Cytra-2

Citric acid and sodium citrate are both alkalinizing agents that make the urine less acidic.

The combination of citric acid and sodium citrate is used to prevent gout or kidney stones, or metabolic acidosis in people with kidney problems.

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

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Citric acid and sodium citrate should be taken after meals to help prevent stomach or intestinal side effects. You may also need to take the medicine at bedtime. Follow your doctor's instructions.

Shake the oral solution (liquid) well just before you measure a dose. To be sure you get the correct dose, measure the liquid with a marked measuring spoon or medicine cup, not with a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The liquid medicine should be mixed with at lease 4 ounces of water or juice. Drink this mixture slowly and then add a little more water to the same glass, swirl gently and drink right away.

You may chill the mixed medicine to make it taste better, but do not allow it to freeze.

Drink plenty of liquids while you are taking citric acid and sodium citrate.

Your treatment may include a special diet. It is very important to follow the 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.

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.

Store citric acid and sodium citrate at room temperature away from moisture, heat, or freezing. Keep the medication in a closed container.

Take the missed dose as soon as you remember. If you are more than 2 hours late in taking your medicine, wait until your next regularly scheduled time to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.

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.

• If you have an allergy to sodium citrate, citric acid, or any other part of Cytra-2 (sodium citrate and citric acid).
• If you are allergic to any drugs like this one, any other drugs, foods, or other substances. Tell your doctor about the allergy and what signs you had, like rash; hives; itching; shortness of breath; wheezing; cough; swelling of face, lips, tongue, or throat; or any other signs.
• If you have any of these health problems: Fluid loss (dehydrated), heat cramps, high potassium levels, a certain problem that causes periods of muscle weakness (adynamia episodica hereditaria), kidney disease, heart disease, unable to pass urine, or untreated Addison's disease.
• If you are on a low-salt or salt-free diet.

This is not a list of all drugs or health problems that interact with this medicine.

Tell your doctor and pharmacist about all of your drugs (prescription or OTC, natural products, vitamins) and health problems. You must check to make sure that it is safe for you to take Cytra-2 with all of your drugs and health problems. Do not start, stop, or change the dose of any drug without checking with your doctor.

Use this medicine as ordered by your doctor. Read all information given to you. Follow all instructions closely.

• Take after meals and at bedtime.
• Do not take aluminum products at the same time as Cytra-2. Talk with your doctor.
• Shake well before use.
• Mix with water as you have been told before drinking.
• Measure liquid doses carefully. Use the measuring device that comes with this medicine. If there is none, ask the pharmacist for a device to measure Cytra-2.

What do I do if I miss a dose?

• Take a missed dose as soon as you think about it.
• If it is close to the time for your next dose, skip the missed dose and go back to your normal time.
• Do not take 2 doses at the same time or extra doses.

All drugs may cause side effects. However, many people have no side effects or only have minor side effects. Call your doctor or get medical help if any of these side effects or any other side effects bother you or do not go away:

• Loose stools (diarrhea).
• Upset stomach or throwing up.

These are not all of the side effects that may occur. If you have questions about side effects, call your doctor. Call your doctor for medical advice about side effects.

You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects at http://www.fda.gov/medwatch.