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What should I discuss with my healthcare provider before taking citric acid, potassium citrate, and sodium citrate (Cytra-3, Polycitra, Polycitra-LC, Tricitrates)?

You should not use this medication if you are allergic to it, or if you have:

• severe kidney disease;
• severe heart damage (such as from a prior heart attack);
• Addison's disease (an adrenal gland disorder);
• high levels of potassium in your blood (hyperkalemia);
• high levels of sodium in your blood (hypernatremia); or
• if you are severely dehydrated.

You should not take citric acid, potassium citrate, and sodium citrate tablets if you have problems with your esophagus, stomach, or intestines that make it difficult for you to swallow or digest pills.

If you have certain conditions, you may need a dose adjustment or special tests to safely take this medication. Before you take citric acid, potassium citrate, and sodium citrate, tell your doctor if you have:

• kidney disease;
• low levels of calcium in your blood (hypocalcemia);
• congestive heart failure, heart rhythm problems, or history of heart attack;
• other heart disease or high blood pressure;
• diabetes;
• a peptic ulcer in your stomach;
• swelling of your hands or feet, or in your lungs (pulmonary edema);
• toxemia of pregnancy;
• urination problems (or if you are unable to urinate);
• chronic diarrhea (such as irritable bowel disease, ulcerative colitis, Crohn's disease); or
• if you are on a low-salt diet.

It is not known whether this medication is harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment.

It is not known whether this medication passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.

How should I take citric acid, potassium citrate, and sodium citrate (Cytra-3, Polycitra, Polycitra-LC, Tricitrates)?

Take this medication exactly as prescribed by your doctor. Do not take it in larger amounts or for longer than recommended. Follow the directions on your prescription label.

Citric acid, potassium citrate, and sodium citrate should be taken after meals to help prevent stomach or intestinal side effects. You may also need to take the medicine at bedtime. Follow your doctor's instructions.

Measure the liquid medicine with a special dose-measuring spoon or cup, not a regular table spoon. If you do not have a dose-measuring device, ask your pharmacist for one.

The liquid medicine should be mixed with at lease 4 ounces of water or juice. Drink this mixture slowly and then add a little more water to the same glass, swirl gently and drink right away.

You may chill the mixed medicine to make it taste better, but do not allow it to freeze.

Your treatment may include a special diet. It is very important to follow the diet plan created for you by your doctor or nutrition counselor. You should become very familiar with the list of foods you should eat or avoid to help control your condition.

To be sure this medication is helping your condition, your blood and urine may need to be tested often. Your heart rate may also be checked using an electrocardiograph or ECG (sometimes called an EKG) to measure electrical activity of the heart. Follow your doctor's instructions carefully and do not miss any scheduled appointments.

Do not stop taking this medication without first talking to your doctor. If you stop taking potassium suddenly, your condition may become worse.

Store citric acid, potassium citrate, and sodium citrate at room temperature away from moisture, heat, or freezing. Keep the medication in a closed container.

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