Tricitrates oral solution for renal tubular acidosis and cystinosis

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Tricitrates oral solution for renal tubular acidosis and cystinosis

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

Information-StandardThis leaflet has been written for parents and carers about how to use this medicine in children. Our information sometimes differs from that provided by the manufacturers, because their information is usually aimed at adult patients. Please read this leaflet carefully. Keep it somewhere safe so that you can read it again.

Name of drug

Tricitrates oral solution

Why is it important for my child to take this medicine?

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?

The solution is usually given three or four times a day. Your doctor will tell you how often to give it. Space out the times out evenly as you can. 

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

Give the medicine at about the same times 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.

It is important that you follow your doctor’s instructions about how much to give.

How should I give it?

Liquid-medicineMeasure 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, you do not need to give them another dose. Wait until the next normal dose.

What if I forget to give it?

Do not give the missed dose. Give the next dose as usual.

What if I give too much?

It is unlikely that you will cause any harm if you give your child too much tricitrates solution by mistake. If you are worried, contact your doctor or local NHS services (111 in England and Scotland; 0845 4647 in Wales).

Have the medicine container 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 http://www.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, 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 or 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.
  • If you think someone else may have taken the medicine by accident, contact your doctor straight away.
  • 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 medicine you have at home has 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.

You can also get useful information from: 
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