Polycitra used for Relief of discomfort in mild urinary-tract infections & Alkalinisation of urine,

1 mL of oral solution contains 2 mEq of bicarbonate, 1 mEq of sodium, and 1 mEq of potassium. Each 5ml solution gives 10meq of

HCO3+

INDICATIONS AND USE IN Neonates: Treatment of metabolic acidosis or as a urinary alkalinizing agent for conditions that require the maintenance of alkaline urine. ACTIONS: Sodium and potassium citrate salts are capable of buffering gastric acidity (pH >2.5) and are metabolized to bicarbonate to act as systemic alkalinizers.

DOSAGE:

PO. •2 to 3 mEq/kg/day of bicarbonate in divided doses 3 to 4 times per day with water.

Note Theses ADVERSE EFFECTS:

Metabolic alkalosis, hypernatremia (if sodium salt used), hypocalcemia, hyperkalemia (if potassium salt used), diarrhea.

Ref: Gomella Neonatology 8th edition.

Renal tubular acidosis (RTA), distal (Type 1): Limited data available: Note: Dose requirements may vary with age. Infants, Children, and Adolescents: Oral: Usual dose: 2 to 4 mEq bicarbonate/kg/day (1 to 2 mL/kg/day) in divided doses; reported range: 1 to 7 mEq bicarbonate/kg/day; adjust dose to maintain target serum CO2 (Chan 2001; Kliegman 2016; Rodríguez Soriano 2002; Santos 1986).

Renal tubular acidosis (RTA), proximal (Type 2): Limited data available: Note: Dose requirements may vary with age; for Type 2 RTA, bicarbonate doses are higher than those required for other types of RTA. Infants, Children, and Adolescents: Oral: Usual range: 10 to 20 mEq bicarbonate/kg/day (5 to 10 mL/kg/day) in divided doses (Chan 2001; Kliegman 2016; Rodríguez Soriano 2002); Note: May not be appropriate as monotherapy in some cases due to high therapeutic alkali requirement and corresponding potassium load; could be used in combination with sodium citrate formulations to meet alkali needs (Rodríguez Soriano 2002).

Systemic alkalinization; chronic:

Volume-based dosing: Children and Adolescents: Oral: 5 to 15 mL (10 to 30 mEq bicarbonate) per dose after meals and at bedtime.

Weight-based dosing (mEq bicarbonate/kg): Limited data available: Infants, Children, and Adolescents: Oral: 2 to 3 mEq bicarbonate/kg/day (1 to 1.5 mL/kg/day) in 3 to 4 divided doses; adjust dose to targeted serum bicarbonate levels; typical adult doses do not exceed 60 mEq/dose (30 mL/dose) (Gal 2007).