2 hours.devil's clawMinor (1)devil's claw decreases effects of sodium citrate/citric acid by pharmacodynamic antagonism. Minor/Significance Unknown.dextroamphetamineMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of dextroamphetamine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.diflunisalMinor (1)sodium 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).digoxinSerious - Use Alternative (1)sodium citrate/citric acid will increase the level or effect of digoxin by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.doxycyclineSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of doxycycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.eltrombopagSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of eltrombopag by inhibition of GI absorption. Applies only to oral form of both agents. Contraindicated. Separate by at least 4 hours.enalaprilMonitor Closely (1)sodium citrate/citric acid decreases effects of enalapril by unspecified interaction mechanism. Use Caution/Monitor.ephedrineMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of ephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.erythromycin baseMonitor Closely (1)sodium citrate/citric acid increases levels of erythromycin base by unknown mechanism. Use Caution/Monitor.erythromycin ethylsuccinateMonitor Closely (1)sodium citrate/citric acid increases levels of erythromycin ethylsuccinate by unknown mechanism. Use Caution/Monitor.erythromycin lactobionateMonitor Closely (1)sodium citrate/citric acid increases levels of erythromycin lactobionate by unknown mechanism. Use Caution/Monitor.erythromycin stearateMonitor Closely (1)sodium citrate/citric acid increases levels of erythromycin stearate by unknown mechanism. Use Caution/Monitor.esmololMonitor Closely (1)sodium citrate/citric acid decreases levels of esmolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.etidronateMonitor Closely (1)sodium citrate/citric acid decreases levels of etidronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.ferric maltolMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of ferric maltol by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.ferrous fumarateMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of ferrous fumarate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.ferrous gluconateMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of ferrous gluconate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.ferrous sulfateMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of ferrous sulfate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.flecainideMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of flecainide by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.fleroxacinSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of fleroxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.fosamprenavirMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of fosamprenavir by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.fosinoprilMonitor Closely (1)sodium citrate/citric acid decreases effects of fosinopril by unspecified interaction mechanism. Use Caution/Monitor.gabapentinMonitor Closely (1)sodium citrate/citric acid decreases levels of gabapentin by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.gabapentin enacarbilMonitor Closely (1)sodium citrate/citric acid decreases levels of gabapentin enacarbil by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.gemifloxacinSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of gemifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.glipizideMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of glipizide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.glyburideMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of glyburide by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.ibandronateMonitor Closely (1)sodium citrate/citric acid decreases levels of ibandronate by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.imidaprilMonitor Closely (1)sodium citrate/citric acid decreases effects of imidapril by unspecified interaction mechanism. Use Caution/Monitor.indinavirSerious - Use Alternative (1)sodium citrate/citric acid will decrease the level or effect of indinavir by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.iron dextran complexMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of iron dextran complex by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.iron sucroseMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of iron sucrose by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.isoniazidMonitor Closely (1)sodium citrate/citric acid decreases levels of isoniazid by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.itraconazoleMonitor Closely (1)sodium citrate/citric acid decreases levels of itraconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.Serious - Use Alternative (1)sodium citrate/citric acid will decrease the level or effect of itraconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.ketoconazoleMonitor Closely (1)sodium citrate/citric acid decreases levels of ketoconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.Serious - Use Alternative (1)sodium citrate/citric acid will decrease the level or effect of ketoconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.labetalolMonitor Closely (1)sodium citrate/citric acid decreases levels of labetalol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.lactuloseMonitor Closely (1)sodium citrate/citric acid decreases effects of lactulose by pharmacodynamic antagonism. Use Caution/Monitor.levofloxacinSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of levofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.levoketoconazoleMonitor Closely (1)sodium citrate/citric acid decreases levels of levoketoconazole by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.Serious - Use Alternative (1)sodium citrate/citric acid will decrease the level or effect of levoketoconazole by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.lisinoprilMonitor Closely (1)sodium citrate/citric acid decreases effects of lisinopril by unspecified interaction mechanism. Use Caution/Monitor.memantineMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of memantine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.mesalamineMinor (1)sodium 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).methscopolamineMonitor Closely (1)sodium citrate/citric acid decreases levels of methscopolamine by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor.metoprololMonitor Closely (1)sodium citrate/citric acid decreases levels of metoprolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.mexiletineMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of mexiletine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.minocyclineSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of minocycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.moexiprilMonitor Closely (1)sodium citrate/citric acid decreases effects of moexipril by unspecified interaction mechanism. Use Caution/Monitor.moxifloxacinSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of moxifloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.mycophenolateMonitor Closely (1)sodium citrate/citric acid will decrease the level or effect of mycophenolate by increasing gastric pH. Applies only to oral form of both agents. Use Caution/Monitor.nadololMonitor Closely (1)sodium citrate/citric acid decreases levels of nadolol by inhibition of GI absorption. Applies only to oral form of both agents. Use Caution/Monitor. Separate by 2 hours.nebivololMonitor Closely (1)sodium 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.nimodipineSerious - Use Alternative (1)sodium citrate/citric acid will increase the level or effect of nimodipine by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.nisoldipineSerious - Use Alternative (1)sodium citrate/citric acid will increase the level or effect of nisoldipine by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.nitrendipineSerious - Use Alternative (1)sodium citrate/citric acid will increase the level or effect of nitrendipine by increasing gastric pH. Applies only to oral form of both agents. Avoid or Use Alternate Drug.nitrofurantoinMonitor Closely (1)sodium 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.ofloxacinSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of ofloxacin by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.omadacyclineMonitor Closely (1)sodium 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.oxytetracyclineSerious - Use Alternative (1)sodium citrate/citric acid decreases levels of oxytetracycline by inhibition of GI absorption. Applies only to oral form of both agents. Avoid or Use Alternate Drug. Separate by 2 hours.pamidronateMonitor Closely (1)sodium 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.penbutololMonitor Closely (1)sodium 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.penicillamineMonitor Closely (1)sodium 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.perindoprilMonitor Closely (1)sodium citrate/citric acid decreases effects of perindopril by unspecified interaction mechanism. Use Caution/Monitor.pindololMonitor Closely (1)sodium 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 ironMonitor Closely (1)sodium 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.posaconazoleMonitor Closely (1)sodium 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.propranololMonitor Closely (1)sodium 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.pseudoephedrineMonitor Closely (1)sodium citrate/citric acid will increase the level or effect of pseudoephedrine by passive renal tubular reabsorption - basic urine. Use Caution/Monitor.quinaprilMonitor Closely (1)sodium citrate/citric acid decreases effects of quinapril by unspecified interaction mechanism. Use Caution/Monitor.quinidineMonitor Closely (1)sodium 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. ramiprilMonitor Closely (1)sodium citrate/citric acid decreases effects of ramipril by unspecified interaction mechanism. Use Caution/Monitor.risedronateMonitor Closely (1)sodium 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 hipsMonitor Closely (1)sodium 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.rosuvastatinMonitor Closely (1)sodium 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.salicylates (non-asa)Minor (1)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).salsalateMinor (1)sodium 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).sarecyclineMonitor Closely (1)sodium citrate/citric acid will decrease the