Citrates (Systemic)

Before Using This Medicine

In deciding to use a medicine, the risks of taking the medicine must be weighed against the good it will do. This is a decision you and your doctor will make. For citrates, the following should be considered:

Allergies - Tell your doctor if you have ever had any unusual or allergic reaction to potassium citrate or potassium. Also tell your health care professional if you are allergic to any other substances, such as foods, preservatives, or dyes.

Pregnancy - Studies on effects in pregnancy have not been done in either humans or animals.

Breast-feeding - Although it is not known whether citrates pass into the breast milk, this medicine has not been reported to cause problems in nursing babies.

Children - Although there is no specific information comparing use of citrates in children with use in other age groups, these medicines are not expected to cause different side effects or problems in children than they do in adults.

Older adults - Many medicines have not been studied specifically in older people. Therefore, it may not be known whether they work exactly the same way they do in younger adults or if they cause different side effects or problems in older people. There is no specific information comparing use of citrates in the elderly with use in other age groups.

Other medicines - 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. When you are taking citrates, it is especially important that your health care professional know if you are taking any of the following:

• Amiloride (e.g., Midamor) or
• Benazepril (e.g., Lotensin) or
• Captopril (e.g., Capoten) or
• Digitalis glycosides (heart medicine) or
• Enalapril (e.g., Vasotec) or
• Fosinopril (e.g., Monotril) or
• Heparin (e.g., Panheprin) or
• Lisinopril (e.g., Prinivil; Zestril) or
• Medicines for inflammation or pain (except narcotics) or
• Potassium-containing medicines (other) or
• Quinapril (e.g., Accuprol) or
• Ramipril (e.g., Altase) or
• Salt substitutes, low-salt foods or milk or
• Spironolactone (e.g., Aldactone) or
• Triamterene (e.g., Dyrenium) - Use with potassium-containing citrates may further increase potassium blood levels, possibly leading to serious side effects

• Antacids, especially those containing aluminum or sodium bicarbonate - Use with citrates may increase the risk of kidney stones; also, citrates may increase the amount of aluminum in the blood and cause serious side effects, especially in patients with kidney problems

• Methenamine (e.g., Mandelamine) - Use with citrates may make the methenamine less effective

• Quinidine (e.g., Quinidex) - Use with citrates may cause quinidine to build up in the bloodstream, possibly leading to serious side effects

Other medical problems - The presence of other medical problems may affect the use of citrates. Make sure you tell your doctor if you have any other medical problems, especially:

• Addison's disease (underactive adrenal glands) or
• Diabetes mellitus (sugar diabetes) or
• Kidney disease - The potassium in potassium-containing citrates may worsen or cause heart problems in patients with these conditions

• Diarrhea (chronic) - Treatment with citrates may not be effective; a change in dose of citrate may be needed

• Edema (swelling of the feet or lower legs) or
• High blood pressure or
• Toxemia of pregnancy - The sodium in sodium-containing citrates may cause the body to retain (keep) water

• Heart disease - The sodium in sodium-containing citrates may cause the body to retain (keep) water; the potassium in potassium-containing citrates may make heart disease worse

• Intestinal or esophageal blockage - Potassium citrate tablets may cause irritation of the stomach or intestines

• Stomach ulcer or other stomach problems - Potassium citrate-containing products may make these conditions worse

• Urinary tract infection - Citrates may make conditions worse