This medication is used to make the urine less acidic. This effect helps the kidneys get rid of uric acid, thereby helping to prevent gout and kidney stones. This medication can also prevent and treat certain metabolic problems (acidosis) caused by kidney disease.

Citric acid and citrate salts (which contain potassium and sodium) belong to a class of drugs known as urinary alkalinizers. If you have a condition that requires you to limit your intake of potassium and sodium, your doctor may direct you to take a product that is lower in potassium and sodium.

Take this medication by mouth as directed by your doctor, usually 4 times a day after meals and at bedtime. To help prevent diarrhea, take each dose after a meal. To prevent stomach upset/injury, mix your prescribed dose of medication in cold water or juice as directed. Drink the entire mixture slowly. If you still have stomach upset, mixing your dose in a larger amount of liquid may help unless your doctor directs you otherwise. Ask your doctor or pharmacist for further instructions.

The liquid form of this medication must be mixed with at least 4 - 8 ounces (120 - 240 milliliters) of water before taking. Shake the bottle well before each dose and carefully measure the dose using a special measuring device/spoon. Do not use a household spoon because you may not get the correct dose. If you are using the powdered/crystal form of this medication, mix the contents of the packet in at least 3/4 cup (6 ounces or 180 milliliters) of cool water or juice before taking.

Refrigerating the mixture before drinking may improve the taste. Drink more water or juice after taking this medication unless otherwise directed by your doctor.

Dosage is based on your medical condition and response to treatment.

Take this medication exactly as prescribed. Do not increase your dose or take this more often without your doctor's approval. Use this medication regularly to get the most benefit from it. To help you remember, take it at the same times each day.

While taking this medication, you may need to test the pH (acidity) of your urine using special paper. The pH will help determine the proper dose. Consult your doctor or pharmacist for more information.

Nausea, vomiting, diarrhea, and stomach pain may occur. Mixing the medication with water or juice, taking it after meals, and drinking more fluids will help prevent these side effects. If any of these effects last or get worse, tell your doctor or pharmacist promptly.

Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects. Many people using this medication do not have serious side effects.

Tell your doctor right away if you have any serious side effects, including:

• severe stomach/abdominal pain
• tingling/numbness of the hands/feet
• weakness
• fast/slow/irregular heartbeat
• mental/mood changes (such as confusion, restlessness)
• muscle spasms
• seizures
• bloody/black/tarry stools
• vomit that looks like coffee grounds

A very serious allergic reaction to this drug is rare. However, get medical help right away if you notice any symptoms of a serious allergic reaction, including:

• rash
• itching/swelling (especially of the face/tongue/throat)
• severe dizziness
• trouble breathing

This is not a complete list of possible side effects. If you notice other effects not listed above, contact your doctor or pharmacist.

In the US - Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.

In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345.

Before taking this medication, tell your doctor or pharmacist if you are allergic to it; or if you have any other allergies. This product may contain inactive ingredients, which can cause allergic reactions or other problems. Talk to your pharmacist for more details.

Before using this medication, tell your doctor or pharmacist your medical history, especially of:

• underactive adrenal gland (Addison's disease)
• heart disease (such as recent heart attack, irregular heartbeat, heart failure)
• kidney disease
• potassium-restricted diet
• high potassium levels
• dehydration
• low calcium levels
• stomach/gut problems (such as peptic ulcers, irritable bowel)

Liquid forms of this product may contain sugar. Caution is advised if you have diabetes. Ask your doctor or pharmacist about using this product safely.

During pregnancy, this medication should be used only when clearly needed. Discuss the risks and benefits with your doctor.

It is unknown if this drug passes into breast milk. Consult your doctor before breastfeeding.

Drug interactions may change how your medications work or increase your risk for serious side effects. This document does not contain all possible drug interactions. Keep a list of all the products you use (including prescription/nonprescription drugs and herbal products) and share it with your doctor and pharmacist. Do not start, stop, or change the dosage of any medicines without your doctor's approval.

Some products that may interact with this drug are:

• antacids that contain aluminum
• aspirin and other salicylates (such as salsalate)
• certain blood pressure medications (including ACE inhibitors such as lisinopril, angiotensin blockers such as losartan)
• drospirenone
• eplerenone
• certain heart medications (such as quinidine, digoxin)
• lithium
• potassium supplements
• certain "water pills" (potassium-sparing diuretics such as amiloride, spironolactone, triamterene)

If your doctor has told you to take low-dose aspirin to prevent heart attack or stroke (usually 81-162 milligrams a day), you should keep taking the aspirin unless your doctor tells you not to. Ask your doctor or pharmacist for more details.

If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call 1-800-222-1222. Canada residents can call 1-844-764-7669. Symptoms of overdose may include: slow heartbeat, muscle spasms, seizures.

Do not share this medication with others.

Lab and/or medical tests (such as potassium levels) should be done while you are taking this medication. Keep all medical and lab appointments. Consult your doctor for more details.

If you miss a dose, take it as soon as you remember. If it is near the time of the next dose, skip the missed dose. Take your next dose at the regular time. Do not double the dose to catch up.

Store at room temperature away from heat, light, and moisture. Do not freeze. Do not store in the bathroom. Keep all medications away from children and pets.

Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company.