Dose: 0.5 to 2 mEq/kg/Day PO as starting dose          

Comments:  Sodium citrate is administered with feedings to treat metabolic acidosis.  It is rapidly absorbed and converted to sodium bicarbonate. Prior to absorption, it acts as an antacid. Sodium citrate is useful in the prevention of uric acid calculi due to increased uric acid excretion in the urinary tract. Sodium citrate is effective for treating long-term metabolic acidosis. It should not be used when an aluminum-containing antacid is being administered. Each ml contains one mEq of sodium and is equivalent to one mEq of bicarbonate.

Toxicity: Excessive sodium administration may cause hypernatremia. Excessive intake may lead to diarrhea, nausea, and vomiting. Serum electrolytes should be followed to avoid excessive alkalinization (more likely to occur if renal function is marginal) and in the presence of hypocalcemia.

Preparation:  Sodium citrate (Bicitra) is available in a 4 ounce bottle.  Stable at room temperature.  May dilute dose with water.