Drug reference

Citric acid

Laxative · Bowel Cleansing Agent

Also known as Citric acid anhydrous, Magnesium citrate

LaxativeBowel Cleansing Agent

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

4 major

SEVERE in our sources

PREGNANCY

Use with caution.

FDA category + note

Top interactions

Aluminum HydroxideSevereDatabaseDDInter
BictegravirSevereDatabaseDDInter
DolutegravirSevereDatabaseDDInter
ErdafitinibSevereDatabaseDDInter

Mechanism

Citric acid reacts with magnesium carbonate upon reconstitution to form magnesium citrate. Magnesium citrate is an osmotic laxative that draws water into the intestinal lumen. This increased fluid volume in the bowel distends it and stimulates peristalsis, leading to bowel evacuation.

Indications

Bowel evacuation for surgeryBowel evacuation for colonoscopyBowel evacuation for radiological examinationBowel cleansing before any procedure requiring a clean bowel

Dosing

Adult: 1 sachet, given 8 a.m. the day before the procedure and 1 sachet, given between 2 and 4 p.m. the day before the procedure.
Pediatric: Child 5–9 years: One-third of a sachet to be given at 8 a.m. the day before the procedure and, one-third of a sachet to be given between 2 and 4 p.m. the day before the procedure. Child 10–17 years: 0.5–1 sachet, given at 8 a.m. the day before the procedure and 0.5–1 sachet, given between 2 and 4 p.m.
Renal adjustment: Adults and children: Avoid if eGFR less than 30 mL/minute/1.73 m2—risk of hypermagnesaemia.
Geriatric: Use half the adult dose in frail elderly patients.