Citric Acid & Medication Interaction

Your doctor may prescribe citric acid to help alkalize your urine, alleviate metabolic acidosis or neutralize hydrochloric acid in your stomach. Be sure to tell your doctor about any medications you take before using citric acid because it is contraindicated for some medicines. In some cases, taking the wrong combination of medication raises your risk for death.

Raised Drug Levels

Taking citric acid along with anti-arrhythmic medication such as flecainide and quinidine may increase the levels of these drugs in your blood and raise the risk of side effects, according to the Drugs website. An overdose of flecainide, for example, can cause vomiting, nausea, seizures, irregularities in heartbeat, loss of consciousness and sudden death, according to PubMed Health. Quinidine also can raise your risk for death, notes MedlinePlus. Seek immediate medical attention if you suspect an overdose.

Heart Problems

Combining citric acid with sympathomimetic drugs like ephedrine, adrenaline or isoprenaline can raise your blood levels of such drugs, according to Drugs. The book "Understanding Anesthesia" notes that overdoses of such substances can cause heart arrhythmias including ventricular fibrillation, a severely abnormal arrhythmia that can be deadly. Using citric acid with mecamylamine, a drug used to treat high blood pressure, can also raise levels of this drug in your body. Overdose can cause fainting, anxiety or irregular heartbeat, the Drugs site notes.

Decreased Drug Levels

Citric acid can decrease the levels of some drugs in your body by increasing your excretion of them. This may decrease the therapeutic effects of such drugs. These include the bipolar medication lithium, the diabetes medication chlorpropamide, the antibiotics tetracycline and methenamine, salicylates such as aspirin and the psoriasis medicine methotrexate, according to Drugs.

Aluminum

Do not take aluminum-containing medicines such as aludrox along with citric acid from dietary from sources like orange juice or in prescription form, because it raises your risk for aluminum toxicity, according to the book "Deadly Drug Interactions." Aluminum toxicity may cause muscle weakness, altered mental status, bone pain, anemia, osteoporosis, seizures, dementia and impaired immune function, according to the New York University Langone Medical Center.

Considerations

If your doctor prescribes the combination of acetaminophen, sodium bicarbonate and citric acid to alleviate heartburn or acid indigestion, you raise your risk for side effects of certain drugs. These include blood-thinners like warfarin and acenocoumarol, anti-seizure medicines like carbamazepine and phenytoin, the tuberculosis medication isoniazid, the leukemia medicine dasatinib, antifungals like itraconazole and the HIV drug zidovudine, according to the Mayo Clinic website. Your doctor may change the dosage of such medications if he also prescribes acetaminophen, sodium bicarbonate and citric acid.