inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.nebivololsodium citrate/citric acid decreases levels of nebivolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.nitrofurantoinsodium citrate/citric acid decreases levels of nitrofurantoin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.omadacyclinesodium citrate/citric acid will decrease the level or effect of omadacycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.pamidronatesodium citrate/citric acid decreases levels of pamidronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.penbutololsodium citrate/citric acid decreases levels of penbutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.penicillaminesodium citrate/citric acid decreases levels of penicillamine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.perindoprilsodium citrate/citric acid decreases effects of perindopril by unspecified interaction mechanism. Use Caution/Monitor.pindololsodium citrate/citric acid decreases levels of pindolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.polysaccharide ironsodium citrate/citric acid will decrease the level or effect of polysaccharide iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.posaconazolesodium citrate/citric acid will decrease the level or effect of posaconazole by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.propranololsodium citrate/citric acid decreases levels of propranolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.pseudoephedrinesodium citrate/citric acid will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.quinaprilsodium citrate/citric acid decreases effects of quinapril by unspecified interaction mechanism. Use Caution/Monitor.quinidinesodium citrate/citric acid will increase the level or effect of quinidine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor. Elevated quinidine plasma levels, possibly with cardiac conduction disturbances and arrhythmias, may occur. ramiprilsodium citrate/citric acid decreases effects of ramipril by unspecified interaction mechanism. Use Caution/Monitor.risedronatesodium citrate/citric acid decreases levels of risedronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.rose hipssodium citrate/citric acid will decrease the level or effect of rose hips by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.rosuvastatinsodium citrate/citric acid decreases levels of rosuvastatin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.sarecyclinesodium citrate/citric acid will decrease the level or effect of sarecycline by inhibition of GI absorption. Applies only to oral form of both agents. Modify Therapy/Monitor Closely. Multivalent cation-containing products may impair absorption of tetracyclines, which may decrease its efficacy. Separate dosing of tetracyclines from these products.sotalolsodium citrate/citric acid decreases levels of sotalol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.tiludronatesodium citrate/citric acid decreases levels of tiludronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.timololsodium citrate/citric acid decreases levels of timolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.tolbutamidesodium citrate/citric acid will increase the level or effect of tolbutamide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.trandolaprilsodium citrate/citric acid decreases effects of trandolapril by unspecified interaction mechanism. Use Caution/Monitor.ursodiolsodium citrate/citric acid decreases effects of ursodiol by pharmacodynamic antagonism. Use Caution/Monitor.zoledronic acidsodium citrate/citric acid decreases levels of zoledronic acid by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.Minor (15)aspirinsodium citrate/citric acid, aspirin. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).aspirin rectalsodium citrate/citric acid, aspirin rectal. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).aspirin/citric acid/sodium bicarbonatesodium citrate/citric acid, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).balsalazidesodium citrate/citric acid, balsalazide. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).blessed thistleblessed thistle decreases effects of sodium citrate/citric acid by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.choline magnesium trisalicylatesodium citrate/citric acid, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).chromiumsodium citrate/citric acid decreases levels of chromium by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Separate by 2 hours.devil's clawdevil's claw decreases effects of sodium citrate/citric acid by pharmacodynamic antagonism. Minor/Significance Unknown.diflunisalsodium citrate/citric acid, diflunisal. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).mesalaminesodium citrate/citric acid, mesalamine. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).salicylates (non-asa)sodium citrate/citric acid, salicylates (non-asa). Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).salsalatesodium citrate/citric acid, salsalate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).strontium ranelatesodium citrate/citric acid decreases levels of strontium ranelate by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Separate by 2 hr when possible.sulfasalazinesodium citrate/citric acid, sulfasalazine. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).willow barksodium citrate/citric acid, willow bark. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).acebutololMonitor Closely (1)sodium citrate/citric acid decreases levels of acebutolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.alendronateMonitor Closely (1)sodium citrate/citric acid decreases levels of alendronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.allopurinolMonitor Closely (1)sodium citrate/citric acid decreases levels of allopurinol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.ampicillinMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of ampicillin by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.aspirinMinor (1)sodium citrate/citric acid, aspirin. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).aspirin rectalMinor (1)sodium citrate/citric acid, aspirin rectal. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).aspirin/citric acid/sodium bicarbonateMinor (1)sodium citrate/citric acid, aspirin/citric acid/sodium bicarbonate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).atazanavirSerious - Use Alternative (1)sodium citrate/citric acid will decrease the level or effect of atazanavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.atenololMonitor Closely (1)sodium citrate/citric acid decreases levels of atenolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.azithromycinMonitor Closely (1)sodium citrate/citric acid decreases levels of azithromycin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.balsalazideMinor (1)sodium citrate/citric acid, balsalazide. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).bearberryMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of bearberry by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.benazeprilMonitor Closely (1)sodium citrate/citric acid decreases effects of benazepril by unspecified interaction mechanism. Use Caution/Monitor.benzphetamineMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of benzphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.betaxololMonitor Closely (1)sodium citrate/citric acid decreases levels of betaxolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.bisoprololMonitor Closely (1)sodium citrate/citric acid decreases levels of bisoprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.blessed thistleMinor (1)blessed thistle decreases effects of sodium citrate/citric acid by pharmacodynamic antagonism. Minor/Significance Unknown. Theoretical interaction.capecitabineMonitor Closely (1)sodium citrate/citric acid increases levels of capecitabine by enhancing GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.captoprilMonitor Closely (1)sodium citrate/citric acid decreases effects of captopril by unspecified interaction mechanism. Use Caution/Monitor. Sodium citrate/citric acid may decrease absorption of captopril.carbonyl ironMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of carbonyl iron by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.carvedilolMonitor Closely (1)sodium citrate/citric acid decreases levels of carvedilol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.cefpodoximeMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of cefpodoxime by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.celecoxibMonitor Closely (1)sodium citrate/citric acid decreases levels of celecoxib by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.celiprololMonitor Closely (1)sodium citrate/citric acid decreases levels of celiprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.chenodiolMonitor Closely (1)sodium citrate/citric acid decreases levels of chenodiol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.choline magnesium trisalicylateMinor (1)sodium citrate/citric acid, choline magnesium trisalicylate. Mechanism: passive renal tubular reabsorption due to increased pH. Minor/Significance Unknown. Salicylate levels increased at moderate doses; salicylate levels decreased at large doses (d/t increased renal excretion of unchanged salicylic acid).chromiumMinor (1)sodium citrate/citric acid decreases levels of chromium by inhibition of GI absorption. Applies only to oral form of both agents. Minor/Significance Unknown. Separate by 2 hours.ciprofloxacinMonitor Closely (1)sodium citrate/citric acid decreases levels of ciprofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. A large proportion of ciprofloxacin is normally excreted unchanged in the urine. When urinary alkalinizing agents such as sodium citrate are used concomitantly, the solubility of ciprofloxacin can be decreased because of alkaline urine. Patients should be monitored for crystalluria and nephrotoxicity.dapsoneSerious - Use Alternative (1)sodium citrate/citric acid will decrease the level or effect of dapsone by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.dasatinibSerious - Use Alternative (1)sodium citrate/citric acid will decrease the level or effect of dasatinib by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.deferoxamineMonitor Closely (1)deferoxamine decreases levels of sodium citrate/citric acid by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Deferoxamine chelates iron; its affinity for other minerals is unknown.demeclocyclineSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of demeclocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by