sodium citrate/citric acid

Action and Spectrum

Actions and Spectrum 

sodium citrate/citric acid work by chelating the calcium ions in the blood, which are essential for the coagulation cascade to start. The medication lowers the risk of blood clotting during medical procedures by binding to calcium ions, which prevents blood clot formation. 

The range of bacteria that the medication is effective against is referred to as the sodium citrate and citric acid spectrum. They do not have a wide range of activity against microbes because they are not commonly utilised as antimicrobial agents. 

Drug Interaction

Adverse Reaction

Frequency not defined  

Metabolic alkalosis 

Vomiting 

Fluid retention 

Stomach pain 

Diarrhea 

Nausea 

Tetany 

Black Box Warning

Black Box Warning 

sodium citrate/citric acid do not have any black box warnings associated with their use as an anticoagulant drug. 

Contraindication / Caution

Contraindication/Caution: 

• Patients with a known hypersensitivity to any of the drug’s ingredients should not take sodium citrate or citric acid. 
• Patients who have hypercalcemia should use the medication with caution because it can make it worse. 
• When administering sodium citrate and citric acid, patients with renal impairment may be more susceptible to metabolic alkalosis and hypocalcaemia, hence the medication should be administered with caution in these patients. 
• Patients receiving sodium citrate and citric acid may have an increased risk of developing metabolic alkalosis, hence the medication should be used with caution in these patients. 

Pregnancy / Lactation

Pregnancy warnings:     

Pregnancy category: C 

Lactation: Excretion into human milk is unknown  

Pregnancy Categories:         

Category A: Studies that were well-controlled and met expectations revealed no risk to the fetus in either the first or second trimester. 

Category B: There were lack of studies on pregnant women and no evidence of risk to the foetus in animal experiments.   

Category C: there was evidence of risk of adverse effects in animal reproduction studies, and no adequate evidence in human studies must take care of potential risks in pregnant women.    

Category D: adequate data available with sufficient evidence of human fetal risk from various platforms, but despite the potential risk, and used only in emergency cases for potential benefits.   

Category X: Drugs listed in this category outweigh the risks over benefits. Hence these categories of drugs need to be avoided by pregnant women.    

Category N: There is no data available for the drug under this category

Pharmacology

Pharmacology 

A combination medication that contains both sodium citrate/citric acid is used as an anticoagulant to stop blood clotting. The drug’s pharmacology is based on its capacity to bind to or chelate calcium ions in the blood.  

sodium citrate/citric acid prevent blood clots by attaching calcium ions, which lowers the risk of clotting during medical treatments like hemodialysis or blood transfusions. 

Pharmacodynamics 

sodium citrate/citric acid function by building complexes with calcium ions, which results in the production of a soluble calcium-citrate complex that cannot take part in the coagulation cascade.  

sodium citrate/citric acid both have an anticoagulant effect, but their effects are dose-dependent, with higher doses causing a greater decrease in coagulation factors. With anticoagulant effects appearing minutes after delivery, the medication has a relatively quick beginning of action and a brief half-life, with effects typically lasting 4 to 6 hours. 

Pharmacokinetics 

Absorption   

When given intravenously, sodium citrate/citric acid is quickly absorbed into the bloodstream. 

Distribution 

The medication is widely dispersed throughout the body, with the citrate component mainly found in extracellular fluid and the citric acid component mainly found in intracellular fluid. 

Metabolism 

The liver is the primary site of metabolism for sodium citrate/citric acid, where they are converted to carbon dioxide and water. Bicarbonate ions may be produced during the drug’s metabolism, and these ions can help to buffer excess acid in the blood. 

Elimination and excretion 

The medicine is mostly excreted in the urine, with any remaining drug being filtered by the kidneys and expelled in the urine after not being metabolized. The medicine has a relatively short half-life for elimination, between 2 to 3 hours. 

Adminstartion

Administration:  

sodium citrate/citric acid given intravenously. 

The rate of administration should be based on the patient’s state and the drug should be given gently over a period of several minutes. 

Patient Information Leaflet

Patient information leaflet 

Generic Name: sodium citrate/citric acid 

Why do we use sodium citrate/citric acid? 

The main purpose of sodium citrate/citric acid is to act as an anticoagulant during medical treatments like haemodialysis and blood transfusions to stop blood clotting. 

They are used in haemodialysis to stop blood coagulation in the extracorporeal circuit.  

They are used in blood transfusions to stop the blood from clotting while it is being stored and administered.  

To keep the blood from clotting and to make sure that the transfused blood stays liquid and viable, the medication is given to the blood product.