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

Citric acid and sodium 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). Mix the medicine with at least 4 ounces of water or juice. Stir and drink this mixture right away. Add a little more water to the glass, swirl gently and drink right away.

Drink plenty of liquids while you are taking citric acid and sodium citrate.

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 and heat.

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

• severe kidney disease;

• decreased urination (or if you are unable to urinate);

• 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;

• toxemia of pregnancy;

• swelling in your hands or feet, or in your lungs (pulmonary edema); or

• an electrolyte imbalance (such as low levels of potassium or magnesium in your blood).

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.

Avoid taking an antacid within 2 hours before or after you take citric acid and sodium citrate. Antacids that contain aluminum can interact with citric acid and sodium citrate and cause serious side effects.

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

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

• nausea, vomiting; 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.

Other drugs may affect citric acid and sodium citrate, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell your doctor about all your current medicines and any medicine you start or stop using.