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Indications and Dosage
Oral
Cystitis Adult: In female patients: 1 sachet (4 g) tid for 2 days. Dissolve contents in a glass of water. Parenteral Anticoagulant Adult: For use with automated plasmapheresis equipment: As 4% trisodium citrate dihydrate solution: Recommended dose is determined by apheresis device. Refer to device operator’s manual.
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Renal Impairment
Oral
Severe: Contraindicated. |
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Administration
Should be taken with food. Take w/in 30 min after a meal or bedtime snack. Swallow whole w/ a glass of water. Ensure adequate fluid intake.
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Contraindications
Heart disease, diabetes, hypertension, or those on a low salt diet. Severe renal impairment, oliguria, azotemia or anuria. Pregnancy and lactation. Not intended for direct IV infusion.
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Special Precautions
Patient with peripheral or pulmonary oedema; severely-ill patients or those who are in shock. Renal and hepatic impairment.
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Adverse Reactions
Cardiac disorders: Arrhythmia.
Gastrointestinal disorders: Diarrhoea, gastrointestinal discomfort. Nervous system disorders: Paraesthesia. Renal and urinary disorder: Diuresis. Vascular disorder: Hypotension. |
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Monitoring Parameters
Monitor serum creatinine, BUN, LFTs, serum bicarbonate and urinary pH.
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Overdosage
Symptoms: Gastrointestinal discomfort, diarrhoea. Management: Symptomatic treatment. May do fluid and electrolyte balance correction.
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Drug Interactions
Na-containing preparation increases lithium excretion and reduced plasma levels.
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Action
Description: Sodium citrate is metabolised to bicarbonate, which in turn neutralises gastric acid with the production of carbon dioxide. It also acts as an extracorporeal anticoagulant by chelating free Ca in the blood and inhibits clotting.
Pharmacokinetics: Metabolism: Converted to bicarbonate via hepatic oxidation. Excretion: Via urine, <5% as sodium citrate. |
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Chemical Structure
 Source: National Center for Biotechnology Information. PubChem Database. Sodium citrate, CID=6224, https://pubchem.ncbi.nlm.nih.gov/compound/Sodium-citrate (accessed on Jan. 23, 2020) |
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Storage
Store below 25°C.
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ATC Classification
B05CB02 - sodium citrate ; Belongs to the class of salt solutions used as irrigating solutions.
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References
Anon. Anticoagulation for Continuous Renal Replacement Therapy. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 02/01/2019. Anon. Sodium Citrate. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 13/04/2016. Buckingham R (ed). Bicarbonate. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/01/2018. Joint Formulary Committee. Sodium Citrate. British National Formulary [online]. London. BMJ Group and Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 02/01/2019. Sodium Citrate 4% w/v Anticoagulant – Trisodium Citrate Dihydrate Injection Solution (Terumo BCT, Ltd). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 02/01/2019.
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