Disodium hydrogen citrate with glucose, potassium chloride and sodium chloride

How it works

Glucose promotes coupled sodium and water absorption across the intestinal mucosa, while the included sodium, potassium and citrate (a bicarbonate precursor) replace fluid and electrolyte losses and help correct acidosis.

Prescribing in practice

• Reconstitute the preparation only with the recommended volume of water and use it as directed, since incorrect dilution can produce a dangerous electrolyte imbalance; use with care where there is renal impairment.
• It is intended to replace fluid and electrolyte losses, particularly in acute diarrhoea, and the made-up solution should be discarded after the stated time.
• Caution is needed in patients in whom sodium or potassium load is a concern, such as those with renal or cardiac disease.

Monitoring

Assess hydration and clinical status, and check electrolytes and renal function where losses are severe or in patients at risk of imbalance.

Counselling the patient

• Make up the solution with the correct amount of water and do not add sugar or salt.
• Discard any made-up solution that is not used within the recommended time.
• Seek medical advice if diarrhoea is severe or persistent, especially in young children or older people.

Evidence & guidelines

Oral rehydration with glucose-electrolyte solutions is supported by strong evidence and is recommended for managing dehydration from acute diarrhoea.