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ALIZER     

Generic Name:                  Disodium Hydrogen Citrate

Therapeutic Category:   Urinary Alkalizer, Systemic Alkalizer

Pharmacological Class: Alkalinizing agent

Composition:                     Each 5 ml contains Dihydrogen Sodium Citrate BP 1.38 gm

Pregnancy Category:      A

 

Presentation:                    Available in 100 ml bottle with a measuring cap

Description

Disodium citrate, more properly, Disodium Hydrogen Citrate is an acid salt of citric acid with the chemical formula Na2C6H6O7. It is used as an antioxidant in food as well as to improve the effects of other antioxidants. It is also used as an acidity regulator and sequestrant.

Disodium citrate may be used in patients to alleviate discomfort from urinary tract infections.

Mechanism of Action

As Urinary Alkalizer

Renal acid-base regulation– Kidneys helps regulating blood pH by secreting H+ and absorbing HCO3.

  • When you take sodium citrate, it moves through your body.
  • When it reaches your liver, it is converted to bicarbonate, a usable form of base in the body.
  • This helps change the pH in your urinary tract from acidic to more basic.
  • By reducing the acidity of the urinary tract, you can experience a reduction in symptoms.

In reduction of stone formation

As an added bonus, citrate can bind with acidic materials in kidneys to prevent calcium oxalate stones from forming.

  • A rise in urinary pH increases the solubility of Cysteine in the urine and the ionization of Uric Acid to more soluble urate ion.
  • By maintaining alkaline urine, the actual dissolution of uric acid stones may be accomplished.

Indications

  • Acidosis following diarrhea
  • Painful/Burning Micturition* (UTI)
  • Renal Tubular Acidosis
  • Uremic Acidosis (Hyperuricemia*)
  • Kidney stones

 

Dosage

Route of administration: Oral

Adults: 5-10ml three times a day

 

Children: 2.5-5ml three times a day

 

Medication to be taken after meals

Pharmacokinetics

Absorption: Reaches maximum concentration in 1-2 hours

Metabolism: Citrate is metabolized to bicarbonate in the liver and plays a role as an intermediate in the citric acid cycle

Route of elimination: Largely eliminated through hepatic metabolism with very little cleared by the kidneys

Half-life: 18-54 minutes

Adverse Effects

Mild diuresis, stomach cramps, flatulence, diarrhea, GI ulceration, metabolic alkalosis, anxiety, mood swings

Contraindications

ALIZER is contraindicated in the following populations and situations:

  • Hypersensitivity to any component of the formulation
  • Patients on sodium restricted diets
  • Hypertension
  • Oedema
  • Hyperosmolar states

Precautions

Hypoventilatory states*, Alkalosis*, Hypocalcaemia*, Neonates, Renal impairment, Cardiac Failure, Hypertension, Pulmonary Oedema, Monitor Serum Electrolytes.

Drug Interactions

  • Enhances elimination of salicylates and barbiturates
*Terminologies:

Micturition: The act of passing urine; urination.

Hyperuricemia: An excess of uric acid in the blood

Hypoventilatory states: Breathing at an abnormally slow rate, resulting in an increased amount of carbon dioxide in the blood.

Alkalosis: An excessively alkaline condition of the body fluids or tissues, which may cause weakness or cramp.

Hypocalcaemia: Deficiency of calcium in the bloodstream.

Hypochloremic alkalosis: A metabolic disorder resulting from an increase in blood bicarbonate level secondary to loss of chloride from the body.

  • Additive effect with sodium retention caused by corticosteroids.
  • Potentiates renal excretion of tetracycline.
  • Hypochloraemic alkalosis* may occur with concomitant Potassium depleting diuretic
*Terminologies:

Micturition: The act of passing urine; urination.

Hyperuricemia: An excess of uric acid in the blood

Hypoventilatory states: Breathing at an abnormally slow rate, resulting in an increased amount of carbon dioxide in the blood.

Alkalosis: An excessively alkaline condition of the body fluids or tissues, which may cause weakness or cramp.

Hypocalcaemia: Deficiency of calcium in the bloodstream.

Hypochloremic alkalosis: A metabolic disorder resulting from an increase in blood bicarbonate level secondary to loss of chloride from the body.