Sodium Citrate Overdose

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What happens if I overdose Sodium Citrate?

Contact 1-800-222-1222 (the American Association of Poison Control Centers), your local poison control center, or emergency room immediately. Symptoms may include diarrhea; nausea; seizures; vomiting.

Proper storage of Sodium Citrate:

Store Sodium Citrate at room temperature, between 68 and 77 degrees F (20 and 25 degrees C), in a tightly closed container. Store away from heat, moisture, and light. Do not freeze. Keep Sodium Citrate out of the reach of children and away from pets.

Overdose of Sodium Citrate in details

infoWhen a dose is taken in higher dose than the recommended doses, it is called Overdose. Overdose always needs a clinical supervision. Any medicine or drug when consumed in Overdose produces untoward side effects on one or various organs in the body. A medicine is excreted in the kidney or metabolized in the liver most of the times. This process goes without any hurdles when taken in normal dose, but when taken in an overdose, the body is not able to metabolize it or send it out properly which causes the effects of anoverdose.
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Overdosage may result in metabolic alkalosis. Sodium Citrate should be discontinued, appropriate treatment instituted and electrolyte and acid-base determinations should be carried out as appropriate.

What should I avoid while taking Sodium Citrate?

Avoid using antacids without your doctor's advice, including household baking soda (sodium bicarbonate). Antacids that contain aluminum or sodium can interact with citric acid and Sodium Citrate, causing a serious electrolyte imbalance or aluminum toxicity.

Avoid eating foods that are high in salt, or using extra table salt on your meals.

It is very important to follow any 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.

Sodium Citrate warnings

infoWarnings are a mix of Precautions. Contraindications and interactions and serious harmful effects associated with the medicine intake. A diabetic or Hypertensive patient need to be warned about few drug interactions. A known hypersensitivity patient needs to be careful about the reactions or anaphylactic shock. A pregnant woman or a breastfeeding woman should be warned of certain medications. A Hepatitis [liver disease] patient or a cardiac patient should avoid few drugs.

Pregnancy

Category C.

Lactation

Undetermined.

Renal Function

Because alkalosis can occur, especially in the presence of hypocalcemia, use with caution.

Special Risk Patients

Sodium salts should be used with caution in patients with cardiac failure, hypertension, impaired renal function, peripheral and pulmonary edema, and toxemia of pregnancy.

GI effects

Dilute with water to minimize GI disturbance. Take after meals to avoid saline laxative effect.

Urolithiasis

Citrate mobilizes calcium from bones and increases its renal excretion; this, along with the elevated urine pH, may predispose to urolithiasis.

What should I discuss with my healthcare provider before taking Sodium Citrate?

Some medical conditions may interact with Sodium Citrate. Tell your doctor or pharmacist if you have any medical conditions, especially if any of the following apply to you:

  • if you are pregnant, planning to become pregnant, or are breast-feeding
  • if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement
  • if you have allergies to medicines, foods, or other substances
  • if you are taking aluminum salts (eg, aluminum hydroxide), amphetamines or lithium
  • if you have a history of kidney disease, heart disease, electrolyte/mineral imbalances (eg, high potassium levels), Addison disease, or stomach problems (eg, ulcer disease)
  • if you have high blood pressure, a urinary tract infection, or toxemia, or you are on a sodium-restricted diet

Some MEDICINES MAY INTERACT with Sodium Citrate. Tell your health care provider if you are taking any other medicines, especially any of the following:

  • Aluminum salts (eg, aluminum hydroxide) because the risk of severe aluminum toxicity may be increased
  • Anorexiants (eg, phentermine) or sympathomimetics (eg, pseudoephedrine) because side effects may be increased by Sodium Citrate
  • Lithium or tetracyclines (eg, doxycycline) because effectiveness may be decreased by Sodium Citrate

This may not be a complete list of all interactions that may occur. Ask your health care provider if Sodium Citrate may interact with other medicines that you take. Check with your health care provider before you start, stop, or change the dose of any medicine.

Sodium Citrate precautions

infoCertain people who are very sick or very old or who are sensitive show an exacerbation of side effect of the drug which can turn dangerous at times. So, it is very important to remember the precautions while taking the medicine. Pregnancy and Breastfeeding are also special categories wherein extra care or precaution is needed when taking a drug. Few patients may have a hypersensitivity reaction to few medications, and that can be life-threatening rarely. Penicillin hypersensitivity is one example. Diarrhea, rashes are few other symptoms which need a watch. A patient with other co-existing diseases like liver disease, heart disease, kidney disease should take special precautions.
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Sodium Citrate contains sodium 650 mg/sachet which should be taken into account by those on a low sodium diet. Patients should be advised to consult a doctor if pain or irritation persists for >48 hrs or if blood is noticed in their urine. Sodium Citrate should be used cautiously in patients with cardiac failure, hypertension, impaired renal function, peripheral and pulmonary oedema and preeclampsia. The clinical condition of the patient should be evaluated and laboratory determinations (eg. serum electrolytes, acid-base balance) obtained periodically during Sodium Citrate therapy, particularly in patients with renal disease.

Use in pregnancy & lactation: Studies regarding the effect of citrates on pregnancy have not been done. Caution should be exercised when administered to a nursing mother.

Use in children: Do not give Sodium Citrate to children <12 years unless advised to do so by a doctor.

What happens if I miss a dose of Sodium Citrate?

infoWhen you miss a dose, you should take it as soon as you remember, but you should take care that it should be well spaced from the next dose. You should not take an extra dose at the time of the second dose as it will become a double dose. The double dose can give unwanted side effects, so be careful. In chronic conditions or when you have a serious health issue, if you miss a dose, you should inform your health care provider and ask his suggestion.

Take the missed dose as soon as you remember. If you are more than 2 hours late in taking your medicine, wait until your next regularly scheduled time to take the medicine and skip the missed dose. Do not take extra medicine to make up the missed dose.


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References

  1. DailyMed. "SODIUM CITRATE: DailyMed provides trustworthy information about marketed drugs in the United States. DailyMed is the official provider of FDA label information (package inserts).". https://dailymed.nlm.nih.gov/dailyme... (accessed September 17, 2018).
  2. DrugBank. "Sodium citrate". http://www.drugbank.ca/drugs/DB09154 (accessed September 17, 2018).
  3. MeSH. "Buffers". https://www.ncbi.nlm.nih.gov/mesh/68... (accessed September 17, 2018).

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Information checked by Dr. Sachin Kumar, MD Pharmacology

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