Citric acid/glucono-delta-lactone/magnesium carbonate topical Disease Interactions

The use of glucono-delta-lactone is contraindicated in the presence of demonstrable urinary tract extravasation and also should be stopped immediately in the presence of a urinary tract infection (UTI). Glucono-delta-lactone is part of an irrigant (citric acid, glucose-delta-lactone, magnesium carbonate) designed to dissolve struvite renal stones, which contain urea- splitting bacteria. Dissolution of bacteria- containing stones in the presence of a UTI may result in sepsis and death. Urine should be sterile prior to initiating therapy and antibiotics administered throughout the course of dissolution therapy.

Magnesium is eliminated by the kidney. The serum concentration of magnesium is increased in patients with renal impairment. Magnesium toxicity includes CNS depression, muscular paralysis, respiratory depression, hypotension and prolonged cardiac conduction time. Disappearance of the patellar reflex is a useful clinical sign of magnesium intoxication. Therapy with magnesium should be administered cautiously and dosages should be modified in patients with compromised renal function. Clinical monitoring of serum magnesium levels is recommended.