AdultPediatricDosage Forms & Strengths citric acid/glucono-delta-lactone/magnesium carbonate renal irrigation solution (1980.6mg/59.4mg/980.4mg)/30mL single-use plastic bottle Renal Calculi Indicated for local irrigation for dissolution of renal calculi composed of apatite (a calcium carbonate-phosphate compound) or struvite (magnesium ammonium phosphates) in patients who are not candidates for surgical removal Also indicated as adjunctive therapy to dissolve residual apatite or struvite calculi and fragments after surgery or to achieve partial dissolution of renal calculi to facilitate surgical removal Instilled via nephrostomy tube to permit calculus lavage; use second catheter for drainage if calculi obstruct ureter Infuse NS at 60 mL/hr and increase until elevated pressure, pain, or maximum flow rate of 120 mL/hr reached Start flow of infusion at maximum rate achieved with NS Bladder Calculi Indicated or dissolution of bladder calculi of the struvite or apatite variety by local intermittent irrigation through a urethral catheter or cystostomy catheter as an alternative or adjunct to surgical procedures 30 mL instilled through a urinary catheter into the bladder and the catheter is clamped for 30-60 minutes, release clamp and drain bladder Repeat 4-6 times daily Urinary Catheter Incrustation Indicated for intermittent irrigation to prevent or minimize incrustations of indwelling urinary tract catheters Instill 30 mL of the solution through the catheter and then clamp catheter for 10 minutes, after which the clamp is removed to allow drainage of the bladder Repeat 3 times dailySafety and efficacy not established >10% Flank pain, transient (>50%) Fever (20-40%) Urothelial ulceration with or without edema (13%) Frequency Not Defined Urinary tract infection Back pain Dysuria Transient hematuria Nausea Hypermagnesemia Hyperphosphatemia Elevated serum creatinine Candidiasis Bladder irritability Septicemia Ileus Vomiting Thrombophlebitis 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 Cautions Obtain urine specimen and culture prior to 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 for infection and, therefore, antibiotic therapy should be continued throughout the course of dissolution therapy Discontinue immediately if the patient develops 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 prior to initiating therapy Concurrent use of magnesium containing medications may contribute to 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; cystogram prior to initiation irrigation is essential for such patients; if reflux 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 q3Days or less and at the first sign of fever Pregnancy Category: C; generally avoided in pregnancy Lactation: Magnesium is known to be excreted in human milk; unknown whether Renacidin components distributed in breast milk, caution advisedPregnancy Categories A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk. B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available. Mechanism of Action Action on susceptible apatite calculi results from an exchange of magnesium from the irrigating solution for calcium contained in the stone matrix; resulting magnesium salts formed are soluble in the glucono-citrate irrigating solution, thereby resulting in the calculus dissolution Struvite calculi are composed mainly of magnesium ammonium phosphates which are solubilized by Renacidin Irrigation due to its acidic pH (ie, 3.85) BRAND FORM. UNIT PRICE PILL IMAGE Renacidin irrigation- 1980.6 mg-59.4 mg-980.4mg/30mL solutionCopyright © 2010 First DataBank, Inc.Print Patient Educationcitric acid-gluconolactone-magnesium carbonate irrigation NO MONOGRAPH AVAILABLE AT THIS TIME USES: Consult your pharmacist. HOW TO USE: Consult your pharmacist. SIDE EFFECTS: Consult your pharmacist.In the US -Call your doctor for medical advice about side effects. You may report side effects to FDA at 1-800-FDA-1088 or at www.fda.gov/medwatch.In Canada - Call your doctor for medical advice about side effects. You may report side effects to Health Canada at 1-866-234-2345. PRECAUTIONS: Consult your pharmacist. DRUG INTERACTIONS: Consult your pharmacist.Keep a list of all your medications with you, and share the list with your doctor and pharmacist. OVERDOSE: If someone has overdosed and has serious symptoms such as passing out or trouble breathing, call 911. Otherwise, call a poison control center right away. US residents can call their local poison control center at 1-800-222-1222. Canada residents can call a provincial poison control center. NOTES: No monograph available at this time. MISSED DOSE: Consult your pharmacist. STORAGE: Consult your pharmacist.Do not flush medications down the toilet or pour them into a drain unless instructed to do so. Properly discard this product when it is expired or no longer needed. Consult your pharmacist or local waste disposal company for more details about how to safely discard your product. Information last revised July 2016. Copyright(c) 2023 First Databank, Inc. IMPORTANT: HOW TO USE THIS INFORMATION: This is a summary and does NOT have all possible information about this product. This information does not assure that this product is safe, effective, or appropriate for you. This information is not individual medical advice and does not substitute for the advice of your health care professional. Always ask your health care professional for complete information about this product and your specific health needs. FormularyPatient DiscountsAdding plans allows you to compare formulary status to other drugs in the same class.To view formulary information first create a list of plans. 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