Tricitrates oral solution for renal tubular acidosis and cystinosis

Name of medicine

Tricitrates oral solution 

This leaflet is about the use of tricitrates oral solution for the treatment of renal tubular acidosis and cystinosis.

Why is it important for my child to take Tricitrates oral solution?

When the body produces energy, acid is produced as a waste product. The kidneys usually remove this from the blood. In renal tubular acidosis, the kidneys do not work properly and the amount of acid in the body builds up which can make a child feel unwell and affect their growth. Tricitrates oral solution is converted into bicarbonate which neutralises this acid build up.

There are several causes of renal tubular acidosis, including cystinosis.

What is Tricitrates oral solution available as?

Tricitrates oral solution is a liquid that contains sodium citrate, potassium citrate and citric acid. Each millilitre (mL) of the solution gives the equivalent of 2 mmol of bicarbonate, 1 mmol of sodium and 1 mmol of potassium.

The solution contains a very small amount of alcohol.

When should I give Tricitrates oral solution

Tricitrates oral solution is usually given three or four times a day.

• Three times a day: This should be in the morning, early afternoon and at bedtime. Ideally, these times are at least 6 hours apart, for example 8am, 2pm and 8pm.
• Four times a day: This is usually first thing in the morning, at about midday, late in the afternoon and at bedtime. Ideally, these times should be at least 4 hours apart, for example 8am, midday, 4pm and 8pm.

Give the medicine at about the same time(s) each day so that this becomes part of your child’s daily routine, which will help you to remember.

How much should I give?

Your doctor will work out the amount of tricitrates oral solution that is right for your child. The dose will be shown on the medicine label.

The dose may need to be adjusted from time to time. Your doctor will tell you if this is necessary.

How should I give Tricitrates oral solution?

Oral solution

• Measure out the right amount using a medicine spoon or oral syringe. You can get these from your pharmacist. Do not use a kitchen teaspoon as it will not give the right amount.
• Your child should have a drink of water or juice after taking the medicine.
• If your child has an upset stomach, measure out the right dose and mix it into a small glass of water or juice. Your child should drink this slowly over about 10 minutes.

When should the medicine start working?

This medicine starts to work straight away. You may not see an obvious difference but your child should feel better as their levels of bicarbonate or acid return to normal.

Your doctor will do blood tests to measure the amount of bicarbonate, so that they can tell how well the medicine is working and change the dose if necessary.

What if my child is sick (vomits)?

• If your child is sick less than 30 minutes after having a dose of Tricitrates oral solution, give them the same dose again.
• If your child is sick more than 30 minutes after having a dose of Tricitrates oral solution, do not give them another dose. Wait until the next normal dose.

If your child is sick again, seek advice from your family doctor, nurse, pharmacist, or hospital. They will decide what to do based on your child’s condition and the specific medicine involved.

What if I forget to give it?

If you miss a dose, wait until the next normal dose. Do not give the missed dose.

What if I give too much?

You are unlikely to cause harm if you give an extra dose of Tricitrates oral solution by mistake. If you are concerned that you may have given too much, contact your doctor or local NHS services (details at end of leaflet). Have the medicine or packaging with you if you telephone for advice.

Are there any possible side effects?

We use medicines to make our children better, but sometimes they have other effects that we don’t want (side-effects).

• When your child first starts taking tricitrates oral solution, they may get stomach pain and feel sick or be sick (vomit). Giving each dose with some food and plenty of water may help. This effect usually wears off after a few days. If it is still a problem after a week, contact your doctor.

There may sometimes be other side effects that are not listed above. If you notice anything unusual and are concerned, contact your doctor. You can report any suspected side effects to a UK safety scheme at mhra.gov.uk/yellowcard

Can other medicines be given at the same time as Tricitrates oral solution?

• You can give your child medicines that contain paracetamol or ibuprofen, unless your doctor has told you not to.

Check with your doctor or pharmacist before giving any other medicines to your child. This includes herbal and complementary medicines.

General advice about medicines

• Try to give medicines at about the same times each day, to help you remember.

• Only give this medicine to your child. Never give it to anyone else, even if their condition appears to be the same, as this could do harm.

• Make sure that you always have enough medicine. Order a new prescription at least 2 weeks before you will run out.

• Make sure that the medicines you have at home have not reached the ‘best before’ or ‘use by’ date on the packaging. Give old medicines to your pharmacist to dispose of.

Where should I keep this medicine?

• Keep the medicine in a cupboard, away from heat and direct sunlight.

• It does not need to be kept in the fridge.

• Make sure that children cannot see or reach the medicine.

• Keep the medicine in the container it came in.

Who to contact for more information?

Your child’s doctor, pharmacist or nurse will be able to give you more information about Tricitrates oral solution and about other medicines used to treat renal tubular acidosis and cystinosis.

Copyright disclaimer

Version [2]. © NPPG, RCPCH and WellChild, all rights reserved. Review by September 2017.

The primary source for the information in this leaflet is the British National Formulary for Children. For details on any other sources used for this leaflet, please contact us through our website, www.medicinesforchildren.org.uk.

We take great care to make sure that the information in this leaflet is correct and up-to-date. However, medicines can be used in different ways for different patients. It is important that you ask the advice of your doctor or pharmacist if you are not sure about something. This leaflet is about the use of these medicines in the UK, and may not apply to other countries. The Royal College of Paediatrics and Child Health (RCPCH), the Neonatal and Paediatric Pharmacists Group (NPPG), WellChild and the contributors and editors cannot be held responsible for the accuracy of information, omissions of information, or any actions that may be taken as a consequence of reading this leaflet.