Comprehensive medication guide to Sodium Citrate including estimated pricing, availability information, side effects, and how to find it in stock at your local pharmacy.
Estimated Insurance Pricing
$0–$20 copay on most insurance plans; typically Tier 1–2 on commercial and Medicare Part D formularies. Always request the generic to ensure lowest tier placement.
Estimated Cash Pricing
$25–$40 retail for a 16 oz (473 mL) bottle without insurance; as low as $6–$15 with a GoodRx or SingleCare coupon at most pharmacies for a 30-day supply.
Medfinder Findability Score
62/100
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Sodium Citrate is a prescription oral solution classified as a urinary alkalinizer and systemic alkalinizer. It is sold under brand names including Bicitra, Cytra-2, Oracit, and Virtrate, and is widely available in generic form as Sodium Citrate and Citric Acid Oral Solution USP. Each teaspoonful (5 mL) contains 500 mg of sodium citrate dihydrate and 334 mg of citric acid monohydrate, providing the equivalent of 1 mEq of bicarbonate per mL.
Sodium Citrate is primarily prescribed for metabolic acidosis (especially from chronic kidney disease and renal tubular acidosis), prevention of uric acid and calcium oxalate kidney stones, gout management via urinary alkalinization, and gastric acid neutralization prior to surgery. It is not a controlled substance and can be prescribed by any licensed prescriber, including via telehealth.
The FDA has not formally approved the labeling for Sodium Citrate and Citric Acid oral solution through the NDA/ANDA process, though the product is widely and legally prescribed and dispensed throughout the United States. The anticoagulant Sodium Citrate 4% solution for apheresis procedures is a separately FDA-approved product and should not be confused with the oral solution.
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Sodium Citrate works through a straightforward metabolic mechanism. After you swallow it, sodium citrate is absorbed from the intestinal tract into the bloodstream. In the liver, it is metabolized (converted) into sodium bicarbonate — the same compound as baking soda but generated naturally within the body's tissues.
This sodium bicarbonate neutralizes excess hydrogen ions (acid) in the blood, raising the blood pH back toward the normal range of 7.35–7.45. When the excess bicarbonate is filtered and excreted by the kidneys, it raises the urine pH as well — making the urine less acidic. This alkalinized urine environment makes it much harder for uric acid crystals to form (preventing uric acid kidney stones) and allows citrate to bind to calcium (preventing calcium oxalate stone formation).
The medication begins raising urine pH within a few hours of each dose. For blood chemistry correction in metabolic acidosis, measurable changes in serum bicarbonate appear within days to weeks of consistent therapy. Long-term benefits — like kidney stone prevention and slowing CKD progression — are measured over months to years of treatment.
500 mg/334 mg per 5 mL — oral solution
Standard concentration: 500 mg sodium citrate dihydrate / 334 mg citric acid monohydrate per 5 mL (1 teaspoonful). Available in 16 fl oz (473 mL) bottles.
Sodium Citrate is not listed on the FDA Drug Shortage Database as of early 2026. However, many patients experience significant difficulty finding it at their local pharmacies. This is because Sodium Citrate is a lower-volume liquid medication produced by a small number of manufacturers, and large pharmacy chains often do not keep it in regular stock.
Availability varies considerably by region and even by ZIP code. A pharmacy in one area may have plenty of stock while pharmacies in the next town are completely out. Independent pharmacies and mail-order pharmacies generally maintain better inventory than large chain retailers. Checking under all brand names — Bicitra, Cytra-2, Oracit, Virtrate — can reveal stock that a generic-only search might miss.
The most efficient way to find Sodium Citrate in stock is to use medfinder, which calls pharmacies near you to check which ones can fill your prescription and texts you the results — eliminating the frustration of calling pharmacies one by one.
Because Sodium Citrate is not a controlled substance, it can be prescribed by any licensed medical professional with prescribing authority. No special DEA license or waiver is required. The prescribing provider type typically depends on the underlying condition being treated:
Nephrologists — most commonly prescribe for chronic kidney disease, renal tubular acidosis, and metabolic acidosis
Urologists — frequently prescribe for recurrent kidney stone prevention
Primary Care Physicians, Internists, and Family Medicine Doctors — prescribe for straightforward stone prevention or mild metabolic acidosis
Rheumatologists — may prescribe for gout management
Pediatricians and Pediatric Nephrologists — prescribe for renal tubular acidosis and kidney stone prevention in children
Nurse Practitioners (NPs) and Physician Assistants (PAs) — can prescribe within their state scope of practice in any of the above specialties
Sodium Citrate is also available via telehealth in all 50 states. Telehealth platforms like Teladoc, MDLive, and specialty nephrology telehealth services can evaluate patients and prescribe this medication without an in-person visit, making it accessible to patients in rural or underserved areas.
