Avosoda

Sodium bicarbonate, anhydrous sodium citrate, anhydrous citric acid, tartaric acid.

Each 4g sachet contains: Sodium Bicarbonate BP 1.760g, Sodium Citrate Anhydrous USP 0.630g, Anhydrous Citric Acid BP 0.720g, Tartaric Acid BP 0.890g.

Pharmacology: Sodium bicarbonate acts as urinary alkaliser by excretion of free bicarbonate ions in the urine, thus effectively raising the urinary pH. By maintaining alkaline urine, the actual dissolution of uric acid stones may be accomplished. It also acts as antacid by chemically neutralizing or buffering existing quantities of stomach acid but has no direct effect in its output. This action results in increased pH value of stomach contents, thus providing relief of hyperacidity symptoms.
Pharmacokinetics: Sodium citrate is metabolized to bicarbonates, which increases urinary pH by increasing the excretion of free bicarbonates ions, without producing systemic alkalosis when administered recommended doses. A rise in urinary ph increases the solubility of cysteine in the urine and the ionization of uric acid to more soluble urate iron. It also reacts chemically to neutralize or buffer existing quantities of gastric hydrochloride acid but has no direct effects in its output. Sodium bicarbonate is excreted through renal and also via lung by forming CO2. Sodium citrate, citric acid and absorbed tartaric acid are excreted through urine.

Urinary alkalinization where indicated in the treatment of mild urinary tract infections.
Symptomatic relief of dysuria.
To enhance the action of certain antibiotics especially sulfonamides.
In gout, especially when treated with uricosurics and possibly allopurinol.
Symptomatic treatment of gastric hyperacidity.

1-2 sachets (4g - 8g) in a glass contains 200ml of water, two to three times daily. Drink after the effervescence has settled down to avoid eructation.

Overdosage with sodium salts may cause serious electrolyte disturbances. Ingestion of large amounts of sodium citrate irritates the gastrointestinal mucosa & may result in diarrhea, nausea, vomiting, hypernoia, oedema & convulsions.

Patients with severe renal impairment and associated oliguria, azotaemia or anuria, untreated Addison's disease, acute dehydration; heat cramps and severe myocardial damage.
Not be given with urinary tract antiseptics that require acid urine, such as methenamine mandelate and methenamine hippurate.

Caution should be used in patients with peptic ulceration and patients with renal abnormalities, to avoid the condition of metabolic alkalosis.
Should not be taken by patients on a sodium-restricted diet.

Pregnancy: Use in pregnancy should be considered only when the possible benefits outweigh the potential risks.
Lactation: Use in nursing mothers should be considered only when the possible benefits outweigh the potential risks.

Excessive Doses of sodium salts may also lead to sodium overload and hyperosmolarity.
Large doses of oral citrate salts may result in gastrointestinal events such as diarrhea, nausea & vomiting, and laxative effects. Diluting with large amount of water and administration after meals can minimize these effects.

Antacid: Concurrent use of antacids with citrates may result in systemic alkalosis.
Concomitant administration of antacids with sodium citrate and sodium bicarbonate may promote the development of calcium stones in patients with uric acid stones and may also cause bypernatraemia.
Concurrent use of aluminium-containing antacids with citrate salts can increase aluminium absorption, possibly resulting in acute aluminium toxicity, especially in patients with renal insufficiency.
Quinolones: Citrates may reduce the solubility of ciprofloxacin, norfloxacin, or ofloxacin in the urine. Patients should be observed for signs of crystalluria and nephrotoxicity.
Salicylates: Concurrent use of salicylates with citrates may increase the urinary excretion and decrease the therapeutic effects of salicylates due to alkalinization of the urine.

Store below 30°C. Protect from moisture.
Shelf Life: 36 Months from the date of manufacture.

Other Drugs Acting on the Genito-Urinary System

B05CB02 - sodium citrate ; Belongs to the class of salt solutions used as irrigating solutions.

NP