Sodium Citrate/Citric Acid
Bicitra keeps the acid levels in your body in a normal range. It's useful for people who have a buildup of acid in their blood or urine and need long-term treatment. Although it works well to lower your acid levels, you might need to have your blood work done regularly to monitor your electrolyte levels.
What is Bicitra?
What is Bicitra used for?
- Prevent gout or kidney stones by lowering the acid levels in your urine
- Buildup of acid in your body (metabolic acidosis)
- Excess stomach acid
How Bicitra works
Bicitra makes your body more alkaline, or less acidic. Sodium citrate is broken down in your body to sodium bicarbonate, which neutralizes acid in your blood and urine.
Drug facts
Side effects of Bicitra
The following side effects may get better over time as your body gets used to the medication. Let your healthcare provider know immediately if you continue to experience these symptoms or if they worsen over time.
Common Side Effects
- Diarrhea
- Nausea
- Vomiting
- Muscle cramps, spasms, or tremors (tetany)
Less Common Side Effects
- Buildup of bases in your body (metabolic alkalosis)
The following Bicitra side effects have also been reported
Along with its needed effects, a medicine may cause some unwanted effects. Although not all of these side effects may occur, if they do occur they may need medical attention.
Stop taking this medicine and get emergency help immediately if any of the following effects occur:
Rare
Abdominal or stomach pain or cramping (severe)
black, tarry stools
vomiting (severe), sometimes with blood
Check with your doctor as soon as possible if any of the following side effects occur:
Confusion
convulsions (seizures)
dizziness
irregular or fast heartbeat
irritability
mood or mental changes
muscle pain or twitching
nervousness or restlessness
numbness or tingling in hands, feet, or lips
shortness of breath, difficult breathing, or slow breathing
swelling of feet or lower legs
unexplained anxiety
unpleasant taste
unusual tiredness or weakness
weakness or heaviness of legs
Some side effects may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects. Check with your health care professional if any of the following side effects continue or are bothersome or if you have any questions about them:
Other side effects not listed may also occur in some patients. If you notice any other effects, check with your healthcare professional.
Call your doctor for medical advice about side effects. You may report side effects to the FDA at 1-800-FDA-1088.
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Pros and cons of Bicitra
Pros
- Good for people who have a chronic buildup of acids in their body (metabolic acidosis), which is a condition in some people with kidney problems
- Can be used long-term to balance out acid in your urine
- Works well to lower your stomach acid
- Generally doesn't cause too many side effects for people without kidney problems
- Comes in a grape flavor
Cons
- Has to be taken 4 times per day
- Occasional blood work is needed for people with kidney disease or for people who don't make enough urine
- Cannot be used for people with severe kidney problems, severe heart damage (such as from a prior heart attack), Addison's disease (an adrenal gland disorder), high potassium levels (hyperkalemia), if you are severely dehydrated, have heat cramps, or if you have to limit your sodium intake
Pharmacist tips for Bicitra
- To prevent diarrhea and stomach upset, mix Bicitra with the appropriate amount of water, shake it well, and take it after a meal. Read the FAQ section above for how much water you should use.
- Store Bicitra at room temperature. If you want it to taste better, you can chill it first. But, don’t let it freeze.
- Don't take Bicitra with antacids that contain aluminum, such as Gaviscon, Gelusil, or Mylanta. Taking these medications together with Bicitra can make your body absorb too much aluminum.
- If Bicitra doesn't come in a pre-measured cup, be sure to use the measuring device that your pharmacy provides so you can measure out the correct dose.
Common questions about Bicitra
Use Bicitra carefully if you have kidney problems because it might cause your acid levels to go too low (systemic alkalosis). If your acid levels are too low, you can feel confused, lightheaded, numbness or tingling in your face, hands, or feet, or you can have muscle spasms and twitching. Let your provider know if you experience any of these symptoms. Don't use Bicitra if you have severe kidney disease, unless directed by your provider.
Diarrhea is a common side effect of Bicitra. Taking Bicitra after meals can lower your risk of diarrhea. Diluting the medication with water can help prevent stomach upset.
Bicitra contains about 1 mEq of sodium, so it can raise your sodium levels. Take Bicitra exactly as prescribed. Taking too much of this medication can cause diarrhea, nausea and vomiting, racing thoughts or intense imagination, and sudden, irregular movements of your body. If you are sensitive to sodium or if you have a condition where you need to limit your sodium intake, let your healthcare provider know. Your provider likely will do blood work to monitor your sodium levels.
Bicitra is concentrated and needs to be diluted with water before you take it. If you're taking Bicitra to control acid levels in your urine, the typical dose is 2 to 6 teaspoonfuls, diluted in 1 oz to 3 oz of water, after each meal and at bedtime. If you're taking Bicitra to neutralize stomach acid, the typical dose is 1 to 3 teaspoonfuls, diluted in 15 mL of water, after each meal and at bedtime.
Medications weren't required to be tested for safety until 1938 when the Federal Food, Drug, and Cosmetic Act was passed. In 1962, the Food and Drug Administration (FDA) amended the law so medications had to be tested for both safety and effectiveness. Many of the medications that were used before 1938 still haven't had the thorough evaluation required by the FDA today but they were “grandfathered” in under the law. This means they weren't required to go through the same approval process as new drugs and they're considered "unapproved" medications. Bicitra has been used since before 1938, which is why it's unapproved.
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Risks and warnings for Bicitra
Bicitra can cause some serious health issues. This risk may be even higher for certain groups. If this worries you, talk to your doctor or pharmacist about other options.
Changes in electrolytes
- Risk factors: Kidney disease | Heart disease | High blood pressure | Swelling (edema) | Pre-eclampsia
Bicitra contains sodium (salt) and might change your electrolyte levels, which can cause heart and kidney problems. If you have kidney disease, your healthcare provider will do occasional blood tests to make sure your electrolytes are in balance.
Bicitra dosage
Ml of oral solution| Dosage | Quantity | Price as low as | Price per unit |
|---|---|---|---|
| 500mg/334mg/5ml | 473 ml | $13.78 | $0.03 |
Typical dosage for Bicitra
The typical dose is 10 mL to 30 mL, diluted with water, by mouth after each meal and at bedtime. Your provider might raise your dose slowly depending on how you respond to the medication.
Interactions between Bicitra and other drugs
Although certain medicines should not be used together at all, in other cases two different medicines may be used together even if an interaction might occur. In these cases, your doctor may want to change the dose, or other precautions may be necessary. Tell your healthcare professional if you are taking any other prescription or nonprescription (over-the-counter [OTC]) medicine.
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