious side effects may include:

• nausea, or vomiting, stomach pain;

• mild or occasional diarrhea; or

• mild stomach pain.

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.

The following drugs can interact with citric acid and sodium citrate. Tell your doctor if you are using any of these:

• lithium (Eskalith, LithoBid);

• methenamine (Hiprex, Mandelamine, Urex),

• quinidine (Quinaglute, Quinidex, Quin-Release);

• cold or allergy medicine (decongestants), diet pills, ADHD medication;

• a vitamin, mineral supplement, or medication that contains calcium;

• salicylates such as aspirin, Backache Relief Extra Strength, Novasal, Nuprin Backache Caplet, Doan's Pills Extra Strength, Tricosal, and others; or

• an antacid that contains aluminum or sodium, including Alka-Seltzer, Maalox, Mylanta, Di-Gel, Gelusil, Alamag Plus, Rulox Plus, Tempo, and others.

This list is not complete and there may be other drugs that can interact with citric acid and sodium citrate. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.