Citric Acid Monohydrate is available under the brand names “Alka-Seltzers”, “Alka-Seltzer Fruit Chews”, and “Alka-Seltzer Heartburn Relief”, mainly found in fruits and is classified into a drug class of Tricarboxylic Acids. It is used in pharmaceutical preparations as an excipient because of its antioxidant properties. It maintains the active ingredient preserved from microorganisms and makes it stable. Clinically it is indicated to be used as an acidulant to control the pH. It is also called an anticoagulant, which prevents coagulation by chelating calcium in the blood. It is mainly used in the treatment of acute liver failure. Side effects are often serious and include numbness or tingly feeling, swelling, rapid weight gain, muscle cramps, and twitching, abnormal heart rate, i.e., sometimes fast, and other times slow, confusion, changes in mood, bloody stools, severe stomach pain, diarrhea, and seizures/convulsions. It is mostly taken in the form of a solution through the oral route of drug administration. This pharmaceutical medicine is classified under the safe pregnancy drugs category “C”. It should be only used if the benefits outweigh the potential risks. It is safe to be consumed by lactating women. Citric Acid Monohydrate is contraindicated in patients having the conditions like azotemia, hyperkalemia, myocardial damage, Addison’s disease, acute dehydration, adynamia episode hereditary, anuria, and cramps. It is approved by FDA and stated safe in good manufacturing or feeding practices.

The citrate ion chelates free ionized calcium, making calcium unavailable to the coagulation system, and thus acts as an anticoagulant.

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