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Sodium Citrate Anticoagulant Solution

Generic name: trisodium citrate dihydrate
Dosage form: injection, solution

Medically reviewed by Drugs.com. Last updated on Jan 1, 2020.

Indications and Usage for Sodium Citrate Anticoagulant Solution

SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP is intended for use only for the anticoagulation of whole blood as part of automated apheresis procedures. [See Dosage and Administration (2).]

Sodium Citrate Anticoagulant Solution Dosage and Administration

General Dosing Information

SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP is added to tubing sets during apheresis procedures. The solution bag is connected to the tubing set in an apheresis collection. The recommended dose is determined by the apheresis device and metered into the tubing set by the apheresis device. It is not intended for direct intravenous infusion.

For instructions on the use of the solution with the apheresis device and tubing set, see the device operator's manual.

Administration

  • Ensure solution is the SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP and is within the expiration date.
  • Inspect the bag. Do not use if the container is damaged, leaking or if there is any visible sign of deterioration.
  • Use only if solution is clear and free of particulate matter.
  • Protect from sharp objects.

Directions for connecting the SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP bag to the apheresis device.

At the prompt to connect anticoagulant to the apheresis device tubing set:

  1. Remove the overwrap by pulling down at the notch, and remove the SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP bag.
  2. Before use, perform the following checks [see Warnings and Precautions (5)]:
    • Check for leaks by gently squeezing the bag. If leaks are found, discard the bag.
    • Ensure that the solution is the SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP and is within the expiration date.
    • Inspect the solution in good light. Bags showing cloudiness, haze, or particulate matter should not be used.
  3. Remove the protective cap from the port on the bag.
  4. Connect the bag to the apheresis device tubing set using aseptic technique and hang the solution.
  5. Proceed according to the apheresis device operator's manual.

Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever the solution and container permit.

Dosage Forms and Strengths

250 mL SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP is a sterile solution in a polyolefin bag. Each 100 mL contains: Sodium Citrate (dihydrate) 4.0 g; Water for Injection to 100 mL, (pH adjusted with citric acid). Approximate millimoles of Sodium Citrate: 13.8.

Contraindications

DO NOT INFUSE SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP DIRECTLY TO THE DONOR.

Warnings and Precautions

  • Verify that the SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP has been securely attached to the anticoagulant (AC) line on the system tubing set. Use aseptic technique throughout all procedures to ensure donor safety and quality.
  • Single-use container. Do not reuse. Discard any unused or partially used product.
  • Rx only.

Adverse Reactions

Citrate reactions or toxicity may occur with the infusion of blood products to patients and return of blood containing citrate anticoagulant to donors. The recipient of the blood containing citrate should be monitored for the signs and symptoms of citrate toxicity. The signs and symptoms of citrate toxicity begin with paresthesia, a "tingling" sensation around the mouth or in the extremities, followed by severe reactions that are characterized by hypotension and possible cardiac arrhythmia. Citrate toxicity may occur more frequently in patients who are hypothermic, have impaired liver or renal function, or have low calcium levels because of an underlying disease.

USE IN SPECIFIC POPULATIONS

SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP has not been adequately studied in controlled clinical trials with specific populations.

Sodium Citrate Anticoagulant Solution Description

SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP is designed to be metered by an apheresis device in apheresis procedures, to prevent platelet activation and coagulation as blood moves throughout the extracorporeal unit (tubing set) in an apheresis procedure.

The solution is sterile and non-pyrogenic, and it contains no bacteriostatic or antimicrobial agents. Sterilized with steam.

The formulas of the active ingredients are provided in Table 1.

Table 1: Active Ingredients
Ingredients Molecular Formula Molecular Weight
Sodium Citrate Dihydrate C6H9Na3O9 294.10
Water for Injection H2O 18.00

Each 100 mL of SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP contains: Sodium Citrate (dihydrate) 4.0 g; and Water for Injection to 100 mL (pH adjusted with citric acid). Approximate millimoles of sodium citrate: 13.8.

The polyolefin bag is not made with natural rubber latex.

The bag contains materials that have been tested to demonstrate the suitability of the container for storing pharmaceutical solutions. The bag is nontoxic and biologically inert. The bag-solution unit is a closed system and is not dependent upon entry of external air during administration. The bag is overwrapped to provide protection from the physical environment and to provide an additional moisture barrier when necessary.

Sodium Citrate Anticoagulant Solution - Clinical Pharmacology

Mechanism of Action

SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP acts as an extracorporeal anticoagulant by binding the free calcium in the blood. Calcium is a necessary co-factor to several steps in the clotting cascade. The following ingredients are key components of the solution:

  • Citric acid for pH regulation
  • Sodium Citrate anticoagulant

This solution has no pharmacological effect.

How Supplied/Storage and Handling

SODIUM CITRATE 4% W/V ANTICOAGULANT SOLUTION USP is a clear solution supplied in sterile and non-pyrogenic polyolefin bags. The bags are packaged 30 bags per case.

SIZE CATALOG NUMBER NDC NUMBER
250 mL 40883 Bag: 14537-883-00
Case: 14537-883-03

STORAGE

Up to 25 °C.

Protect from freezing.

Issued: December 2019

Manufactured by
Terumo BCT, Inc.
10811 W. Collins Ave.

Lakewood, CO 80215

PRINCIPAL DISPLAY PANEL - 250 mL Bag Carton Label

Sodium Citrate 4% w/v Anticoagulant Solution USP

Catalog # 40883
Polyolefin Bag
30 x 250 mL units

NDC 14537-883-03

Indications for use: For use only for the anticoagulation of whole blood
as part of automated apheresis procedures. See apheresis device
operator's manual for complete instructions. Read the package insert
before application. The solution is sterile and non-pyrogenic, and it
contains no bacteriostatic or antimicrobial agents. Sterilized with Steam.

Caution: Use only if solution is clear. Do not use if the container is
damaged. Single use container. Discard any unused product.
Not for direct intravenous infusion. Rx Only.

Recommended storage: Up to 25 °C. Protect from freezing.

Each 100 mL contains:
Sodium Citrate Dihydrate
4.0 g
Water for Injection to
(pH adjusted with citric acid)
100 mL
Approximate Millimoles:
Sodium Citrate
13.8

Manufactured by Terumo BCT, Inc.
10811 W. Collins Ave., Lakewood CO 80215, USA

TERUMOBCT
0000000783

Lot
Expiry Date

SODIUM CITRATE W/V ANTICOAGULANT
trisodium citrate dihydrate injection, solution
Product Information
Product Type HUMAN PRESCRIPTION DRUG LABEL Item Code (Source) NDC:14537-883
Route of Administration INTRAVENOUS DEA Schedule
Active Ingredient/Active Moiety
Ingredient Name Basis of Strength Strength
TRISODIUM CITRATE DIHYDRATE (ANHYDROUS CITRIC ACID) ANHYDROUS CITRIC ACID 4 g in 100 mL
Inactive Ingredients
Ingredient Name Strength
water
Citric Acid monohydrate
Packaging
# Item Code Package Description
1 NDC:14537-883-03 30 BAG in 1 CARTON
1 NDC:14537-883-00 250 mL in 1 BAG
Marketing Information
Marketing Category Application Number or Monograph Citation Marketing Start Date Marketing End Date
ANDA BA125608 06/26/2018
Labeler - Terumo BCT, Ltd (233649834)
Establishment
Name Address ID/FEI Operations
Terumo BCT, Ltd 233649834 MANUFACTURE(14537-883), ANALYSIS(14537-883), STERILIZE(14537-883), LABEL(14537-883)
Terumo BCT, Ltd

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