No. Sodium Citrate is not a controlled substance and has no DEA scheduling. It carries no recognized abuse or dependence potential. This means it can be prescribed by any licensed prescriber — including physicians, nurse practitioners, and physician assistants — without a DEA-licensed prescription form.
Because it is not a controlled substance, Sodium Citrate can also be prescribed via telehealth in all 50 states without any special restrictions or limitations that apply to scheduled medications. Patients do not need to visit a provider in person to receive a Sodium Citrate prescription, making telehealth an accessible option for those managing kidney stones, metabolic acidosis, or gout remotely.
Most side effects are mild and gastrointestinal in nature, especially when taken without adequate water dilution or on an empty stomach:
Nausea
Vomiting
Diarrhea or loose stools (saline laxative effect)
Stomach cramping or pain
Fluid retention (edema) — more likely in patients with heart failure or hypertension
Hypernatremia (high sodium): confusion, excessive thirst, muscle weakness, fatigue
Metabolic alkalosis (over-alkalinization): muscle spasms, tingling in hands or face, lightheadedness, irritability
Allergic reaction (rare): hives, difficulty breathing, facial swelling — seek emergency care immediately
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Potassium Citrate (Cytra-K, Urocit-K)
Identical mechanism of action — alkalinizes blood and urine via bicarbonate. Preferred for patients on sodium-restricted diets (hypertension, heart failure). Available as oral solution and extended-release tablets.
Tricitrates (Cytra-3)
Combination of sodium citrate, potassium citrate, and citric acid. Provides alkalinization from both sodium and potassium pathways. Not appropriate for patients requiring restriction of either electrolyte.
Sodium Bicarbonate
Simpler alkalinizing agent available as tablets or powder. Effective for metabolic acidosis management; less optimal for kidney stone prevention compared to citrate formulations due to lack of direct citrate-calcium binding.
Allopurinol (Zyloprim)
For patients taking Sodium Citrate specifically for gout or uric acid stones: reduces uric acid production rather than alkalinizing urine. A complementary or alternative approach depending on clinical context.
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Aluminum-containing antacids (Gaviscon, Maalox, Mylanta)
majorSodium Citrate dramatically increases aluminum absorption from the GI tract, risking aluminum toxicity especially in CKD patients. Avoid concurrent use.
Eltrombopag (Promacta)
majorSodium Citrate reduces eltrombopag absorption significantly. Separate doses by at least 4 hours or avoid concurrent use.
Digoxin (Lanoxin)
moderateSodium Citrate increases gastric pH, enhancing digoxin absorption and potentially raising digoxin levels to toxic range. Monitor digoxin levels closely.
Atazanavir (Reyataz)
moderateRequires acidic stomach for absorption. Sodium Citrate raises gastric pH, reducing atazanavir levels significantly. Avoid or consult HIV specialist.
Tetracyclines (doxycycline, demeclocycline)
moderateSodium Citrate decreases absorption of tetracycline antibiotics. Separate doses by at least 2 hours.
Fluoroquinolones (levofloxacin, gemifloxacin)
moderateDecreased absorption when taken close to Sodium Citrate. Separate by at least 2 hours.
Itraconazole / Ketoconazole
moderateRequire acidic environment for absorption. Sodium Citrate reduces their effectiveness significantly. Consider alternative antifungals such as fluconazole.
Sodium Citrate and Citric Acid oral solution is a well-established, affordable medication for managing some of the most common chronic conditions in nephrology and urology. It is not a controlled substance, generally costs $6–$40 per month depending on insurance and pharmacy, and works through a well-understood mechanism of systemic and urinary alkalinization. For most patients, it is a foundational part of long-term kidney stone prevention and metabolic acidosis management.
The main challenge with Sodium Citrate in 2026 is not cost or access to a prescription — it's finding it in stock at your pharmacy. As a liquid medication from a concentrated manufacturer base, it can be inconsistently available at chain pharmacies. Independent pharmacies, mail-order pharmacies, and special orders are the most reliable strategies for keeping a steady supply.
If you're having trouble finding Sodium Citrate at a pharmacy near you, medfinder can call pharmacies in your area to identify which ones have it in stock and text you the results — taking the frustration out of the search so you can focus on managing your health.
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Our medication guides are researched and written to help patients make informed decisions. All content is reviewed for accuracy and updated regularly. Learn more about our standards
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