Drug Interactions between citric acid/sodium citrate and dihydroxyaluminum sodium carbonate

Citrate, or citric acid, can increase the absorption of dihydroxyaluminum sodium carbonate. This may lead to elevated blood levels of aluminum, particularly in individuals with reduced kidney function, since aluminum is primarily eliminated by the kidneys. Excess aluminum may deposit and cause problems in various tissues including bone, brain, heart, liver, muscles, and spleen. Over time, weak bones, bone pain, fractures, skeletal deformity, brain disorders, and anemia may develop. Talk to your doctor before using dihydroxyaluminum sodium carbonate if you have kidney impairment or are on hemodialysis. You should avoid or limit the consumption of citrate-containing foods and beverages (e.G., soft drinks, citrus fruits, fruit juices) during treatment with dihydroxyaluminum sodium carbonate. Be aware that some effervescent and dispersible drug formulations may also contain citrate and should be restricted as well. Even if you do not have kidney problems, it may be best to separate the dosing of dihydroxyaluminum sodium carbonate and citrate-containing products by 2 to 3 hours. Talk to a healthcare professional if you have any questions or concerns. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medications without first talking to your doctor.

When dihydroxyaluminum sodium carbonate is taken during enteral nutrition therapy (tube feeding), the tube may get clogged. Therefore, dihydroxyaluminum sodium carbonate should not be mixed with or given after high-protein tube feedings. The dose should be separated from the feeding by as much as possible, and the tube should be thoroughly flushed before administration of the dose.