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Indications and Dosage
Oral
Urine alkalinisation Adult: 15-30 mL bid-tid.
Child: <7 yr 2 mL tid; 7-12 yr 5 mL tid. |
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Contraindications
Hyperosmolar states, HTN, oedema.
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Special Precautions
Hypocalcaemia, hypoventilatory states, alkalosis. Renal disease. Childn including neonates. Pregnancy and lactation.
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Adverse Reactions
Mild diuresis, stomach cramps, flatulence, diarrhoea, GI ulceration, hypokalaemia, metabolic alkalosis, tiredness, dyspnoea, anxiety, mood swings.
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Overdosage
Symptom: Metabolic alkalosis. Management: Symptomatic and supportive treatment.
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Drug Interactions
Enhances elimination of salicylates and barbiturates. May increase the half-life of quinidine, ephedrine, pseudoephedrine. Additive effect w/ Na retention caused by corticosteroids. Potentiates renal excretion of tetracycline. Hypochloraemic alkalosis may occur w/ concomitant K-depleting diuretics.
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Food Interaction
Avoid alcohol.
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Lab Interference
May interfere w/ urine ketone test.
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Action
Description:
Mechanism of Action: Disodium hydrogen citrate is metabolised to bicarbonate, which then increases urinary pH by increasing the excretion of free bicarbonate ions, thereby increasing the solubility of cystine in the urine and the ionization of uric acid to more soluble urate ion. Onset: <1 min. Duration: 4-6 hr. |
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References
Buckingham R (ed). Bicarbonate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 27/04/2016 .
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