Drug reference

Citric acid with magnesium carbonate

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 76

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

Bowel evacuation for surgery, colonoscopy or radiological examination ▶BY MOUTH ▶Child 5–9 years: One-third of a sachet to be given at 8 a.m. the day before the procedure and, one-third of a sachet to be given between 2 and 4 p.m. the day before the procedure ▶Child 10–17 years: 0.5–1 sachet, given at 8 a.m. the day before the procedure and 0.5–1 sachet, given between 2 and 4 p.m. the day before the procedure ▶Adult: 1 sachet, given 8 a.m. the day before the procedure and 1 sachet, given between 2 and 4 p.m. the day before the procedure, use half the dose in frail elderly patients

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Contra Indications

Acute intestinal or gastric ulceration. acute severe colitis. gastric retention. gastro- intestinal obstruction. gastro-intestinal perforation. toxic megacolon

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Cautions

Debilitated. elderly. hypovolaemia (should be corrected before administration of bowel cleansing preparations). patients with ﬂuid and electrolyte disturbances CAUTIONS, FURTHER INFORMATION Adequate hydration should be maintained during treatment.

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Prescribing And Dispensing Information

Reconstitution of one sachet containing 11.57 g magnesium carbonate and 17.79 g anhydrous citric acid produces a solution containing magnesium citrate with 118 mmol Mg2+. Flavours of oral powders may include lemon and lime.

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Safety

Interactions

→Appendix 1: bowel cleansing preparations

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Side Effects

▶Common or very common Gastrointestinal discomfort. nausea. vomiting ▶Uncommon Dehydration. dizziness. electrolyte imbalance . headache SIDE-EFFECTS, FURTHER INFORMATION Abdominal pain is usually transient and can be reduced by taking preparation more slowly.

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Pregnancy

Use with caution.

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Breast Feeding

Use with caution.

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Renal Impairment

▶In adults Avoid if eGFR less than 30 mL/minute/1.73 m2— risk of hypermagnesaemia. ▶In children Avoid if estimated glomerular ﬁltration rate less than 30 mL/minute/1.73 m2—risk of hypermagnesaemia.

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Monitoring Requirements

Renal function should be measured before starting treatment in patients at risk of ﬂuid and electrolyte disturbances.

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Dose and formulations

Directions For Administration

One sachet should be reconstituted with 200 mL of hot water; the solution should be allowed to cool for approx. 30 minutes before drinking.

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Medicinal Forms

There can be variation in the licensing of different medicines containing the same drug. Effervescent powder CAUTIONARY AND ADVISORY LABELS 13, 10 ELECTROLYTES: May contain Magnesium ▶Citramag (Sanochemia Diagnostics UK Ltd) Magnesium carbonate heavy 11.57 gram, Citric acid anhydrous 17.79 gram Citramag effervescent powder sachets sugar-free | 10 sachet p £20.50 DT = £20.50

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Clinical care

Patient And Carer Advice

Low residue or ﬂuid only diet (e.g. water, fruit squash, clear soup, black tea or coffee) recommended before procedure (according to prescriber’s advice) and copious intake of clear ﬂuids recommended until procedure. Patient or carers should be given advice on how to administer oral powder.

PDF page 76

Dose text by age group

Child 5–9 years

One-third of a sachet to be given at

First-line fragment. Read the complete Indications and Dose section above.

PDF page 76

Child 10–17 years

0.5–1 sachet, given at 8 a.m. the day

First-line fragment. Read the complete Indications and Dose section above.

PDF page 76

Adult

1 sachet, given 8 a.m. the day before the

First-line fragment. Read the complete Indications and Dose section above.

PDF page 76

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.

Drug reference

Citric acid with magnesium carbonate

BNF 80 (2020–2021)

Source: BNF 80 (2020–2021)
PDF pages: 76

Review source pages for extracted sections and age labels. BNF dose snippets show only their first line.

Overview

Indications And Dose

PDF page 76

Contra Indications

Acute intestinal or gastric ulceration. acute severe colitis. gastric retention. gastro- intestinal obstruction. gastro-intestinal perforation. toxic megacolon

PDF page 76

Cautions

PDF page 76

Prescribing And Dispensing Information

PDF page 76

Safety

Interactions

→Appendix 1: bowel cleansing preparations

PDF page 76

Side Effects

PDF page 76

Pregnancy

Use with caution.

PDF page 76

Breast Feeding

Use with caution.

PDF page 76

Renal Impairment

PDF page 76

Monitoring Requirements

Renal function should be measured before starting treatment in patients at risk of ﬂuid and electrolyte disturbances.

PDF page 76

Dose and formulations

Directions For Administration

One sachet should be reconstituted with 200 mL of hot water; the solution should be allowed to cool for approx. 30 minutes before drinking.

PDF page 76

Medicinal Forms

PDF page 76

Clinical care

Patient And Carer Advice

PDF page 76

Dose text by age group

Child 5–9 years

One-third of a sachet to be given at

First-line fragment. Read the complete Indications and Dose section above.

PDF page 76

Child 10–17 years

0.5–1 sachet, given at 8 a.m. the day

First-line fragment. Read the complete Indications and Dose section above.

PDF page 76

Adult

1 sachet, given 8 a.m. the day before the

First-line fragment. Read the complete Indications and Dose section above.

PDF page 76

Age labels are extracted for navigation. Check the complete source section and current local guidance before clinical use.