Citric Acid-Glucono-delta-lactone-Magnesium Carbonate

Citric Acid-Glucono-delta-lactone-Magnesium Carbonate is a combination medication used for the treatment of renal calculi, bladder calculi, and urinary catheter incrustation. 

• Citric Acid-Glucono-delta-lactone-Magnesium Carbonate is available under the following different brand names: Renacidin.

Common side effects of Citric Acid-Glucono-delta-lactone-Magnesium Carbonate include:

• Yeast infection,
• Nausea, and
• Swelling

Serious side effects of Citric Acid-Glucono-delta-lactone-Magnesium Carbonate include:

• Hives,
• Difficulty breathing,
• Swelling of the face, lips, tongue, or throat,
• Rash,
• Itching,
• Red, swollen, blistered, or peeling skin with or without fever,
• Wheezing,
• Tightness in the chest or throat,
• Difficulty swallowing or talking,
• Unusual hoarseness,
• Cloudy or pink urine,
• Frequent need to urinate,
• Fever,
• Stomach or pelvic pain,
• Confusion,
• Feeling sluggish,
• Shortness of breath,
• Upset stomach,
• Severe dizziness,
• Fainting,
• Lower back or side pain, and
• Bladder irritation

Rare side effects of Citric Acid-Glucono-delta-lactone-Magnesium Carbonate include:

• None 

Seek medical care or call 911 at once if you have the following serious side effects:

• Severe headache, confusion, slurred speech, arm or leg weakness, trouble walking, loss of coordination, feeling unsteady, very stiff muscles, high fever, profuse sweating, or tremors;
• Serious eye symptoms such as sudden vision loss, blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights;
• Serious heart symptoms include fast, irregular, or pounding heartbeats; fluttering in the chest; shortness of breath; sudden dizziness, lightheadedness, or passing out. 

This is not a complete list of side effects and other serious side effects or health problems that may occur because of the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may report side effects or health problems to FDA at 1-800-FDA-1088.

Adult dosage

Renal irrigation solution

• (1980.6 mg/59.4 mg/980.4 mg)/30 mL single-use plastic bottle

Renal Calculi

Adult dosage

• Infuse NS at 60 mL/hour and increase until elevated pressure, pain, or maximum flow rate of 120 mL/hour is reached.
• Start the flow of infusion at the maximum rate achieved with NS.

Bladder Calculi

Adult dosage

• 30 mL is instilled through a urinary catheter into the bladder and the catheter is clamped for 30-60 minutes, release the clamp, and drain the bladder.
• Repeat 4-6 times daily.

Urinary Catheter Incrustation

Adult dosage

• Instill 30 mL of the solution through the catheter and then clamp the catheter for 10 minutes, after which the clamp is removed to allow drainage of the bladder.

Dosage Considerations – Should be Given as Follows: 

• See “Dosages”

If your medical doctor is using this medicine to treat your pain, your doctor or pharmacist may already be aware of any possible drug interactions and may be monitoring you for them. Do not start, stop, or change the dosage of any medicine before checking with your doctor, health care provider, or pharmacist first.

• Citric Acid-Glucono-delta-lactone-Magnesium Carbonate has no noted severe interactions with any other drugs.
• Citric Acid-Glucono-delta-lactone-Magnesium Carbonate has no noted serious interactions with any other drugs.
• Citric Acid-Glucono-delta-lactone-Magnesium Carbonate has no noted moderate interactions with any other drugs.
• Citric Acid-Glucono-delta-lactone-Magnesium Carbonate has no noted minor interactions with any other drugs.

This information does not contain all possible interactions or adverse effects. Visit the RxList Drug Interaction Checker for any drug interactions. Therefore, before using this product, tell your doctor or pharmacist about all your products. Keep a list of all your medications with you and share this information with your doctor and pharmacist. Check with your healthcare professional or doctor for additional medical advice, or if you have health questions or concerns.

Contraindications

• Hypersensitivity
• Urinary tract infections (urea-splitting bacteria reside within struvite and apatite stones); dissolution therapy in the presence of an infected urinary tract may lead to sepsis and death.
• Treatment (dissolution) of calcium oxalate, uric acid, cysteine calculi

Effects of drug abuse

• None

Short-Term Effects

• See “What Are Side Effects Associated with Using Citric Acid-Glucono-delta-lactone-Magnesium Carbonate?”

Long-Term Effects

• See “What Are Side Effects Associated with Using Citric Acid-Glucono-delta-lactone-Magnesium Carbonate?”

Cautions

• Obtain urine specimen and culture before initiating chemolytic therapy and treat with appropriate antibiotic therapy if infection evident
• Demonstrable urinary tract extravasation
• An infected stone can serve as a continual source of infection and, therefore, antibiotic therapy should be continued throughout dissolution therapy
• Discontinue immediately if the patient develops a fever, urinary tract infection, signs, and symptoms consistent with urinary tract infection, or persistent flank pain.
• Discontinue if hypermagnesemia or elevated serum creatinine develops.
• Sterile urine must be present before initiating therapy
• Concurrent use of magnesium-containing medications may contribute to the production of hypermagnesemia
• Maintain patency of the irrigating catheter; calculus fragments and debris may obstruct the outflow catheter
• Intrapelvic pressures must be maintained at or below 25cm of water.
• Patients with indwelling urethral or cystostomy catheters frequently have vesicoureteral reflux; a cystogram before initiation irrigation is essential for such patients; if reflux is demonstrated, all precautions recommended for renal pelvis irrigation must be taken
• Monitor serum creatinine, phosphate, and magnesium every several days.
• Urine specimens should be collected for culture and antibacterial sensitivity every 3 days or less and at the first sign of fever.

Pregnancy and Lactation

• Use with caution if the benefits outweigh the risks during pregnancy. Generally avoided in pregnancy.
• Lactation
  • Magnesium is known to be excreted in human milk; unknown whether Rimocidin components are distributed in breast milk, caution is advised.