Usage instructions:
Dosage and directions for use:Citro-Soda granules and Citro-Soda cranberry granules:Adults:One to two 5 ml medicine measures (4 g to 8 g) in half a glass of cold water 3 to 4 times daily, taken on an empty stomach and followed with additional water. Drink after effervescence.Long-term therapy: One 5 ml (4 g) medicine measure daily.Children (6 to 12 years of age):One 5 ml medicine measure (4 g) in halt a glass of cold water 2 to 3 times daily, taken on an empty stomach and followed with additional water. Drink after effervescence.Citro-Soda orange tablets:Adults:One or two effervescent tablets in half a glass of cold water 3 to 4 times daily, taken on an empty stomach and followed with additional water Drink after effervescence.Long-term therapy One tablet daily. Children (6 to 12 years of age):One effervescent tablet in half a glass of cold water 2 to 3 times daily, taken on an empty stomach and followed with additional water. Drink after effervescence.

Storage instructions:
Store in a cool (below 25 degrees C), dry place.

Warnings:
Contraindications:Hypersensitivity to any of the ingredients in the preparations. Patients with severe renal disease, metabolic disturbances with alkalosis, hypocalcaemia or hypochlorhydria.Citro-Soda should not be given with urinary antiseptics which require an acid urine, such as methenamine mandelate and methenamine hippurate (see "Interactions").Phenylketonurics.Citro-Soda cranberry granules and Citro-Soda orange tablets contain phenylalanine.Use with care in patients suffering from renal insufficiency.Do not use this product if you are suffering from congestive cardiac failure or hypertension except under the advice and supervision of a doctor (see "side effects and special precautions").Alkalinising agents do not eradicate bacteriuria although they may temporarily relieve lower urinary tract-symptoms.Interactions:Antacids: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 hypernatraemia.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 crystalluna and nephrotoxicity.Salicylates:Concurrent use of salicylates with citrates may increase the urinary excretion and decrease the therapeutic effects of salicylates due to alkalinisation of the urine.Tetracyclines:Tetracycline absorption may be decreased when it is used concurrently with sodium bicarbonate because of the Increase in intragastric pH. Citro-Soda should not be taken within 1 to 2 hours of tetracyclines.Ketoconazole:Sodium bicarbonate may cause increased gastrointestinal pH; concurrent administration with sodium bicarbonate may result in a marked reduction in absorption of ketoconazole; patients should take Citro-Soda at least 2 hours after ketoconazole.Methenamine:Alkalinisation of the urine caused by sodium bicarbonate and citrates may reduce the effectiveness of methenamine by inhibiting its conversion to formaldehyde; concurrent use with Citro-Soda is not recommended.Pregnancy and lactation:Pregnancy:Studies regarding the effect of citrates on pregnancy have not been done.Nursing mothers:Caution should be exercised when administered to a nursing mother.Side effects and special precautions: side effects:The following convention is used to define the frequency of side effects: Very common (> 1/10), Common (> 1/100, < 1/10); Uncommon (> 1/1 000, < 1/100); Rare (> 1/10 000, < 1/1 000); Very rare (< 1/10 000) including isolated reports.Gastrointestinal disorders:The following side effects have been reported and the frequency data are not available: Abdominal distension, flatulence, belching and nausea may occur if the product is taken before effervescence is complete.Less frequently: Stomach cramps and laxative effect (diarrhoea or loose bowel movements) may occur.Metabolism and nutrition disorders:The following side effects have been reported and the frequency data are not available:Metabolic alkalosis (shortness of breath, muscle weakness and mental disturbances such as retlessness, convulsions and coma) may occur especially in patients with renal dysfunction.Excessive doses may lead to sodium overloading and hyperosmolality.Less frequently: Increased thirst.Very rarely: Hypernatraemia (dizziness; fast heartbeat, high blood pressure; irritability; muscle twitching; restlessness; seizures; swelling of feet or lower legs; weakness) may occur.Musculoskeletal and connective tissue disorders:The following side effects have been reported and the frequency data are not available:Muscle hypertonicity, twitching and tetany may develop, especially in hypocalcaemic patients.Special precautions:Caution should be used in patients with peptic ulceration and patients with renal abnormalities, to avoid the condition of metabolic alkalosis Patients with renal disease should have periodic determinations of serum electrolytes to ensure that acid-base balance is maintained.Should not be taken by patients on a sodium-restricted diet. Caution should also be observed in patients with cirrhosis of the liver, congestive heart failure or hypertension, peripheral and pulmonary oedema and pre-eclampsia.Known symptoms of overdosage and particulars of its treatment:Overdosage may result in metabolic alkalosis and hypernatraemia (see "side effects and special precautions").Symptomatic and supportive treatment should be instituted to correct fluid and electrolyte balance with complete withdrawal of the preparation.In these cases, regular electrolyte estimations should be taken and the necessary therapy instituted.Keep out of reach of children.

Information not available.