Citric acid and potassium citrate is a combination medicine that helps make your urine less acidic. Sometimes called a urinary alkalizer, citric acid and potassium citrate is used to treat acidosis or to prevent gout or kidney stones.

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

Follow all directions on your medicine label and package. Tell each of your healthcare providers about all your medical conditions, allergies, and all medicines you use.

Follow all directions on your prescription label and read all medication guides or instruction sheets. Your doctor may occasionally change your dose. Use the medicine exactly as directed.

This medicine is usually taken after meals and at bedtime. Follow your doctor's dosing instructions very carefully.

Measure liquid medicine carefully. Use the dosing syringe provided, or use a medicine dose-measuring device (not a kitchen spoon).

This medicine can irritate your esophagus, stomach, or intestines. To prevent this, mix the liquid or powder form of this medicine with water or juice. The amount of water or juice used will depend on your dose and whether you use the liquid or powder.

Drink plenty of liquids while you are taking this medicine.

You may need to follow a special diet. Follow all instructions of your doctor or dietitian. Learn about the foods to eat or avoid to help control your condition.

You will need frequent blood and urine tests.

Store in a tightly-closed container at room temperature, away from moisture, heat, and freezing.

You should not use citric acid and potassium citrate if you have:

• severe kidney disease;

• little to no urination;

• severe heart damage (such as from a heart attack);

• untreated Addison's disease (an adrenal gland disorder);

• high levels of potassium in your blood (hyperkalemia);

• a genetic condition that causes episodes of severe muscle weakness; or

• if you are severely dehydrated or have heat cramps.

Tell your doctor if you have ever had:

• kidney problems;

• heart problems, high blood pressure; or

• stomach or intestinal bleeding.

Tell your doctor if you are pregnant or breastfeeding.

Take the medicine as soon as you can, but skip the missed dose if it is almost time for your next dose. Do not take two doses at one time.

Seek emergency medical attention or call the Poison Help line at 1-800-222-1222. An overdose of citric acid and potassium citrate can be fatal very quickly if your potassium level gets too high.

Overdose symptoms may include nausea, weakness, tingling, or irregular heartbeats.

Ask your doctor before using an antacid, and use only the type your doctor recommends. Antacids that contain aluminum can interact with this medicine and cause serious side effects.

Avoid using potassium supplements or salt substitutes without your doctor's advice.

Get emergency medical help if you have signs of an allergic reaction: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

Citric acid and potassium citrate may cause serious side effects. Call your doctor at once if you have:

• swelling or severe pain in your stomach;

• vomiting;

• black or tarry stools, coughing up blood or vomit that looks like coffee grounds;

• alkalosis (when the body is too alkaline)--confusion, nausea, vomiting, numbness or tingling, tremors, muscle twitching or spasm; or

• high potassium level--nausea, weakness, tingly feeling, chest pain, irregular heartbeats, loss of movement.

Common side effects of citric acid and potassium citrate may include:

• upset stomach; or

• diarrhea.

This is not a complete list of side effects and others may occur. Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088.

Tell your doctor about all your other medicines, especially:

• digoxin, digitalis;

• a diuretic or "water pill"--amiloride, eplerenone, spironolactone, triamterene; or

• heart or blood pressure medication--benazepril, captopril, enalapril, lisinopril, quinapril, ramipril, and others.

This list is not complete. Other drugs may affect citric acid and potassium citrate, including prescription and over-the-counter medicines, vitamins, and herbal products. Not all possible drug interactions are listed here.